Learning from a distance


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LOYALTON - Upper Dauphin fourth-grader Joey Paul faces the computer screen, sits up straight, and tells his certified speech therapist he wants to work on "s" sounds today.

Miles away in a Pittsburgh office, his therapist, Jenna Olson, prompts Joey to look at the words she's placed on the screen and to make a sentence using one of the words - words like "best" and "vest". In front of Joey, there's a split screen, showing Joey's face on one side, and his therapist's on the other.

A high-definition webcam on the computer allows the two to talk back and forth and see and hear each other in real time.

After the lesson and some more communication interaction, Olson asks Joey if he wants to pick a favorite game, and he chooses a touch-screen version of Tic-Tac-Toe. The game is designed to reinforce language skills Joey's learning, while also allowing him to physically manipulate what's shown on the screen with a touch of his finger.

Telepractice

The session - on a system called VocoVision - is an example of what some local school districts have begun using to help them meet the needs of their students while addressing the lack of available, certified/licensed speech therapists in rural communities.

At Upper Dauphin Area (UDA), the district began using the VocoVision system this May, according to Brandy M. Wiest, UDA Supervisor of Special Education and Student Services. Meanwhile, in neighboring Williams Valley School District in Tower City, the TinyEYE system has been in use since the 2011-12 school year. Both VocoVision and TinyEYE are known as "telepractice" speech service providers, which enable schools to remotely supply qualified, certified speech therapists to their students via a password-protected computer system and webcam (camera) program. Both districts have been using the telepractice as a complement to their on-site therapy services.

"We've been very happy with it," Wiest said. She noted the district has a certified speech therapist on location, Elizabeth Geiger, who serves the elementary, middle and high school facilities. Olson communicates with Geiger, as well as with parents, to form a team approach of service for students.

Improvement

In Joey's case, VocoVision has enabled him to improve.

"Joey continues to make progress through both the therapy he gets in school and the practice he does at home. He is much more comfortable with speaking in public than he had been when he was younger due to his confidence building," his father said.

Joey, 9, of Lykens, is the son of John and Sue Paul. He was diagnosed with the speech disorder, apraxia, several years ago and has had speech therapy in the school setting and during this past summer. Both of his parents are educators. John is a special education teacher at Williams Valley and Sue is a Learning Support Teacher at Tri-Valley.

Scheduling

In addition to Joey, there are well over 70 Upper Dauphin students, district-wide, who receive some type of speech therapy, according to Wiest.

About 3/4ths of the UDA speech students are at the elementary level, she said. There is an effort made so that each student does not miss something in a core subject area to attend the VocoVision sessions. As an example, an elementary pupil may have speech therapy at the end of a spelling class, but before math class starts, or during an announcement period at the start of the day, so they're never missing the same thing each week. Most sessions last a half-hour. At the high school level, it's a bit easier to schedule, since students there have study halls, or more elective choices during their school day, Wiest said.

Upper Dauphin also contracts through the Capital Area Intermediate Unit (CAIU) for Response To Instruction and Intervention (RTII) services. Through RTII, the district can determine if a student is showing a speech or language problem, due to a lack of exposure, or due to a true deficit. Those with an impairment can be identified and a course of treatment can be initiated. Since using RTII, Wiest said, the district has seen less recommendations for pupils needing speech therapy.

Void

Upper Dauphin Superintendent Paul Caputo said, from a budgetary perspective, using VocoVision is very cost effective. The district has contracted with the company to provide 800 hours of service between March 2012 and the end of the 2013-2014 school year. The total cost of the contract over this time will be approximately $67,000, Caputo said.

The service makes available Pennsylvania licensed/certified bilingual and monolingual speech therapists.

"We have the ability to interview VocoVision speech therapists and to choose the individual who is the best match for our students," said Caputo. "They have proven to be a valuable member of our team."

According to Caputo, the number of speech pathology programs in Pennsylvania is limited.

