Marisha: Hi there, and welcome to The SLP Now Podcast. I am incredibly excited for our guest today. Leanne from Expressable is an amazing speech language pathologist, and she is going to be shedding some light on telepractice and how to connect and engage with parents in this newer setting.
Just a little bit about Leanne, she got her master's in speech language pathologist from Northwestern University, and she's worked in pediatric out-patient clinics, schools, early intervention, and home health. She saw a lot of issues and things that kind of broke her heart out in the field, and so she took action on that, which I love because I feel like I kind of went down the same path. So she partnered with her husband, Nick, and two other teammates, and they created Expressable. Expressable is a telepractice company. They really had a vision for modern and affordable care so that anyone who wants to access speech therapy can. And just an amazing company and service. I cannot wait to dive into all things telepractice. So, welcome, Leanne. And I'm sorry if I totally butchered that mission, but hopefully that encapsulated some of that.

Leanne: No. You explained it perfectly. That's exactly what we set out to do. Thank you for having me on, Marisha.

Marisha: I am incredibly excited, especially given the recent turn of events because everyone is thinking about teletherapy now. I'm curious to hear a little bit more about your story. How did you get started in telepractice and what let you there?

Leanne: Like you kind of mentioned in the intro there, I was doing work with predominantly pediatrics in a couple different settings and primarily dealing with insurance companies, Medicaid, private insurance plans. What I kept continually finding and what I think a lot of us find is frustration, and headaches, and sometimes heartbreak when the families that we're just trying to serve are receiving insurance denials left and right. Sometimes it really felt like it was on a whim of the insurance company just deciding that they wanted some teeny, tiny thing tweaked in your goal a little bit differently so they issued the family a denial. Then, sometimes you can fight it, rewrite your goals, send it back, but then this practice gets dragged out, and that's time going by that the family's not receiving support. And when you're looking at pediatric development, that's valuable time being wasted.
Sometimes it felt like there were no reasons at all or from a therapist viewpoint nonsensical reasons that the families were being denied. On one hand, it caused headaches for us in resending the report, rewriting things, but it really has an impact on the families. So we kind of set out and ... My husband Nick and our other colleagues who work on Expressable with us, they all have experience in the healthcare technology industry. So when I would come home at the end of a long day and maybe tell kind of a sad story to my husband, we started just brainstorming how can we solve this problem. There has to be a better way to get some of these things done. So we pivoted and thought, well, why not telepractice?
In some cases, I know a lot of people feel like technology does some harm to the world in a couple different ways but in some cases it can do a lot of good. So we really set out to leverage telepractice to keep the overhead cost of running a practice down so that we could pass along savings to families while still being able to pay our SLPs a great wage and give them the flexibility and convenience to work how they want to work, which if they're anything like me is really wanting to focus on the therapy, and the planning, the plans of care, engaging with the families and patients, and spending less time on the things that caused headaches and frustrations, and kind of stop being at the mercy of these insurance companies. Because I don't know about anyone else, but I didn't pursue this career to get piled under paperwork.
So that's kind of we got into it. We were testing, an experiment really at first. Was there a need out there to fill this gap that I felt like I was seeing? And I would say so far yes. We really felt that there are families out there and adult clients out there who are clamoring for some other kind of route. That's the other side of it, too. We also provide for adults. Part of our theory evolved where we started looking at cases where an adult client might not have even otherwise thought to pursue speech therapy because it's not covered by insurance at all in the case of things like fluency, or accent modification, or maybe just a lingering articulation error that they never addressed as a child. So there really was a gap on a couple different sides where insurance kind of wasn't meeting the needs. So we're finding that we are able to hopefully fill that for as many people as we can.

Marisha: That's amazing. I love that story. And it's been so cool to see the progression and how you guys are growing. So amazing. It was fun to get to hear a little bit more of that. So you guys do a lot. Do you see anyone in the schools or is it all private?

