To the top ^^ Close ^^

Bridging Distance and Expanding Access: Student and Clinician Perspectives on AAC via Telepractice in Illinois

Published in the June 2025 issue of the ISHA Voice.

By Amy Yacucci and Jennine Harvey-Northrop                        

Telepractice has become a critical service delivery model in speech-language pathology, offering innovative ways to reach individuals who may otherwise face barriers to care due to geography, health status, or limited access to providers. For individuals who use augmentative and alternative communication (AAC), who often require frequent and highly individualized support, telepractice has the potential to significantly improve service accessibility and continuity (Chua et al., 2024; Simacek et al., 2021). Clinicians, families, and AAC users report that telepractice can lead to improved outcomes by increasing the availability, frequency, and flexibility of services (Hurtig et al., 2024). 

While emerging research supports the use of telepractice for AAC assessment and intervention (Hurtig et al., 2024; Weidner & Lowman, 2020), most of this work is still in its early stages. Effective integration of AAC into telepractice requires more than access to digital tools,it requires evidence-based protocols, clinician training, and equitable access to devices and support strategies (Cason & Cohn, 2014). The rapid transition to virtual service delivery during the COVID-19 pandemic accelerated innovation, but many clinicians and graduate students were left without clear guidance, formal instruction, or standardized procedures to support AAC through telepractice. 

To better understand the current landscape in Illinois, the ISHA Telepractice Committee and Technology Track Chair conducted a statewide survey of graduate students and practicing SLPs. The goal was to explore current AAC and telepractice practices, training experiences, and challenges across clinical and educational settings. 

Graduate Student Perspectives: Training Gaps and Growing Interest 

The majority of graduate student respondents were in their first or second year of training (96%), and most had completed 1–2 semesters of clinical practicum (89%). While 82% reported having received formal instruction in AAC assessment and intervention, only 36% had received any formal instruction related to telepractice. Most students (73%) were only slightly to moderately familiar with AAC, and an even higher percentage (72%) reported limited familiarity with telepractice as a service delivery model. 

Despite their limited training, students showed a high level of optimism about the potential oftelepractice. Ninety percent agreed or strongly agreed that telepractice is an effective method for delivering speech-language services, and 85% saw clear potential for telepractice to expand access to AAC services. Students appreciated the convenience and comfort that telepractice offers for clients, with comments such as: 

“…making it more easily accessible and allowing for more frequent services…” 
“…having the client in their home setting may be more comfortable and possibly enhance their engagement.” 

However, when asked about their confidence, only 25% reported any confidence supporting clients via telepractice, and none felt confident supporting AAC use specifically during telepractice sessions. In contrast, 70% felt slightly to moderately confident delivering in-person AAC services. A striking 94% of students expressed a desire for more training in integrating AAC and telepractice, highlighting a clear gap in graduate education. 

Students also identified several anticipated challenges when delivering AAC via telepractice, including: 

  • Modeling AAC use virtually (100%) 
  • Technology issues (95%) 
  • Limited training and resources (79%) 
  • Access to AAC devices (74%) 
  • Client engagement through a screen (74%) 

Student comments reflected these concerns, such as: 

“Technical difficulties or attention deficits while modeling.” 
“I have only had AAC experience in person, so I would not know where to start when doing this through telepractice.” 

Practicing SLP Perspectives: Practical Strategies and Persistent Barriers 

Among the practicing SLPs surveyed, most worked in pediatric settings (75%) and had over 16 years of clinical experience (59%). While fewer than half of respondents were actively using telepractice (44%), of those who were, 60% reported using it with clients who rely on AAC. 

The most commonly used AAC tools during telepractice were low-tech communication supports and tablet-based speech-generating apps. SLPs reported several strategies that helped them support AAC users virtually, including: 

  • Partner coaching to build caregiver confidence 
  • “Dry run” sessions to practice virtual tools before meeting with the client 
  • Emphasizing consistent modeling of AAC use: “modeling, modeling, modeling” 

More than half (54%) of SLPs agreed or strongly agreed that AAC can be effectively delivered through telepractice, and an even greater number (82%) saw its potential to increase access in rural and underserved areas. Still, confidence in service delivery varied widely. While 36% felt confident to very confident supporting AAC via telepractice, 48% reported feeling only slightly or not at all confident. Confidence was higher in training communication partners, with 44% reporting confidence, but 56% still feeling unsure or underprepared. 

