The use of a coaching model in teletherapy has emerged as a powerful tool in the field of speech therapy, particularly for augmentative and alternative communication (AAC) users. This innovative approach leverages the expertise of Speech-Language Pathologists (SLPs) to guide and support individuals in real-world settings, promoting effective communication skills.

In this article, you’ll learn how this model empowers SLPs to maximize AAC success, explore common misconceptions surrounding the practice, and discover actionable strategies for fostering meaningful interactions. With a focus on bridging gaps between theoretical knowledge and practical application, the coaching model is transforming traditional AAC interventions.

Unlocking AAC Potential with Teletherapy

Teletherapy has revolutionized the way Speech-Language Pathologists (SLPs) deliver services—especially for those using Augmentative and Alternative Communication (AAC). Teletherapy sessions are adaptable, allowing SLPs to integrate communication strategies and tools into a user’s daily life. Flexible scheduling and location-independent services often benefit individuals who use AAC systems in diverse settings.

By weaving therapy into real activities rather than relying on table-based interactions, SLPs can tailor support to suit each person’s strengths, routines, and preferences. Two primary teletherapy approaches commonly emerge: the direct model and the coaching model. While the direct model can be valuable in focused, short-term scenarios, the coaching model stands out for fostering everyday caregiver involvement and long-term skill integration.

Debunking Misconceptions About Teletherapy for AAC Users

Some myths persist about teletherapy—namely, that virtual sessions cannot effectively address the nuanced needs of individuals with varied communication and motor skills. However, teletherapy can yield robust outcomes when sessions are designed to be engaging, flexible, and caregiver-inclusive. For example, shorter, more frequent sessions may replace longer sessions. If the person using the AAC device requires alternative access methods (such as switch scanning), an SLP can guide caregivers in managing the technology setup remotely to ensure the best possible experience.

Moreover, teletherapy approaches do not have to mirror traditional, therapist-led table work. With strategies that infuse communication into daily routines—like family mealtime, reading storybooks, or even cooking together—teletherapy becomes not just feasible, but often more approachable for many families. This adaptability is particularly beneficial for those who find extended attention or traditional in-person sessions to be challenging.

Understanding the Two Models: Direct vs. Coaching

When it comes to teletherapy, two models have emerged as the most prominent: the direct and coaching models. While both approaches leverage the benefits of remote therapy, they differ in their core features, strategies, and outcomes. Here’s a closer look at these two models and what sets them apart.

The Direct Model

In the direct model, an SLP leads each session by interacting one-on-one with the AAC user through a digital platform. The sessions tend to be heavily structured with clear, immediate goals—for instance, practicing selections on the device or modeling specific communication functions (e.g., requesting, commenting) during a predictable routine.

• Pros:

• Provides intense, immediate guidance from the SLP.
• Ensures structured practice that can be essential early in intervention.

• Cons:

• Limits naturalistic engagement with caregivers or family members.
• May not automatically extend learned skills beyond the therapy session.
• Required sustained attention from the participant

The Coaching Model

In contrast, the coaching model casts the SLP in a mentor or guide role, teaching caregivers to embed AAC strategies in everyday life. This emphasis on everyday context promotes communication in real-world settings.

• Core Features:

• Ongoing, real-time instruction to caregivers during natural routines (e.g., bath time, mealtime, outdoor play).
• Caregivers learn to integrate AAC usage seamlessly, reinforcing communication techniques as part of daily activities.
• Encourages continuous practice outside formal sessions, building functional communication habits.

Many SLPs have observed that coaching leads to higher caregiver involvement and improved long-term outcomes. By embedding AAC support throughout a child’s daily schedule, the approach can improve communication access well beyond officially “allotted” therapy hours.

Direct Model vs. Coaching Model: Key Comparisons

Comparing these approaches reveals that both can work effectively under the right circumstances, but the coaching model carries particular strengths for long-term development:

• Caregiver Engagement: Over time, direct sessions may struggle to adapt beyond a limited setting. Coaching models leverage caregivers to continually reinforce and adapt strategies.
• Generalization of Skills: Skills introduced only in a direct format may not generalize to daily contexts. Coaching encourages natural application throughout the day.
• Flexibility & Real-Time Adaptation: Coaching is inherently more adaptable to daily changes in schedules, energy levels, or mood, ensuring communication continues in various scenarios.

For some families, a hybrid approach—beginning with direct modeling to establish initial techniques, then transitioning into a coaching-based framework—can strike an optimal balance.

Key Considerations When Choosing the Right Model

Selecting the appropriate teletherapy model for AAC success involves consideration of various factors that can significantly impact the effectiveness of therapy. This includes understanding the unique needs of the individual using the AAC system, the environment in which they operate, and the level of engagement and support available from caregivers. By assessing these elements, families and SLPs can make informed decisions that promote language growth and meaningful AAC integration.

Factors to Consider:

• Communication Goals:
  • Long-term versus short-term objectives: Decide whether the focus is on immediate skills or ongoing communication development.
  • Functional communication: Consider a coaching model that prioritizes real-world usage.

• Caregiver Capacity and Willingness:
  • Level of caregiver involvement: Evaluate the commitment and ability of caregivers to participate actively.
  • Engagement opportunities: Coaching models offer greater chances for caregiver participation and skill reinforcement.

