What SEL Looks Like in Our Schools

Today, many of our schools utilize evidence-based programs that focus on teaching specific competencies. These programs, which are often integrated into morning meetings, counseling sessions, or even academic subjects, focus on five core areas. These are defined by the Collaborative for Academic, Social, and Emotional Learning (CASEL):

1. Self-Awareness: Identifying one’s own emotions, thoughts, and values.
2. Self-Management: Regulating one’s emotions, thoughts, and behaviors effectively in different situations (e.g., managing stress, self-motivation).
3. Social Awareness: Taking the perspective of and empathizing with others.
4. Relationship Skills: Establishing and maintaining healthy and rewarding relationships (e.g., communicating clearly, resolving conflict).
5. Responsible Decision-Making: Making constructive choices about behavior and social interactions.

These structured programs are essential for teaching children the explicit skills they need to navigate school and peer relationships. They are designed to support all students and provide critical intervention for those who are struggling.

But here is the truth that often goes unsaid: This is often an intervention that starts years too late.

We need to stop asking schools to re-wire behavior that was already cemented in the foundational years. The most powerful SEL curriculum a child will ever receive isn’t in a classroom; it’s in the co-regulation of their home environment.

The Myth of Self-Soothing: Why Child Emotional Regulation Starts with the Parent 🧠

For decades, many parents were encouraged to “let babies self-soothe.” We now know this concept is a biological impossibility for a young child.

A baby’s pre-frontal cortex—the part of the brain responsible for self-control and emotional management—is highly immature. They are born requiring an external regulator to help them manage stress. That external regulator is you.

This scientific concept is called co-regulation. When your child is distressed, they are sending out a nervous system alarm. If you respond from a place of calm, your regulated state literally helps sync their nervous system back to a quiet, safe baseline. You are teaching their brain, through repeated experience, how to calm down.

When we react to a child’s meltdown with our own uncontrolled frustration or anger (i.e., parental dysregulation), we are not teaching regulation. Instead, we are modeling and transmitting escalation. Research consistently links high parental stress and non-adaptive emotion regulation with higher rates of social, behavioral, and mental health issues in youth.

The Prenatal SEL Curriculum: It Starts with the Parent 🧘

If co-regulation is the lesson, then the prerequisite must be the parent’s own self-regulation for child SEL. This is why our focus needs to shift, starting before a child is even born:

💡 Parental Self-Awareness: Identifying the Real Emotion

Before we teach a child to recognize their “big feelings,” we need to teach parents to recognize theirs. This means identifying internal stress cues—the tight jaw, the hot chest, the impulse to yell—before they erupt into a reaction. Crucially, this training must help parents understand that anger is very often a symptom of suppressing another, more vulnerable emotion, such as fear, overwhelm, inadequacy, or grief. If a parent can recognize that their rising anger is actually a mask for deep anxiety about being a “good parent,” they can address the true need instead of reacting punitively.

🎯 The Circle of Control

Prenatal and early-parenting training needs to equip adults with strategies like understanding what they can and cannot control. You can control your response and your effort. However, you cannot control the duration of a tantrum or a baby’s need to cry. Reducing this anxiety is foundational self-care.

⚓ The Calming Anchor

Every parent needs a rapid, go-to self-regulation strategy, like Square Breathing or a quick grounding exercise. This allows a parent to down-regulate their own system in seconds. Thus, they can approach their child with calm instead of conflict.

🚶 When to Walk Away: The Ultimate Self-Regulation Skill

All of these skills culminate in the powerful knowledge of when walking away is the kindest, safest response. If you cannot find your calming anchor, the most responsible action is to temporarily exit the situation. This means placing your child in a safe space (like a crib or playpen) and giving yourself a few moments, or even a minute, to calm down completely—even mommies need time-outs!

Taking a break is firmly identified as responsible, proactive parenting—not neglect or “giving up.” Walking away when you are dysregulated prevents you from passing on that distress or reacting in a way you will regret. By doing this, you model the highest level of self-control for your child.

We must recognize that a parent who is emotionally supported and regulated is the most effective preventative measure against future maladaptive behavior. The early investment in parental self-regulation for child SEL is far more cost-effective than the long-term societal cost of special education, behavioral intervention, and juvenile justice.

📢 An Urgent Call to Action: Advocate for prenatal SEL

We are asking parents to teach a skill they were often never taught. This is not about blame; it is about providing the missing instruction manual. Parental self-regulation is the prerequisite for child SEL.

I am asking you, my fellow SLPs, educators, and concerned parents, to use your voice to advocate for this foundational shift.

The Ask: Contact your State Representatives and State Department of Health officials to urge them to mandate and fund the inclusion of an evidence-based Parental Self-Regulation and Co-Regulation Module as a standard component of all state-funded prenatal and early postnatal care programs.

We are not asking for a new program; we are asking for essential SEL skills to be taught at the right time, to the right person.

Here is a template email you can adapt and send to your elected officials today. Let’s make parental self-regulation a public health imperative.