Key challenges identified by SLPs included: 

  • Engaging caregivers during sessions (82%) 
  • Internet or device limitations (64%) 
  • Client fatigue or limited engagement (59%) 
  • Difficulty modeling AAC remotely (50%) 

Notably, 95% of SLPs surveyed expressed a desire for more professional development opportunities focused specifically on AAC service delivery via telepractice. 

 

Conclusion: Bridging the Training Gap in Tele-AAC 

Findings from both graduate students and practicing clinicians highlight a shared recognition of telepractice as a valuable and increasingly necessary service delivery model for AAC. However, these results also reveal gaps in training, confidence, and access to resources that must be addressed to ensure equitable, effective care. 

These findings provide a compelling call to action for academic programs, professional associations, and continuing education providers to develop targeted training opportunities and evidence-based implementation tools. By equipping both new and experienced clinicians with the knowledge and resources to deliver high-quality AAC services via telepractice, we can ensure that this promising model of care continues to evolve in ways that are effective, accessible, and person-centered. 

Tele-AAC Quick Reference and Resources for Clinicians 

Core Components of Effective Tele-AAC: 

  1. Evidence-Based Practice Foundations 
    • Use the ASHA Telepractice Portal for compliance, licensure, and scope: asha.org/Telepractice 
    • Reference the ASHA AAC Portal for AAC assessment, intervention, and team-based care: asha.org/AAC 

  1. Modeling AAC Remotely 

    • Use screen sharing to model on virtual versions of AAC systems (apps like LAMP, TouchChat, Proloquo2Go) 
    • Share communication boards using Google Slides, LessonPix, or Boardmaker Online 
    • Narrate your actions (“I’m pointing to ‘go’ because we are ready!”) and highlight icons visually 

  1. Partner Coaching During Tele-AAC 

    • Plan a pre-session “dry run” with caregivers to review device use and platform navigation 
    • Give specific praise and feedback during sessions (“Great job waiting for her message!”) 
    • Provide follow-up tip sheets or video modeling 

  1. Increasing Engagement and Reducing Fatigue 

    • Keep sessions short and flexible using high-interest topics 
    • Rotate between active communication tasks and passive input 
    • Use websites like Monarch Reader, Boom Cards, or interactive, adapted books 

  1. Addressing Access and Equity 

    • Connect families with local AT lending libraries like IATP or The AT3 Center 
    • Use UDL principles to guide flexible supports: udlguidelines.cast.org 
    • Keep backup low-tech boards available and email printable versions when needed 

Top Continuing Education and Training Resources: 

Quick Tips 

  • Always check internet stability before sessions 

  • Build rapport early! AAC success depends on the connections you make. 

  • Document strengths and challenges after each session to track progress and guide adjustments. 

     

References 

Biggs, E. E., Rossi, E. B., Douglas, S. N., Therrien, M. C. S., & Snodgrass, M. R. (2022). Preparedness, training, and support for augmentative and alternative communication telepracticeduring the COVID-19 pandemic. Language, Speech, and Hearing Services in Schools, 53(2), 335–359. https://doi.org/10.1044/2021_LSHSS-21-00159 

Cason, J., and Cohn, E. R. (2014). Telepractice: An overview and best practices. Perspectives on Augmentative and Alternative Communication, 23(1), 4-17. https://doi.org/10/1044/aac23.1.4 

Chua, E.C.K., Manansala, J.R.G., Tee, D.A.G., Lirio, M.J.A., Masa, M.K.P., and Garcia, F.D.S. (2024). A scoping review of augmentative and alternative communication (AAC) telepractice research (2002-2021).  Philippine Journal of Health Research and Development, 28(20), 20-33.  

Hurtig, R., Blackstone, S., & Goldman, A. (2024). Bridging the gap: Insights from telepracticeaugmentative and alternative communication services in the digital age. Perspectives of the ASHA Special Interest Groups (10). 249–260.https://doi.org/10.1044/2024_PERSP-24-00209.