Leanne: We are all private, so we don't currently provide to anyone in the schools. I know that that's a big side of telepractice as it is right now. I think that that's going to change. I think that it's going to be cracked open a little bit wider here. But part of me feels like I'm so proud of all the telepractice, SLPs that have been providing to schools. I think that they have really helped lead the way on figuring out how this stuff works, and I will definitely say that in conducting research back when we were starting that I definitely leveraged a lot of their help. So hopefully we can keep passing that forward.

Marisha: so I'm asking that because I'm curious how ... In the schools, we often have a facilitator, or an SLP assistant, or someone helping with the therapy. But what does that look like if we're not in the school? Because we're focusing on the interaction with parents today, so I'm curious how you set that up and how you navigate that.

Leanne: Yeah.

Marisha: How that works.

Leanne: Yeah, absolutely. Our facilitator basically just becomes the parent or the caregiver. So it's really important, I think, for expectations to be clear up front. I know that the way we work is we always do a consultation before we get started, and that's where we start laying groundwork for how the setup works. In a lot of cases, I think that the model of therapy has been changing for a while now where we used to families just kind of passing the kiddo to the therapist and the therapist would take them back to the clinic room and work for 45 minutes and then bring them back up to the parent. That's been changing for a while now. A lot of research has been done to kind of show that that might not be the most valuable way to address a lot of goals.
So what we see in telepractice is setting the expectation up front where we really let them know you are going to be a huge part of this, and we want you to feel empowered to work on these things on home. I usually put a caveat in there for families saying, "We don't want you to become therapists. That's not our goal. Our goal is for your child to be able to have their needs met at home, communicate effectively at home and in their community." And we know that children, especially young children, learn best from the people that are the most important to them, and that's their family. And they learn best in the environment that's natural to them, and that's their home surrounded by the things that they're used to seeing.
So we set up expectations up front. Then, when we jump into the actual therapy, parents start going beyond even just that facilitator role maybe, and we look at much more of a parent coaching model, doing lots of parent education. We can model things on our side of the camera but what the main focus might be, especially for younger ages, is really coaching the parents to apply these strategies, and supports, and cues into their daily life, so playing with the toys that the kiddo has. Maybe we have the laptop. We carry it over to the kitchen because the kiddo's hungry, and we work on having them ask for the snack that they're hungry for.
If we get into a little bit of an older age kiddo, maybe young school age, pre-K, kindergarten where maybe we're working on something a little bit past early language development, maybe we start to see a model where it's not ... Again, it's hopefully a little bit more than just a facilitator role, a little bit more than just keeping their kiddo on track, but I find it really valuable to have the parent alongside the child throughout the session. So not only can they see what the therapist is working on and the supports that we're giving, the visuals we're giving, but they're right there to kind of chat and keep that education going throughout the session.
I think that it's really exciting to see the way that families respond to it. They more often than not are really excited to be included in the process. They want to help their kids learn. You really can see their faces light up when they try out a strategy that the therapist has gone over with them, and they try it out and the kiddo rises to the occasion and meets the goal, and they're the ones who've done it. They find it really exciting, and that just warms our heart then in return.

Marisha: Ooh, I love that. What do you think ... So it doesn't sound like there have been a lot of hurdles, but have there been any hurdles in getting to that point?

Leanne: To the point of parent coaching?

Marisha: crosstalk. Yeah. And just are there some parents who ... Because I guess if you set the expectation up front, then they're expected to participate in the session. But do you ever have issues or challenges with them not showing up? Or what hurdles could we anticipate in getting the parents involved?