Subject: Urgent: Fund Foundational Parental Self-Regulation Training for Child Health & Preventative Care

Dear [Representative/Senator/Official Name, or State Department of Health Leadership],

I am writing to you today as [Your Title/Profession: e.g., a School-Based Speech-Language Pathologist and concerned resident of District X]. My work with children in schools across [Your County/Region] consistently reveals that the most effective interventions for social, emotional, and behavioral challenges begin not in the classroom, but with the parent.

The Foundational Challenge: Current efforts in school-based Social-Emotional Learning (SEL) are essential but often start too late. The true foundation for a child’s ability to self-regulate is built through co-regulation—the consistent, calm response of a regulated adult. When parents lack the skills to manage their own stress and emotional triggers, they are inadvertently modeling and transmitting dysregulation to their children, leading to long-term issues.

The Preventative Solution: I urge you to mandate and fund the inclusion of an evidence-based Parental Self-Regulation and Co-Regulation Module as a standard, reimbursable component of all state-funded prenatal and early postnatal care programs.

This funding is not for generic parenting classes. It is an investment in specific, psychoeducational training that teaches parents:

1. Self-Awareness: How to recognize their own internal stress cues (e.g., anxiety, overwhelm) before they escalate into frustration or anger.
2. Calming Anchors: Rapid self-regulation techniques (like deep breathing or grounding) to stabilize their nervous system under pressure.
3. Proactive Parenting: The necessary skill of safely walking away to self-calm when feeling dysregulated, which models the highest level of emotional control for the child.

Cost-Effectiveness: Investing in parental self-regulation is the most powerful preventative measure available. Research consistently shows that early family interventions are dramatically more cost-effective than later remediation efforts (such as special education services, extensive behavioral interventions, or juvenile justice system involvement).

I ask that you prioritize this foundational SEL training. By supporting the mental and emotional health of parents, we are proactively building resilient children and stronger communities.

Thank you for your time and commitment to the health of our state’s families.

Sincerely,

[Your Name] [Your City/Town] [Your Contact Email or Phone Number]

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The post 🛑 The Foundation is Missing: Why Parental Self-Regulation for child SEL is the Most Crucial Skill appeared first on Mrs. Speech Online.

Less is More: Spacing Out Data Points

Data collection shouldn’t dominate every therapy session. Think of it as a progress report, not a live feed. Leave room for teaching and practicing new skills before measuring performance.

Consistency is Key: Setting the Stage for Meaningful Data

Data only tells a story if it’s collected under similar circumstances. Here’s how to ensure your data paints an accurate picture:

• Baseline Before Takeoff: Always collect data at the beginning of a session, before any specific training takes place. This establishes a baseline of the student’s current skills.
• Data Probes: Your Unsung Heroes: Develop consistent data probes for each goal. These probes should directly assess the specific skill you’re working on and be age-appropriate for the student.

Crafting Powerful Probes: What to Consider

Here are some key elements to consider when developing effective data probes:

• Target the Goal: Ensure your probe directly assesses the specific skill you’re working on
  increasing. Don’t phrase it in terms of decreasing a deficit.
  • For example, instead of saying “Decrease the phonological process of stopping,” a more positive phrasing would be “Increase the student’s ability to produce fricatives.”  I’ve gotten some worried phone calls from parents who see the graph rapidly decreasing!!
• Age Appropriateness: Consider the student’s age and developmental level. A picture card probe might be appropriate for younger children working on articulation of /b/. In contrast, older students practicing narrative skills might handle a written story prompt better.
• Multiple Forms: If possible, develop probes in multiple formats (pictures, written words, real-life scenarios). This approach assesses a skill from different angles and reduces the chance of memorization affecting results. For example, a student working on vocabulary might be shown a picture of a banana and asked to name it. Then later describe it using simple adjectives in a sentence.
• Error Analysis: Design probes that allow you to analyze the types of errors a student makes. This can provide valuable insights into their specific challenges and areas for intervention. For instance, a probe assessing a student’s ability to follow two-step directions might involve asking them to “Touch your elbow and then hop on one foot.” Observing if they complete both steps in the correct order or struggle with a specific part helps tailor future therapy sessions.

Examples of Goal-Probe Partnerships:

Let’s see how these principles translate into practice:

• Goal: Improve articulation of the /p/ sound in single words.
• Probe: A list of 10 words containing the /p/ sound at the beginning (e.g., “pan,” “pig”), middle (e.g., “apple,” “happy”), and end (e.g., “cup,” “hop”) of words. Note the number of correct productions and any specific errors made (e.g., substitutions, omissions).

• Goal: Increase expressive language skills by using synonyms in sentences.
• Probe: Provide the student with a sentence with a blank space (e.g., “The dog is very _____ today”). Offer a list of synonyms for the missing word (e.g., happy, joyful, excited) and see if they can choose and use the appropriate synonym in the sentence.

Embrace the Nuance: Moving Beyond Pass/Fail

Data shouldn’t be a simple yes or no. When possible, use rubrics or detailed observations to capture the nuances of a student’s progress. This provides a richer picture of their strengths and areas for development. For example, instead of just marking articulation attempts as correct or incorrect, note if the sound was produced accurately for the first time, required multiple tries, or needed specific prompting.