"Small, rural schools have a difficult time recruiting the small pool of certified therapists because they are not able to match the salaries offered by larger, urban schools as well as by hospitals and health-care agencies which provide this service," he said.

Williams Valley Superintendent Dr. Donald Burkhardt agreed.

He said the lack of available personnel and the state certification program has made it "very difficult" for districts to obtain certified speech therapists.

"They get snatched up by private vendors," Burkhardt said, noting Williams Valley began using the TinyEye program last year and did manage to hire its own speech and language therapist. Prior to that, speech therapy for Williams Valley students was provided through the Schuylkill Intermediate Unit (IU-29).

Brian Lacey, Williams Valley Special Education Supervisor, said school districts in rural Pennsylvania were finding that they weren't getting any applicants applying for certified speech therapist vacancies. Many contract companies started springing up, encouraging districts to hire them instead, meaning a district would pay the therapist's salary, their benefits, as well as a specific fee to the company, Lacey said. Costs could become exorbitant.

"We were in the hunt this year for a speech clinician," Lacey said.

Williams Valley was fortunate enough to hire an in-house speech and language pathologist, Megan Main, and the district's speech therapy program has evolved, according to Lacey. During the 2011-12 school year, TinyEYE was implemented at Williams Valley.

TinyEYE

Initially, students worked solely with Main, then eventually began adding sessions with TinyEYE. The district found that using both an in-house pathologist, along with the telepractice, like TinyEYE, worked effectively for its students.

According to Lacey, TinyEYE allows the district to pay on an as-needed basis as a per-hour fee, based on how frequently the program is used. This has an advantage, unlike a contracted agency, where the district has to be locked-in for a contract year. Currently, Williams Valley pays about $60 per hour for the TinyEYE service, Lacey said.

About 125 Williams Valley students currently receive some form of speech therapy via the district's full-time, in-house speech and language pathologist and two TinyEYE clinicians, according to Lacey.

"The beauty of it is that we got to watch the program unfold," he said. "The (TinyEYE) therapist is visible to the student. The therapist can manipulate games or objects to work on an individual's speech goals. We've seen a number of kids exit out of the program within a year," said Lacey.

Success

According to Lacey, while the TinyEYE program assists students having needs in a range of areas such as articulation, language skills, and categorizing idioms, the district's in-house therapist handles more involved student therapy.

Parents have shown a positive reaction to TinyEYE, he said, although there was some hesitancy in the beginning. The TinyEYE therapist is able to check when the kids are logging in to do their work and TinyEYE offers a free "virtual backpack" program. With the "backpack", interactive practice sessions with games, messages and videos are available to students, so they can practice their communication skills relevant to their goals with a computer at home.

Individual needs

The Pauls believe each student's individual needs need to be examined by their IEP (Individualized Education Program) team before a decision is made on how to present any type of therapy to them.

"This particular option works well for Joey," John Paul said. "I would never recommend that this is the only type of speech option that should be made available in a school district, simply because what works for one student may not work for another. I feels one of the reasons that Joey has been so successful with the program is due to his therapist, Jenna. She has been very good in working with Joey, us and Upper Dauphin. She maintains constant communication with us as parents, offering suggestions and homework that Joey can practice when not at school. As with any services that any student receives, the progress that a student makes relies in part on the involvement and cooperation between both the school and the home."

"I was familiar with this type of program since we have a similar offering here at Williams Valley. When the offer was made to try this similar therapy at UDA, I had an idea what Joey was going to be doing. Both Sue and I decided we would try it. We were glad we did, so much so that when it came time for school to start, we asked if it could continue to be incorporated into his speech therapy during the school year. Mrs. Wiest was very good about doing some leg work for us and incorporating it into Joey's schedule."

"This program works for Joey. It is not the cure all for every student who needs speech, simply because each student has their own individual needs. For some, that might be the use of the VocoVision exclusively, for others it might be the use of a one-on-one with a 'real' speech therapist, for others it might be a combination," John Paul said.

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