Leanne: Certainly. I think that definitely some families still kind of come to the table with the idea that the kiddo will be plunked in front of a screen and they'll work for their time and then they'll be done. Maybe we'll chat just at the end. So if that ever happens where we enter the first few sessions, if that's kind of the feel that we have going on, it's we just got to broach that topic because it's really important and we want to be delivering the best service and really seeing outcomes. So if we know that the way that that's going to happen is to include the parent, then we just have to broach that topic. Hey, your kiddo's been working really hard with me, but I think that we could see even better growth if I would be able to tell you some of these things. I'd love it if you could sit in with us on the next session and see what we're working on. Then, together we can generate some ideas about how to carry it over throughout the week.
I'm a big fan of something I'll never forget learning about. In my graduate program, I had a fantastic early intervention professor. Her name was Megan Roberts, Dr. Megan Roberts. I remember she taught us about noncontingent help giving. And that's a really fancy work for the fact that sometimes your help has a bigger impact if the person has approached you for it, if the light bulb moment has come on for them without you turning the light on. So really just trying to get the parent in there in the session and then letting some occasions arise. If you're talking about a younger client working on early skills, maybe they're playing and there is a moment of frustration. The kiddo isn't able to articulate some thing or have a need met, and the frustration happens, and then the noncontingent help giving moment happens when the parent looks over at you and says, "So, what should I do when they do that?" So they've approached you for the help, and then you've kind of got them on the ... You got them on the line for the buy-in. I do think that the parent buy-in is really important.
Obstacles definitely can arise if parents approach with a preconceived notion about how it's going to go. Some parents might be skeptical that telepractice will be effective for their child. I think that an important way to approach that obstacle is, A, to not let it get in your head as the therapist. You know what skills you have and what we can accomplish with telepractice. And we know from research that we can accomplish just as much in almost any diagnoses but ... So staying confident in our skills and just moving forward but then also just working to try to really bring them into the fold.
And maybe it's not immediate. Maybe it's not there on the first session, but I think every single session we should work to kind of bring them in more and more. So even if that's maybe they're still kind of trying to walk away from the computer for a couple minutes, if it's a school age kiddo, trying to tell them, "Hey, could you run and go get your mom? I have a quick question for her." Getting the parents back in and then just sort of keeping them involved that way and letting them see the growth that can happen. Like I said, if you give the suggestion and they execute on something successfully, you've just got that teensy bit more buy-in happening each time.

Marisha: Yeah. And maybe starting with smaller, easier-to-approach things, like giving them bite-size pieces that they can tackle.

Leanne: Absolutely.

Marisha: Awesome. That's super helpful. Thank you. I'm curious, too, because you work with ... Once we get into the older grades, do you see less ... Do you involve the parents less? Like if you have a middle schooler or a high schooler, what do you think about as the students get much older?

Leanne: I feel as the students get much older, I find it really important to give them some autonomy. So yes, I do think that the parent involvement changes slightly because we want to respect the kiddo's autonomy. And again, that depends very much on the type of goal that you're working on. So if you're working on something that might be a little bit more involved, maybe the parent is with you just as much of the time. But if you're working on something where the kiddo is able to sit independently and work alongside you, I think it's important to give them a little bit of space to do that and feel comfortable and feel independent with that. But no matter what, I always want to loop the parent back in.
So very often, I'll frame the conversation to have everyone involved at the end of the session. So kind of checking in with the teenager, middle school age, high school age individual and checking in with them and the parent, kind of talking together as a group about, okay, here's what we can work on. Here's something you might try throughout the week. Mom, you can maybe give him reminders here if he doesn't remind himself. Things like that. So still keeping parents in the fold and up to date on everything that's being addressed but definitely respecting that the client's autonomy a little bit more.

Marisha: Yeah, that makes a lot of sense. Then, what about different types of disabilities? Because we might have a teenager who is maybe less verbal or uses alternative communication or whatever it may be. So how do you navigate that and what does that look like? Do you think they're a good fit for telepractice or what has your experience been there?