Feeling overwhelmed by creating rubrics? Don’t worry! In our next blog post, we’ll delve into the world of rubrics, providing step-by-step instructions and helpful examples to make crafting these powerful tools a breeze: Mastering the Art of Measurement: A Guide to Creating Rubrics in Speech Therapy (with Bonus Example!).

Let’s Chat!

Have questions or success stories about data collection in speech therapy? Share them in the comments below!

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The post Making Data Meaningful in Speech Therapy: How Often, When & Why appeared first on Mrs. Speech Online.

Teleconferencing has become a significant part of many educators’ and therapists’ lives. While it presents unique challenges, it also offers incredible flexibility. Here are some essential teleconferencing tips and tricks I’ve learned during my time providing full-time teletherapy services to school-aged children:

Invest in a Second Monitor (A Big One!)

This is a game-changer! I use my laptop screen for the Zoom window, one side of the TV for displaying therapy materials (flashcards, videos, etc.), and the other side for my therapy portal (to track student goals and document sessions). I often have two windows that I screenshare, if I have a visual aid for the activity or am giving students choices between activities.  This also means you can keep your icons to a minimum on your tv desktop.

Read my post on Unlocking Language with Youtube for Youtube specific tips, such as Youtube settings and some invaluable playlists.  I also have a post Youtube in Therapy for Older Students.

You might need to adjust the TV height to prevent your laptop screen from blocking the view. Experiment with resolutions to find a comfortable balance between readability and screen real estate.

Prioritize Audio Quality

Invest in a good quality headset with a microphone. While your laptop’s built-in microphone and speakers may suffice, higher-quality audio is crucial, especially for working on articulation skills with young children. Encourage students to use headphones with microphones as well, which can help minimize distractions and keep them engaged.

Bonus remote meeting advice: Noise reduction features are often enabled by default in conferencing apps and computer settings. However, these algorithms can inadvertently cut off crucial sounds, such as the beginnings and ends of words, particularly fricatives like /s/. This can be incredibly frustrating when working on specific speech sounds. Ensure noise reduction is disabled on both your device and the student’s device.

Embrace Ad Blockers

Online resources like YouTube are invaluable for therapy activities, but those pesky ads can be disruptive. I highly recommend using an ad blocker. 

I personally use the free browser “Brave,” which effectively eliminates most ads, including those that appear within videos. It leaves a small white space where the ad would have been. As a bonus, using a dedicated browser for therapy helps keep your bookmarks organized and streamlined.

Turn Your Phone into a Document Camera

Many of us have accumulated a wealth of physical therapy materials over the years. Instead of letting them gather dust or (illegally) scanning them, repurpose them with a document camera. While there are some relatively inexpensive options out there, you can use your phone or another device to capture images or videos of your materials. (This is a great use for those older, unused devices, just connect them to your wireless connection). 

There are numerous online tutorials available to guide you through the setup process, although most are from the COVID epidemic so the technology may have changed somewhat.  I found this one particularly helpful. This is especially beneficial for teaching students using Augmentative and Alternative Communication (AAC) systems.  You might even consider asking for the same setup on the other side, especially if you are testing!

Background Leverage

Don’t just settle for a boring background! Get creative and use it as a teaching tool. You could use an underwater scene for a unit on ocean life, a construction scene for construction vocabulary.  Maybe you post a timeline for the session, or another visual aid.  

FYI – if you have your video mirrored (most of us do), it will appear backwards in your video view, but the right way on your students’ view.

I incorporate a “Pun of the Day” with a themed visual background to encourage flexible language use and explore multiple meanings of words, not to mention starting therapy off with a smile!  *whisper* I have a 56 pages of puns (21 pages of holiday-themed) in my TPT store – It’s So Punny!

Maximize Your Mouse Pointer

Enlarging your mouse pointer makes it easier to locate on the larger screen and improves its effectiveness for pointing out items to students.

Master Video Conferencing Tools

Explore and utilize the built-in tools within your chosen conferencing platform (Zoom, Google Meet, etc.). The whiteboard function is excellent for quick demonstrations and brainstorming, and many students prefer drawing on it to playing online games. The annotation feature allows you to draw or type directly onto any screen-shared content.

Lighting

You want good lighting so students can see your face well.  The room I use as my office is rather dark.  I’ve tried ring lights, and lamps, but they produce strong shadows unless they are low enough that I can’t really tell a difference in my camera, and even then they are rather blinding.  I’ve even tried facing them away from me, toward the wall behind the big screen.  The best solution I’ve found is dispersed light with multiple sources, pointing up or toward a wall, and thoroughly checking the video settings in both my computer and Zoom.  I’ll update with any other options!

Understand Your Students’ Setups

Before the initial therapy session, have a brief conversation with the student or their caregiver to understand their technology setup.

