Telepractice Gone Wrong: 3 Scenarios and How to Deal

speech therapy telepractice, what parnts can do to make telepractice successful

Are you an SLP? Do you want to learn more about telepractice? Are you already practicing in this setting, and do you want some tips to build your skills and get started?

If so, this article is for you.

Telepractice Gone Wrong: 3 Scenarios and How to Deal

I will share my three most common telepractice scenarios gone wrong, and what I do about them.

If you don’t know what telepractice is, you may want to check out my last telepractice-focused post.

If you are a parent and are looking for an article to read, you may want to check out my other blog posts, such as: my three favorite toddler toys,  how to begin speech therapy, or my speech clinic tour.

Now, on to my top three scenarios!

Telepractice Gone Wrong: 3 Scenarios and How to Deal

Internet or Platform Connection Issues

Some internet connectivity and platform issues can’t be solved. (Note: a platform is the videochat program, such as Go To Meeting, Facetime, Zoom, or Skype).

There are many issues that come as a surprise, and come in the moment – and are impossible to predict.

Here are some I’ve run into, and some suggestions:

a) The Problem: Platform – a client not knowing how to operate the video/audio

How to Deal:

Depending on the platform used, there’s likely an option to switch video on and off as well as a way to turn off audio (mute). I’ve been asked if I give written directions on operating this to clients, and the answer is no. Why not? Honestly, it’s a visual task. It’s much easier to explain in real time. If you are meeting a client and just can’t figure it out in the moment, give your client a call and work through it together.

b) The Problem: Internet Connectivity

How to Deal:

Have the internet connection discussion before your first session. Let your client know that 4G or low strength wifi won’t support videochat, which requires a lot of bandwidth. If your client can use an ethernet cord to plug directly from a modem to their computer, bonus points (and huzzah!). More likely, know where the modem is if you are on wifi and make sure the signal is strong.


Telepractice can make it more difficult to manage behavior challenges. Some new behavior challenges may even come up as a result of the telepractice service mode.

For example, a client may:

  • videochat using a tablet or phone, and place the device face down so you cannot see each other
  • roll back and forth in an office chair, which is distracting (and hello, motion sickness)
  • choose a dark place in which to videochat, making the process difficult
  • not listen to or follow the activity instructions

All the scenarios above have happened to me, and they do make things difficult.

A few pointers:

  • It helps to prepare by letting your client know (whenever possible) that there needs to be an adult in the room or at least checking in and monitoring. This is especially true for younger children or older children who might not consistently follow directions
  • It’s helpful to outline expectations for students at the start of each session, and again as needed. You can find these expectations on my instagram page or on the graphic below.

Needing to switch the lesson plan but not having plans/materials to do so

SLPs are known for being flexible and going with the flow when a lesson goes awry. In a live, in-person setting, if a session isn’t going according to plan, we can grab other materials pretty quickly and change the plan.

This can be harder with telepractice, especially when you need quick access to digital materials. But with some preparation, this can become second nature. To be honest, this was a big challenge for me when I started. Now, it’s rarely an issue.

Some ideas:

  • overprepare so when this happens, you’ll be able to change activities easily.
  • find a motivating online activity for those days when clients just can’t focus or need something reinforcing. Quia is my go-to in these circumstances. 
Problems and Solutions

With technology, there can always be hiccups and problems to solve.

Also, with technology, there can be opportunities. Opportunities to serve more families. Families with many children or hectic schedules. Rural families without access to an SLP. Families who live in cities with long commutes and really don’t want one more long drive.

If you are interested in telepractice and begin seeing clients in this setting, there will be challenges. For SLPs willing to do their research, overprepare, clearly outline expectations, and problem solve; well, you just might be ready to dip your toes into the waters of telepractice.

If you liked this post and want to hear more on this topic, you may want to read about some easy ways parents help make telepractice sessions run smoothly. If you’d like to hear more about life as an SLP clinic owner and telepractice provider, you can catch up with me on Instagram.