Leanne: I think that no matter what, we as clinicians are always evaluating if the service delivery model is the most appropriate for the client or student. In some cases, the answer might be no. Either we can't find the research that we want to have to support our reasoning or maybe we give it a shot and it just has a really hard time working out. I think that obviously it's our ethical standard to make that call and be honest with the families.
I think that an issue that a lot of therapists might be running into now in this crisis that we have going on is that their caseload does have those students, right? So if I was taking a consultation for a kiddo who was a little bit ... who needed more support if they were, like you said, less verbal or working on AAC usage. I would be up front about maybe telepractice isn't the best fit and make a recommendation, help them try to find a different resource or another provider. So what we're running into now is that that option's not there. So some school therapists are having to try to provide on their goals for the kiddos, IEP over telepractice as their schools are kind of asking them to fulfill minutes.
And I know that I've been paying a lot of attention to all of the Facebook groups who have been so wonderful about providing support for each other throughout all of this. And a big discussion is kind of, well, are we really helping? If that is the caseload that we have, if that's the goal the individual has, are we really helping them over telepractice? Are we really doing what we're saying we're doing and providing services? I think that it's such an unusual circumstance, right?
This is a time when we're doing things that we would never otherwise do. So I think that being honest is important, and I think that documenting is also important. So being up front with the families in the first place about how I ... You know, maybe I don't feel like this is the best fit, but this is kind of what we're working with. Hopefully we can get back to our regular service delivery model as soon as possible. But, I still want to be there to support you and your family and help this child have his needs met while he's with you guys at home.
So the next thing becomes their goal level. So you have students who maybe use AAC school and are at a certain goal level but maybe they don't even take their devices home. And maybe parents have never used it before. So maybe their goal level at school is much higher than what the parent would even begin to know how to do with them at home. And I don't provide for the schools, but I think something, a perspective I would share is to shift a little bit maybe to thinking about the medical model where we say, "How can we help the families just get to some kind of functional space?" Just coaching them through using the early skills on the device, requesting for food and drink or help and looking at those really early functional skills. No, it might not be where the kiddo is with you, but it might be where the family is at that time with the device or that goal level.
I think it's tricky because, no, that's not what the IEP is written for, and I know that a lot of therapists are really concerned with trying to keep going with those IEPs as they're written. The fact of the matter is I think they're not in school, and the IEPs are written for the situation where they are in school. I'm not entirely sure what schools will be doing about that when this is all said and done, if they'll look at those IEP minutes and consider them not met if we weren't addressing the right goal or if they will just take it at what it was and say, "Well, the SLPs were still meeting with the child." I think that we're just not sure, right? It's all still evolving actively every day, every hour.
But, I think that my two cents would be, as far as it goes, coaching the parents to just see what you can get done with them and meet them where they are. I would say don't try to jump to this really high level if that's where you want them to be. I think try to really meet them where they are.

Marisha: Yeah. I think those are really great points. I mean, part of it is ... I talk a lot about generalization. And if the student can, for example, request at school but they can't do that at home, then we've identified a gap that needs to be addressed, so I think ... It'll be really interesting to see more examples and kind of case studies come in as we actually dive into all of this because we're kind of speculating now of what the issues might be. But, I think it could be a really cool opportunity to have an impact. And really, parent communication is quite challenging in a school setting. We don't get as much time with them as we would like or maybe should so this could be a really cool opportunity to really benefit those students.

Leanne: Absolutely.

Marisha: So it'll be interesting to see how it plays out. If we keep a positive mindset and keep our problem-solving hats on, I think we can make some really amazing progress.

Leanne: Yeah.

Marisha: I'm excited to see how that pans out. So that was a good overview of kind of what telepractice would look like and we can engage with parents across the different ages and disabilities. So what in your experience are some of the things that are most impactful on success with a client?