• Device: Are they using a laptop, tablet, or *shudder* a phone? The size of your share screen will differ according to the size of their device, so consider adjusting your materials accordingly.
• Input Methods: Do they have touch screen, trackpad, or mouse control? How comfortable are they with their chosen input method?
• Conferencing App Configuration: How is the conferencing app configured (e.g., speaker view, gallery view)? Will you be sharing your screen during the session?
• Environment: Are they in a shared space, and if so, what steps can be taken to minimize distractions (e.g., headphones, quiet corner, clear communication with other household members)?
• Internet Connectivity: Briefly inquire about their internet connection to anticipate potential connectivity issues. For example, if they have a slower connection, you may want to consider activities with a lower bandwidth demand, such as games or activities that don’t rely heavily on video.

Student Support System

• Adult Supervision: For safety reasons, it’s crucial to ensure that an adult is always present and supervising the child during teleconferencing sessions.
• Behavior Support: Do they have any behavior support available during sessions (e.g., a parent, teacher, or paraprofessional)?
• Technical Support: Do they have access to any technical support (e.g., a parent, teacher, or school IT support) if they encounter difficulties?

By gathering this information beforehand, you can proactively address potential challenges and ensure a smoother and more effective teletherapy session for both you and your student.

Consider sharing control

Kids are way more into therapy when they feel like they have some control. Sharing your screen can be a game-changer! Let them explore interactive websites, pick their own activities, or even guide the presentation. It makes things more fun and helps them feel like they’re in charge (in a good way!).

Keep in mind that when a student has control of the mouse, it prevents you from using it for other things like entering therapy notes or navigating to other resources.  Having them play a game while you enter notes sounds like a great idea, but I haven’t found a way to split control.

Sometimes you might need to gently remind them to let you take back the mouse, but usually, it’s worth it for the extra engagement and motivation.

Key Telework Pointers: Health & Wellness

Teletherapy can present unique ergonomic challenges. Since you’re likely sitting in front of your computer for extended periods, prioritizing your health and wellness is crucial.

Ergonomics: 

• Chair and Desk Height: Ensure your chair and desk are at the correct height to maintain proper posture. Your feet should be flat on the floor, and your forearms should be parallel to the ground when typing.  You might find a footrest useful.
• Mouse and Keyboard Positioning: Position your keyboard and mouse close to your body to minimize reaching and maintain a neutral wrist position. Consider using a wrist rest for added support.
• Camera Positioning: Position your camera at eye level to maintain natural eye contact with your students.  Keep your conference video at eye level to increase eye contact.

Minimize Eye Strain:

• Blue Light Filter: Use a blue light filter on your computer screen to reduce eye strain. This can be done through your computer’s display settings or by using a dedicated software application. (I also prefer Dark Mode.)
• 20-20-20 Rule: Follow the 20-20-20 rule: Every 20 minutes, look at something 20 feet away for 20 seconds.

Incorporate Movement: 

Schedule regular movement breaks throughout your workday. Stand up, stretch, walk around, or do some simple exercises.

Stay Hydrated: 

Keep a water bottle nearby and sip water throughout the day to stay hydrated.

Set Boundaries:  

Establish clear boundaries between work and personal time.  When you’re not working, disconnect from technology and engage in activities that you enjoy.

By prioritizing your own health and wellness, you’ll be better equipped to provide high-quality teletherapy services to your students and avoid burnout.

Collaborate and Share

Teletherapy presents unique challenges, but it also offers opportunities for collaboration and shared learning. Connect with other educators and therapists online to exchange tips, share resources, and support one another.

By incorporating these indispensable video conferencing strategies into your teletherapy practice, you can create engaging and effective learning experiences for your students, even from a distance.

I’d love to hear about your own teletherapy tips and tricks! Please share your insights in the comments below.

If you found these tips helpful, you might be interested in my comprehensive 140+ page guide, “So You Want to Be a Teletherapist.” It covers all these topics and more, including setting up your workspace, navigating legal documents like BAAs, and building a secure and efficient digital practice from the ground up!

Happy conferencing!

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The post Essential Teleconferencing Tips for SLPs and Teachers appeared first on Mrs. Speech Online.

I’d love to hear from you: What kind of resources do you find would most benefit your students who stutter in developing a better understanding of their speech? Share your thoughts in the comments below!

The Missing Piece: Understanding their own stuttering

Think about it – we spend so much time, and rightfully so, teaching strategies to help ease those bumpy moments in their speech. But how often do we really dig into the “why” behind it all? While doing this, we focus on empowering kids by helping them understand their speech patterns.

I’ve seen so many amazing kids who’ve been in therapy since they were tiny, faithfully practicing their smooth speech techniques with each new SLP who comes along. And yet, when you talk to them, their big questions are often still: “How do I fix this?” and “When can I graduate from speech?” It’s almost like we’re giving them tools without a clear understanding of the landscape they’re navigating.

Beyond “Fixing” the Stutter

Imagine someone with essential tremors just trying to hold still, without knowing it’s a neurological thing. Or someone with nystagmus (involuntary, rhythmic eye movements), where the eyes move in ways they can’t control. It’s kind of the same with stuttering. Knowing this can enable children who stutter by giving them more awareness about their condition.

It’s also important to acknowledge that for young children, early intervention and the teaching of fluency strategies can indeed be highly effective in reducing or even eliminating stuttering. The earlier support is provided, the more neuroplasticity can be leveraged.

However, the longer stuttering persists, the more ingrained it can become, often making complete elimination less likely and the focus of therapy shifting towards management, acceptance, and effective communication. Empowerment lies in knowing how to manage one’s stutter, especially for persistent cases.

Furthermore, the longer a child stutters, the more likely they are to develop negative emotional responses to their disfluency, such as anxiety, frustration, avoidance behaviors, and even shame. These emotional layers can then further complicate their communication experiences, making empowerment a crucial step in therapy.

The Exhaustion of “Smooth Speech” Strategies

For those who haven’t experienced it, try this: for the next half hour, consciously try to use all the fluency strategies we often teach. Go incredibly slowly. Start every consonant with a super soft onset. Pay meticulous attention to every single time your speech isn’t perfectly smooth, every little stumble or word you don’t quite say “right.” Imagine how empowering it can be for kids who stutter to know they’re not alone in this struggle.

It’s exhausting, isn’t it? And for many of our older students who stutter, this isn’t a temporary exercise; it’s their daily reality when they try to mask their natural way of speaking. After years of practicing these strategies, the persistent question echoes: “Why am I still stuttering? Why hasn’t therapy ‘fixed’ it?” Empowering kids who stutter means helping them shift from just managing symptoms to embracing their unique voice.

Empowering Students Who Stutter

That’s why I’m so passionate about education. Kids deserve to know what affects their stuttering – is it stress? excitement? certain words? What’s the deal with incidence rates? (Spoiler alert: it’s more common than many think!). Giving them this knowledge empowers them. It shifts the focus from “fixing” something that isn’t “broken” to understanding and accepting a part of themselves.

This is a big part of why I created “It’s Just the Way I Talk: Facts About Stuttering for Ages 5-8” (reaching #40 in Children’s Books on Physical Disabilities on Amazon!). It’s a gentle way to introduce these concepts to younger kids, empowering them from a young age.

Practical Resources to Foster Self-Advocacy in Kids Who Stutter

And for my fellow educators and therapists working with older students, keep an eye out! I’m diving into the brain research behind stuttering in an upcoming book aimed at those mid to upper grades – because they deserve those deeper answers that empower their understanding of stuttering.

In the meantime, I’ve also put together a resource on Teachers Pay Teachers called “Affirming Stuttering Activities”. It’s packed with activities designed to help students who stutter explore and discuss their experiences, thoughts, and feelings related to their speech. It’s really great for giving voice to kids who stutter.

One tool I’ve found helpful in shifting this perspective is a simple “Speech Self-Rating Scale”. Instead of just focusing on how many stutters they had, students can rate their overall ease of speaking, the tension they felt, how effectively they communicated their message, and their satisfaction with the interaction. This helps them recognize that communication is about more than just fluency.

Subscribe for a FREE 10-question Daily Check-In Form!

Let’s move beyond just the “tricks” and empower our students with knowledge and self-acceptance. Because communication comes in all forms, and every voice deserves to be heard and valued, just the way it is. When we do this, we’re truly empowering kids who stutter to see their voice as valuable and unique.

What comes after the strategies? In my next post, I’ll be exploring the importance of stutter affirming, student-centered goals in stuttering therapy. Don’t miss it!

Talk soon,

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The post Empowering Kids Who Stutter: Practical Tips & Resources appeared first on Mrs. Speech Online.

Hey SLP fam!

Let’s talk about HIPAA compliance at home. I know it’s something that might make your brain do a little loop-de-loop! Whether you’re rocking the teletherapy life from your home office, hustling in a school building, or bringing a stack of papers (or digital files!) home to tackle after hours, you’re dealing with sensitive information.

I remember grad school, taking out the black Sharpie to strike through names and addresses on stacks of papers. It’s what we did, back in the day, to share ideas about goals and treatment plans without breaking client confidentiality. Even with extensive redactions like those seen here, simply blacking out information may not be enough to meet HIPAA’s stringent de-identification requirements. And in the digital age… well, let me share with you.

My HIPAA Compliance wake-up call:

I recently had a bit of an “aha!” moment (or maybe more of an “uh-oh!” moment) for HIPAA compliance at home. I don’t even remember how I found out, but I realized my free Google account wasn’t exactly HIPAA-compliant for handling student info. And that got me thinking… if I was a bit fuzzy on this, how many of us are? Especially when we step outside the secure walls of our schools or clinics?

It turns out, even when you’re comfy in your PJs or working from your kitchen table after school, you’re still 100% responsible for protecting your clients’ Protected Health Information (PHI), even from your family members (who could probably care less). HIPAA doesn’t care if you’re in a fancy clinic, a bustling school, or your spare bedroom – the rules are the same for how you handle that information.

To help you navigate this essential topic, I’ve even created a free worksheet to guide you in developing your own HIPAA policies and procedures for your home-based work environment!  Let’s break down some key areas, with a special spotlight on those cloud services many of us use daily.

HIPAA Compliance In The Cloud: Google, Microsoft 365, and the BAA

This is where it gets real. Many of us use Google Workspace (Gmail, Docs, Drive) or Microsoft 365 (Outlook, Word, OneDrive) for our personal lives, and our schools or districts often use them too. They’re super convenient, right?