Leanne: I think a lot of the things we kind of mentioned and touched on already, that early buy-in. To speak to the point you made, Marisha, a lot of early buy-in does, I feel, in my experience, come with early successes. And that is really supported by what you mention about just giving little tiny pieces. Even if we just catch them and are able to help them get this one little tiny step made forward at home, they are going to see that as, "Oh, this is successful. The therapist who I talked with on the computer helped me do that and helped my kiddo do that here at home." So I think the early success and buy-in is really important to kind of keep families motivated and coming back to want to learn with you.
I think that the generalization is also really important. And that's where we can see a lot of the benefits of the natural environment, the home environment coming into play. Having so much communication with the parents as they are our active facilitators and they are really up to date on everything that we're working on and how to address it that ... I mean, hopefully some of the supports that we practiced with them become second nature in their homes. They know how to sit down and practice maybe an articulation goal with their kiddo for 10 minutes every day and it becomes a part of their routine. It becomes a part of their homework routine. So the generalization I think is also really impactful just the way that you mention it is at school. Yes, we want to see it at the classroom, but we also want to see it at home. So from my side of it, yes, I want to see it at the house, but we also want to see it carried over into school, and the community, and everything.
So I would say those to me are some of the most impactful things for success is the parent buy-in, also the student or child's buy-in. Obviously, it's important for them to find it fun, for them to find it engaging. If they are a school age kiddo, staying creative about ways to keep them involved. I don't really personally find that any different in telepractice than in-person therapy because there's plenty of times that I've had working with a kiddo in person where I'm maybe for a couple minutes floundering around about how to keep them engaged with me, how to get them back to the therapy space where I'm sitting. So that to me doesn't change as far as an obstacle. Maybe the way we problem solve it kind of changed. but that's also important, I think. Because if a parent sees that their child's not super engaged by the telepractice they might start to doubt its effectiveness. But therapists, we're all really creative and there's a ton of great resources out there.
And again, so many kudos goes out to all the therapists who are sharing right now and posting questions, answering questions on all of these boards, sharing resources to help newbies to teletherapy figure this out. There's always been a ton of great resources, but the amount of sharing that's going on right now is really admirable and exciting. And I just love to see all of us lifting each other up in this field to help all these things, to help this telepractice while some people have to do it to be successful.

Marisha: The community aspect is definitely amazing. Well, I am sure we'll continue to come up with hurdles, and challenges, but we've got amazing SLPs backing us up to figure this all out. So a follow-up question that I had, because you were talking about ... You gave a lot of examples in terms of how you communicate with parents, and how you reel them in, and what you say when we get set up, but what does that look like with students in terms of keeping them engaged? Are there certain things that you say when you first start working with them? Or what tools and strategies do you use throughout the session? Because I'm sure there's some aspects that are the same across being one-on-one with the student versus virtually, but I'm curious what kinds of things stand out to you.

Leanne: I think that for me and what I would suggest to others out there who are jumping into it is to, like I said, kind of keep it going the way that you would otherwise if it was in person and not over telepractice. I think that the way that you engage with a kiddo and talking up front about your goals, why are you meeting here today, I know that's really important for a lot of school therapists. I've heard a lot say that every time the kiddo comes to the speech room they set out their intentions for the practice. So why are we here? What are we working on? And why are we working on that specific thing? What's our ultimate goal? Setting up those same kind of things with the students up front, the clients up front so that they know why they are sitting in front of the computer with you working on these things.
Keeping them engaged. Like I said, there's a lot of different games out there. Sometimes it depends on the platform that you're using to provide services. I believe that a majority of them offer screen sharing now where you can show what's on your screen to the therapist. And I would definitely recommend that at a minimum to people jumping into telepractice and looking up platforms that the screen sharing's really helpful not only for just pulling up visual cues, or target word lists, or stories that you're looking at together, worksheets that you already have a PDF of. It's super handy to just be able to put that up on the screen. Then, other platforms also offer the ability to pass over the controls to the student so that they might be able to play a game.
The other side of it is you don't have to use a computer game at all to keep students engaged. I kind of think a nice break is, again, if they have a laptop or a tablet and that's how they're using telepractice. Maybe if they're at their house maybe they want to take a break showing you their favorite toy or show their room and describe what's their favorite thing about their room. So kind of taking breaks about more conversational things. I think a lot of the old practices don't go away either. So visual trackers, visual schedules, keeping students on task. The time really flies as much as it does at in an in-person session. So I think that depending ...
Again, the school age kiddos, I think keeping them engaged for that brief amount of time, there's a lot of ways to keep that going that aren't very different from how you would otherwise do it. The younger kiddos, of course they might kind of get up and walk to the other room, and that's where we're coaching the parents about how to either get them back to the play space or maybe that opportunity we're going to follow their lead. Oh, let's just go see what they're interested in and see if we can create an opportunity out of it.
I would say don't get thrown off by the fact that it's telepractice and continue to just kind of view the resources that you already have in a different light. So the worksheets that you already have, share them on the screen using your platform. Or do a barrier task that you might set up in person with those amazing super-duper magnetic boards where you do the barrier tasks. Do the same type of thing but then you just hold up your final product to the camera and compare and contrast. I think in a lot of ways it's not super different. You can keep using a lot of the same things that you did before.