But here’s the kicker: your personal Google or Microsoft account is NOT HIPAA compliant for handling PHI. Full stop.

Why? HIPAA compliance when dealing with PHI requires a Business Associate Agreement (BAA) with third parties (like Google). A BAA is a legally binding contract that outlines how a third-party service provider will protect PHI on your behalf. Without one, you’re on shaky ground.

Districts Using Cloud Services: A Critical Distinction

So, what about districts using Google Workspace or Microsoft 365? 

This is a critical point. While most paid educational plans (often covered by FERPA – the Family Educational Rights and Privacy Act, which governs educational records) offer robust privacy, FERPA compliance doesn’t automatically mean HIPAA compliance for you. 

PHI in a school setting often includes health diagnoses, medical history, or therapy notes related to health conditions. While these are typically considered education records under FERPA, as an SLP, if you bill Medicaid or other health plans, you are a HIPAA Covered Entity. This means the specific health information you handle is subject to HIPAA regulations, even within a FERPA-governed school environment.

For a district’s Google Workspace or Microsoft 365 environment to be HIPAA compliant for PHI, they need to have specifically configured their accounts for HIPAA. Crucially, they need a signed BAA with Google or Microsoft for that specific enterprise-level service.

Your HIPAA Compliance at Home Takeaway:

Don’t assume. If you’re using a district’s cloud services for anything that involves PHI (even if it’s just student names and health-related goals within an IEP), it’s your responsibility to confirm that the district has a BAA in place with their cloud provider for that specific service. 

And critically, confirm that the specific features and services you use are explicitly covered by that BAA. If they are not, or if no BAA is in place, you need to adjust your practices.  This might mean only using district-approved, HIPAA-compliant EHRs,  purchasing your own subscription, or secure local storage, such as the free LibreOffice Suite (See Technical Safeguards below).

Fortunately, I’d been super cautious and hadn’t used my personal accounts frequently for student information, but it was a good wake-up call!

Beyond the Cloud: Other Key Considerations for HIPAA Happiness

While cloud services are a big piece of the puzzle, let’s not forget the other vital aspects of keeping PHI safe, whether you’re working at school or from home.

Core Pillars for HIPAA Compliance at Home

Risk Analysis (aka “Playing Detective with Your Practice”)

Before you even start working remotely or bringing files home, take a good look at your home setup. Where are the potential weak spots? Is your home Wi-Fi secure? Are your personal devices encrypted? Could your nosy family member or roommate accidentally see your screen? Identify these risks and make a plan to fix them. Document everything!

Workforce Training (Yes, You’re the Workforce!)

Even if it’s just you, train yourself! Stay up-to-date on HIPAA and your own policies. And guess what? Document that training too!

Policies and Procedures (Your Personal HIPAA Rulebook)

You’re the boss of your home workspace, so write down your rules! How do you handle PHI on your personal devices? Where do you store it? What’s your plan if something goes wrong (a “breach”)? Having these written policies keeps you consistent and gives you a roadmap in a pinch. You should also be intimately familiar with your employer’s HIPAA policies, if applicable.

Business Associate Agreements (BAAs)

We talked about this with cloud services, but it applies to almost any third-party service you independently contract that touches PHI. Your teletherapy platform (if you use one), your EHR, your billing service, even encrypted email services – they all need a BAA. Beware of “free” or even personal versions of platforms; they usually do NOT offer BAAs.

Incident Response Plan (Your “Oh Crap” Protocol)

What if your personal laptop gets stolen? What if you accidentally email PHI to the wrong person? Have a clear plan for what to do: contain the issue, investigate, notify affected individuals (and potentially HHS), and prevent it from happening again. Your district should also have a plan; know it!

Physical & Technical Considerations for HIPAA Compliance At Home

Physical Safeguards (Lock it Up!)

• Ensure your home workspace is private.
• Close the door and position your screen away from prying eyes.
• Lock up any physical paper records containing PHI.
• Shred unneeded documents securely when done.
• Never leave PHI visible or accessible to others in your home.

Technical Safeguards (Your Digital Fort Knox)

• Encrypt EVERYTHING: All devices (laptops, desktops, external drives, mobile devices) storing or accessing PHI must be encrypted. This is crucial if a device is lost or stolen.
• Strong Passwords & MFA: Use complex, unique passwords. Enable multi-factor authentication (MFA) everywhere possible for accounts with PHI.
• Antivirus/Firewall: Keep your software updated and firewalls active.
• Secure Network: Use a strong, secure home Wi-Fi connection. NEVER handle PHI on public Wi-Fi. If connecting to your school’s network from home, always use their provided VPN if available.
• HIPAA-Compliant Platforms: For teletherapy, use platforms specifically designed for HIPAA compliance, with end-to-end encryption and a BAA.
• Secure Communication: Stick to secure messaging within your EHR/school system or encrypted email for PHI. Avoid regular email, WhatsApp, or FaceTime for anything confidential.