Marisha: And are there any favorite new tools that you've found?

Leanne: I think Boom Cards. I know a lot of people have thrown those as a suggestion on the boards. Boom Cards, they have them for a lot of different goals, like articulation and language goals. They're super awesome because, again, you can on ... I believe a majority of the platforms you can share the screen and kind of go through them that way. Those are really awesome. So if you haven't heard of those, I would check those out.

Marisha: What are Boom Cards exactly for people who aren't familiar? And could you give a couple examples of maybe how you would use those?

Leanne: Yeah, so they're basically ... And I only have a couple of them. I know that there's a whole library, a big library of them. They're basically like flashcards. Some of them are interactive where ... I know that some that I have are for phonological disorders where you're doing minimal pairs or there's like a little ... So it looks like a flashcard up on the screen but then there's two little bug jars, and the student has to determine which jar that word goes in, so F versus T-H. Is it feet or theet. Which jar does that go in? And then you move the bug. You move the picture over to that little bug jar.
So they're basically like flashcards but they're set up to be used on the computer or on the tablet predominantly. Some of them have that interactive nature to them and some of them are more just like the flashcards style thing. But, I found them super helpful. I don't have a ton of them yet though, so because they do ... Sometimes there's freebies, but some of them do cost money.

Marisha: Okay. That's super helpful. Are there any other ... Do you ever use videos or any other kinds of apps?

Leanne: Yeah.

Marisha: Because I feel like speech therapists are always super interested in the specific tools so curious.

Leanne: We are. We are. And I know I personally kind of do a lot of on the fly creating. I keep a dry erase board, like a small one on hand with a couple different colored markers, whether it's just providing a visual cue sometimes. I'm that therapist who does like a really janky drawing of something to explain my point. Or just writing something out for a kiddo on the dry erase board or using that for the barrier task. So I kind of recommend keeping one of those on hand.
But, other specific materials, I love the Busy Speech app, the Busy Bee. I think that's what it's called. It's Little Bee or Busy Bee, and that's articulation. They have every sound on there, word level, phrase level, sentence level stories. So I actually have that on my tablet already. I'm not sure if it comes ... if you can get it set up just on the laptop or computer to be shared. But what I've done, actually, and it's pretty easy, is you can just tilt the screen down a little bit and prop up the iPad and kind of show the screen that way.
Some therapists in telepractice are big fans of document cameras, which would be like an external camera that would be set up to look down at the desk the way that ... I think of it as the overhead viewers that we used to have in school where you can see what the teacher's writing. Some therapists are really into those document cameras for telepractice. I think that the screen sharing has perhaps eliminated the need for that, but I think it starts to become like a preference thing. If you are the type of therapist who, like me, likes to write out a lot of different things actively as you go along that that can be helpful.
If I'm working on a goal, maybe an articulation or phonology goal, that doesn't need a picture, Home Speech Home is amazing just for word lists, sentences, and every position of the word. ReadWorks I use a lot just for pulling up passages, comprehension for all different age ranges. Then, I'll even sometimes use those passages for adult clients as well.
Yeah. I mean, there's a ton of great resources out there. I think that I would definitely recommend if you're looking at telepractice and you're not on any of the Facebook groups I would recommend joining those because everyone is really active out there and supportive. Teachers Pay Teachers is a great resource for in-person or telepractice resources, obviously. I think that ... I don't know. A lot of things come down to preference. So I would just encourage exploring out there the different resources that are available. I'm sure that as we chug along here more and more will be shared.
I'm a big believer in not reinventing the wheel so I love that the SLP community is so generous with sharing a lot. Because if one person has graciously worked on something and shared it, then they're saving a lot of time for other therapists. And sometimes we're tempted to reinvent the wheel with every client or every home program assignment, but we really don't have to if we just put a little bit up front in exploring what's already out there.

Marisha: Yeah, I love all of those suggestions. And just to recap, so you mentioned the Boom Cards, Little Bee Speech, which is an iPad app, as well as Home Speech Home. And you shared the idea to just tilt your computer and show it that way or to use a document camera, and I ... Some of the platforms actually let you share your iPad screen as well. And there's different apps out there. Like if the platform doesn't have the specific ability to share the iPad screen, there's different ... I can't remember the name. If I find it, I'll add it to the show notes. But, there's some really cool ways to share the screen. It's kind of like using your iPad on your computer, so that can be cool. Then, you also mentioned ReadWorks, which is also one of my favorites. I love that.
I feel like a lot of these suggestions you're right. It's the same as what we would be using in in-person therapy. We're just kind of adjusting it to make it work for this platform. Super amazing. And that's good news because we can use all the things that we've been using. Just getting a little creative.

Leanne: Yeah, absolutely.

Marisha: Okay. Awesome. So anything else that you wanted to touch on in terms of just parent engagement or parent-student engagement in the session?

Leanne: Let me think. I mean, I guess my thing now is that the way that we work currently at Expressable is we have always kind of set it up that way. So I think if I could offer any other support to school therapists who are ... Like we mentioned, it's touch sometimes. They have huge caseloads. Parent communication can be a big challenge just by the nature of just everything going on. So if anyone is jumping in and is really not sure how to engage with parents or get that ball rolling, they can definitely feel free to reach out to us at info@expressable.io, and I'd be happy to try to provide any guidance that I could to help therapists get the ball rolling there.
But, I also would just give everyone a reminded that don't feel ... Try not to feel overwhelmed. Try not to feel frightened of jumping into it because you guys all know your stuff. You know what you're doing. Maybe we just have to make little tweaks here and there, but y'all have the clinical skills and we can keep providing awesome services for these students. So yeah, good luck to everyone, and we're here to help as well.

Marisha: I love that. I feel like that's what we've been ... or what we've been coming back to throughout the whole podcast. This might feel overwhelming and challenging, but you're totally right. We have those clinical skills, and we're just making little tweaks to make that work.
So I'd love to end on a positive note. So we've talked about some of the challenges and some of the hurdles, and you've also given a lot of great strategy to overcome those so hopefully we're feeling better overall. But, can you tell us just some of your favorite parts about being an SLP who does telepractice and maybe a fun ... I don't know. Any highlights for you would be amazing.

Leanne: Yeah. For me, part of the ... The best part might be the flexibility that kind of gets built in with ... And again, I know the circumstances right now the past couple weeks have been a little bit different. But in general, there's a lot of flexibility that can come along with setting up in telepractice and kind of taking control of your own hours as a therapist.
I think what I love about the opportunity that telepractice presents is that ... A goal that we really have for Expressable is to start helping therapists and family connect with another on a specialty level. So there's a lot of geographic barriers. Sometimes families are an hour drive each way to the nearest speech pathologist. And maybe that particular speech pathologist doesn't have a ton of experience in fluency, or AAC, or whatever the diagnosis is. So telepractice can really open doors to connect people with the person who's best fit to their needs.
I know that a lot of therapists find that rewarding if they have an area that they're super interested in. Some therapists really like to try to build a caseload around that niche. Then, that really benefits the family as well because they're getting the expertise. I think that that is sort of perhaps the way that a lot of the health industry is going in general. So I think I'm glad to work in telepractice to be able to reach a group of clients that otherwise might be in a tough spot to get therapy or, like we said too for us, working with adults who otherwise might not have even thought to reach out to get speech therapy for something if their insurance didn't cover it. I think I just love that we are reaching people and providing our highly skilled speech language pathologists and everyone who's worked so hard to be where they are and to gain the knowledge that they have.
I also really love working from home. I'm not a total homebody, but I do find comfort in my house and I find comfort in my dog. I made that comment the other day to him being one of my favorite parts about working from home. Usually he's not in the room with me. Usually he's sleeping on the couch. But, it's nice just to be able to walk out and take a break. Like I said, with the flexibility, even just taking a 15-minute lap around the neighborhood with him in between sessions is a nice way to decompress. And I think that SLPs sometimes forget to decompress. We are hustling all the time, whether it's from classroom to classroom or if you're a home health provider from house to house. You're driving and we maybe forget to take a time to breath, and pause, and decompress. And sometimes that carries over from kid to kid and we might not realize that if we're carrying any excess stress with us that it can reflect on to the kiddos. So I love telepractice being able to work from home and take some moments to breathe deep and relax and remember why I'm doing it in the first place.