A Crucial Note on “De-identification” and AI Tools

Here’s a big one that’s becoming more relevant with the rise of AI…

**Simply removing a client’s or student’s name or a few obvious identifiers does NOT make the information safe to use.**

General-purpose, free AI tools like Gemini or ChatGPT, or even education tools like MagicSchool.ai, are NOT HIPPA compliant. Even if you pay for Gemini Pro, there is no BAA unless it comes with a Workspace plan.

HIPAA De-identification is Stringent

HIPAA has very specific and stringent rules for what constitutes truly “de-identified” information. It’s far more complex than just deleting a name. If you use PHI, even seemingly “de-identified,” with a service that doesn’t have a BAA and isn’t designed for PHI, you’re risking a breach. This means:

Do NOT copy/paste session notes, IEP sections, or any other PHI, even with names removed, into general AI tools like Gemini, ChatGPT, or other free online summarizers to help you write notes, develop goals, or for any other purpose. These services do not typically offer BAAs and are not designed to protect PHI.

The data you input into these tools can become part of their training data, meaning your client’s potentially re-identifiable information could be exposed or used in ways you can’t control.

When in doubt, don’t put it in a service without a BAA! This applies whether you’re trying to draft a progress note at home or summarize a student’s history.

Ready to HIPAA-Happy Your Home Office?

Developing comprehensive HIPAA policies and procedures for home can feel daunting, but it’s a crucial step in safeguarding your clients’/students’ PHI. To make it easier, I’ve created a free, actionable worksheet to guide you through identifying your unique risks and writing down your specific policies for working from home.

Sign up to Download Your Free HIPAA Compliance Home Office Policies & Procedures Worksheet!

The Bottom Line

HIPAA compliance in the cloud or at home can feel overwhelming, but it’s crucial for protecting our clients/students and our professional integrity. Take it step-by-step. Conduct that risk analysis, get those BAAs in place for any services you control, and secure your devices and workspace. Always defer to and understand your district’s policies first and foremost.

It’s a journey, not a destination, so stay informed and don’t be afraid to consult legal counsel or your district’s HIPAA compliance officer if you have specific questions about your practice.

Want to know more?  Check out Navigating Business Associate Agreements as an SLP: Your HIPAA BAA Guide.

What are your biggest HIPAA challenges as an SLP, whether in a school or teletherapy setting? Is there anything you’d like to know more about?  Share your thoughts in the comments below!

Coming up next – an 8-part series on AI & SLPs!

Remember, you are awesome because you do the best with what you know – and taking steps toward HIPAA compliance at home is truly doing your best for your clients.

Keep up the amazing work!

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The post HIPAA Compliance At Home: Cloud, Schools, Teletherapy & PHI Security appeared first on Mrs. Speech Online.

Hands down, short stories in speech therapy emerge as a champion tool for those of us working with mixed-skill groups! Forget juggling endless flashcards or hopping between disparate activities. A meticulously planned story can address a multitude of speech and language goals, all within one engaging context. This saves you precious planning time and making therapy sessions flow seamlessly.

And the best part? The skills practiced during a short story unit are often easier to generalize than skills practiced in isolation.

Research-Backed Reasons to Use Short Stories in Speech Therapy:

• Engages Multiple Brain Areas: Stories activate more parts of the brain than simple facts or lectures, including areas involved in language processing, sensory experiences, and even motor functions if the story describes actions. This creates a richer, more holistic learning experience.
• Emotional Connection: Narratives evoke emotions, and emotions are strongly linked to memory and engagement. When we feel something, we’re more likely to remember it.
• Context and Meaning: Stories provide context for information, making it more meaningful and easier to connect new concepts to existing knowledge. Facts presented in isolation are harder to retain.
• Empathy and Perspective-Taking: Stories allow us to step into the shoes of characters, fostering empathy and understanding different perspectives, which can deepen learning about complex social or emotional concepts.
• Relatability: We naturally relate to characters and their struggles, making the learning feel more personal and relevant.
• Simplicity in Complexity: Stories can simplify complex ideas by presenting them through relatable scenarios and character experiences.
• Sequencing and Causality: Narratives inherently involve sequence and cause-and-effect relationships, which helps in organizing information and understanding how things work.

Plus, once you’ve created or chosen a great story unit, you can use the same material across multiple groups and years, adapting it to diverse needs.

Consider grabbing ready-made short story lesson guides to jumpstart your planning! You can find a comprehensive bundle of my guides on Teachers Pay Teachers for 30% off the individual prices!  ➡️Find my FREE list of favorite short stories on TPT! 

Short Stories are Pure Magic for Mixed Groups

Short stories provide a natural, rich environment for practicing a wide range of speech and language skills. Here’s why they’re so effective:

Core Language & Literacy Skills

Short stories lay a strong foundation by naturally targeting essential skills:

• Context Clues: Students inherently practice deciphering unfamiliar vocabulary by using surrounding words and sentences.
• Vocabulary Development: Encountering new words in an authentic narrative context makes learning fun and helps solidify understanding far better than rote memorization.
• Comprehension & Retelling: Following the story arc, identifying key events, and summarizing what happened are direct, functional language goals.
• Sequencing: Stories provide a natural framework for ordering events. Students can practice identifying the beginning, middle, and end; using transition words; and retelling events in logical order.