Marisha: Oh, that's amazing. You mentioning your dog reminds me of that meme where ... I remember it came up a lot when I was ... I had a massive caseload in the schools, and I was just grappling for anything that would be positive. But, there's a little GIF where someone is opening a file cabinet and there's just this little puppy sitting in there.

Leanne: Oh, yeah.

Marisha: And I was like, "Oh, if only my file cabinet at work could have a puppy in it." But, you could totally make that happen if you worked from home. crosstalk

Leanne: Yeah.

Marisha: I mean, the puppy might not love to be in the cabinet, but ...

Leanne: Yeah. And I know, too, that's actually I think a lot of ... I'm used to it. And my dog doesn't. He doesn't bark very often so that's ... He's a good fit. He's a good coworker because he mostly sleeps on the coach and doesn't make a lot of noise. I know a lot of therapists right now in this crisis are coming. They are really feeling like they're coming up against it with their other coworkers, meaning maybe their own children who are perhaps causing some disruption if they're trying to get things done, and that ... I really feel for everyone. Again, keep your head up. Maybe if you ... It's so busy, and I think we're all so stressed out. Just take a deep breath. Maybe try to set up a schedule with your family where you have ... If you have some time in the morning for noisy time, run around time where you're getting some energy out and then implementing a quiet time for us to get some work done. I know that probably sounds a lot easier said than done.
Again, I would say keep reaching out to each other for support. I don't have my own kiddos yet, and I have my quiet dog coworker. So if anyone out there wants to sound off about ways that they're managing their other coworkers, aka their family, during this specific time, maybe I'll leave it to you guys if you're the experts on that.

Marisha: I'm definitely not an expert either, but I feel like ... Because I have a tiny puppy, too. And I do these interviews and meetings and everything for my business, so it's been interesting trying to navigate that. And I think the routines are super helpful, just like you said. Before this podcast interview, because I had another meeting right before, so the puppy, I knew she'd have to be quiet for a couple hours so we went. We played hard and we did some walking and all of that. I mean, those strategies have worked for me, and I guess we'll just have to keep in touch with everyone else to see how it's going with their pets and children and whatever other coworkers they might have at home.
But yeah, awesome. So any last pieces of wisdom, or advice, or words? Or do you think we've done a good job covering what we wanted to cover today?

Leanne: Well, hopefully we've done a good job.

Marisha: For sure.

Leanne: The last parting remarks may be deep breath. Deep breath, everybody. I know it feels so crazy for so many people in honestly so many ways right now. I just really admire how everyone ... It seems to be just that the top of everyone's mind, all of these SLPs' mind is continuing to provide for their students and their families. It's so amazing that that's where our minds jump to. So I think, everyone, reach around and pat yourself on the back for keep on keeping on and pulling together resources and everything like that.
Like I mentioned before, feel free to reach out to us. If we can be of any help, I would love that. Yeah, deep breath. Hopefully everything will be okay. We'll get it sorted out. We are doing the best we can right now, and ... Yeah, I'm happy to provide any help that I can in any way.

Marisha: Yeah, we are definitely in this together. It's been an absolute pleasure to chat with you and to kind of hear your perspective and hear all of your tips and resources. I'm sure all the other SLPs listening in feel the same way. I'm so grateful for you and you being part of this community, Leanne. Yeah, thank you again.

Leanne: Thanks for having me, Marisha. It was great.