Higher-Level Language & Critical Thinking

For students ready for deeper engagement, short stories offer rich opportunities for analytical and inferential skills:

• Inferences: Reading “between the lines” to understand unstated meanings, character motivations, or future events becomes a natural part of following the plot.
• Perspective-Taking & Emotion Identification: Characters’ actions and reactions offer perfect opportunities to discuss feelings, motivations, and social problem-solving.
• Word Choice & Writer’s Craft: Students can analyze how authors use specific words and literary techniques (like humor, suspense, or vivid descriptions) to create meaning, mood, or character. This enhances expressive language by encouraging more precise and creative word use.
• Syntax, Paraphrasing, and Summarizing: Students can create their own sentences using conjunctions or practice putting the paragraph in their own words, as well as summarizing key events in the story.
• Literary Analysis: For older students, stories are perfect for diving into more advanced elements like point of view (including unreliable narrators!), figurative language (similes, metaphors, personification), tone, mood, and plot structure.

Speech Production & Fluency

Beyond language and comprehension, short stories provide a natural context for speech goals:

• Speech Sounds and Fluency: From just finding target words with a specific sound to practicing smooth, connected speech during read-alouds and discussions, students with articulation and fluency goals can participate easily and meaningfully within a short story lesson. The natural context makes practice more engaging and less isolated.

Practical Strategies for Multi-Goal Mastery

You’ve got the perfect short story for your speech therapy, but how do you use it? Once you have your story selected, here are some ways to weave in goal work:

“What Is It?” (Defining and Describing Game)

Pause at key moments. Select a noun (character, setting detail, object) or even an action. Have students describe it using multiple attributes (category, function, appearance, parts, location, what it’s made of). This hits defining, describing, vocabulary, and expressive language (and plugs in to comprehensive vocabulary learning). You can even draw or pantomime what you see!

“The Five Questions” (Another Approach to Defining and Describing/Comprehension)

After reading a paragraph or section, challenge students to answer five key questions about it: Who? What? Where? When? Why? (or How?). This reinforces comprehension, summarization, and expressive language.

Modified Text for Audio/Read-Aloud

For students who benefit from visual support, provide a written text with simpler synonyms written above or next to challenging vocabulary words. They can follow along while listening to the original audio or your read-aloud, bridging the gap to complex text.

Prefix/Suffix Hunt

Have students identify words with common prefixes or suffixes and predict their meaning, then check the context. This works great for our grammar kiddos too!

Check out my article for more vocabulary ideas: Comprehensive Vocabulary Instruction for Teachers & SLPs

Character Emotions & Motivations: At various points, stop and ask, “How do you think [character] is feeling right now? What makes you say that?” Then, “Why do you think [character] did [action]? What was their motivation?” This supports emotional vocabulary and inferencing.

Plot Predictions: Regularly pause and ask, “What do you predict will happen next? What clues make you think that?” This builds prediction and inferencing skills.

Figurative Language Detective: After introducing similes, metaphors, or personification, have students identify examples as you read and discuss what they mean and why the author used them.

Tips & Tricks for Reading in Speech Therapy

Don’t forget to model your own thinking!

This is an excellent way to teach “in-the-moment”! “I was curious…” or “I was remembering…” are great instruction tools. Showing them your thought process help students understand how to slow down and pay attention to their thoughts!

It’s Okay to Take Your Time! (Multi-Session Approach)

Don’t feel pressured to rush through an entire short story in one session. Breaking it down over several sessions allows for deeper comprehension, more intensive skill practice, and repeated exposure to vocabulary and concepts. This flexible approach makes short stories highly adaptable to your schedule and student needs (and makes planning so much easier!).

Boost Engagement with Student Choice

Student buy-in is gold! When students are interested in the story, their motivation skyrockets, leading to more meaningful participation and better generalization of skills. Get to know your students’ genre favs. Try offering your students a selection of 2-3 short story options to choose from for their next unit. These simple actions can dramatically increase engagement and ownership of their learning.

Ready to Take On Reading in your Speech Therapy sessions?

I’m excited to support you in making short stories in your speech therapy a cornerstone activity. See these strategies in action and explore a wealth of ready-to-use materials!

➡️Find my Ultimate Short Story Comprehensive Lesson Guides Bundle on TPT, with 30% off individual pricing!  All of these stories have been vetted by my own middle school students.

➡️ Download my free short story lesson guide sample! This 20 page comprehensive sample from “The Night the Ghost Got In” is waiting in my Subscriber Exclusive Freebie Library!

Join Here to Visit Our Full Freebie Library! 

What are your go-to short stories for speech therapy? Share your experiences and recommendations in the comments below!

Want to know more about using literature in therapy? Check out my other articles!

• Level Up Literacy Teletherapy: Unleash FREE Online Resources to Captivate Students!
• Unlock Student Engagement: The Magic of Short Stories in Middle School Speech Therapy
• Why, and How, I Started Using Short Stories in Therapy

Happy Reading & Therapizing!

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The post Activity Magic: Short Stories for Multi-Goal Mastery in Speech Therapy appeared first on Mrs. Speech Online.