• Environmental Fit:
  • Suitability of natural settings: Determine if the individual thrives better in  naturalistic environments as opposed to structured settings.
  • Adaptability to everyday situations: Coaching models incorporate AAC use into daily routines seamlessly.

• Session Frequency and Duration:
  • Preference for brief, frequent interactions: Flexibility in session scheduling might be needed to adapt to the individual’s needs and energy levels.
  • Structured routine vs. dynamic implementation: Consider how each model’s structure aligns with family schedules and priorities.

• Hybrid Approach Potential:
  • Combining benefits: Explore starting with direct modeling for foundational skills and transitioning to coaching for long-term application.

Ultimately, the balance between the direct and coaching models should align with the individual’s communication goals, the supportiveness of their environment, and the involvement of caregivers. The model used can change and adapt over time. Weighing these factors ensures that teletherapy is not only effective but also conducive to making AAC a natural and integrated part of daily life. By adopting a personalized approach, SLPs can foster an engaging and effective therapy experience that caters to diverse needs and promotes lasting language development.

Best Practices for Successful Coaching in Teletherapy

Implementing successful coaching in teletherapy requires engaging both the individual using the AAC system and their caregivers. By creating an inclusive and participatory environment, Speech-Language Pathologists (SLPs) can ensure meaningful progress and skill development. Here are key practices to enhance your coaching approach:

Key Practices:

• Integrate Personal Interests:
  • Align therapy activities with the interests and daily routines of the AAC user, such as incorporating preferred hobbies like singing, cooking, playing games, or reading.

• Empower Caregivers Through Guidance:
  • Provide caregivers with clear, step-by-step instructions and practical demonstrations. For example, guide them on modeling phrases on the AAC system during routine activities like snack time or play.

• Encourage Collaborative Efforts:
  • Foster open communication between SLPs, caregivers, and other relevant professionals. Regular interaction ensures that therapy goals remain consistent and collaborative across various settings.

• Promote Active Engagement:
  • Design sessions that encourage active participation, making therapy more engaging and fun while reinforcing communication skills in a naturalistic manner.

• Tailor Sessions to Routine:
  • Adapt activities to fit seamlessly into the natural routines of the AAC user, promoting the practice of communication skills in real-world scenarios.

• Reflect and Adapt:
  • Encourage caregivers to share their experiences, including successes and challenges encountered, after each session. This feedback should inform future strategies, making sessions adaptable and targeted to specific needs.

The success of teletherapy through coaching lies in creating an environment where caregivers and AAC users feel supported and engaged. By focusing on personalized and routine-based strategies, the approach ensures that skills are not only practiced during structured sessions but are also integrated into daily life. This holistic engagement supports long-term language growth.

Enhancing Teletherapy Outcomes with the Coaching Model

The coaching model extends well beyond the scheduled teletherapy session. By teaching caregivers and family members to integrate AAC strategies into common routines or daily tasks, communication support can evolve organically. Such continuous exposure to language fosters stronger language generalization, better device familiarity, and a more empowering environment for AAC users of all ages.

As noted under additional teletherapy insights, a cohesive team approach—where families and SLPs regularly exchange feedback—improves consistency in device use and ensures swift adjustments when challenges arise. This cycle of collaboration and adaptation epitomizes the coaching model’s strength.

Real-World Teletherapy Scenarios: Lessons Learned

Real-life application is where teletherapy truly shines. Rather than confining AAC practice to a therapist’s office, SLPs and families can use video platforms to connect during meaningful daily events. For example:

• Morning Routines: During breakfast, a caregiver might model requesting specific food items using an AAC system. The SLP observes virtually, offers prompts if needed, and praises the caregiver for natural reinforcement in real time.
• Outdoor Play: Caregivers can capture a child’s interest in a favored outdoor activity—like blowing bubbles—and use the AAC device to request “more” or talk about how the bubbles “fly” or “pop.”
• Transition Times: Even brief transitions, such as preparing for bath time, can serve as a prime learning opportunity to model relevant vocabulary (e.g., “wash”) on the AAC device.

In each of these scenarios, the caregiver, guided by the SLP, promotes communication in an organic context. Over time, these repeated, natural interactions build strong pathways to consistent device use, reduce frustration, and streamline the communication process for everyone involved.

Implementing the Coaching Model: Step-by-Step Guidance

Making the shift to a coaching-based teletherapy approach may require strategic planning. Below is a simplified process to consider:

1. Initial Consultation: Begin by discussing goals, family routines, and the AAC user’s interests. Identifying priority areas (e.g., mealtime, getting dressed, outdoor activities) helps focus on meaningful communication targets.
2. Structured Observation: Schedule a teletherapy session where the SLP observes existing interactions and notes possible points to embed AAC strategies. During this phase, the SLP might ask clarifying questions about how the family currently encourages communication.
3. Collaborative Strategy Development: The SLP and caregivers brainstorm ways to incorporate AAC. This may include modeling certain phrases or ensuring the device is always within reach.
4. Real-Time Coaching: During typical daily activities, caregivers practice the agreed-upon strategies while the SLP provides feedback, makes suggestions, and praises effective techniques. If needed, the SLP might briefly switch to a direct approach during a challenging moment to demonstrate a technique, then shift back to coaching.
5. Ongoing Reflection and Adjustment: In subsequent sessions, the caregiver shares updates on what worked well and what needs refinement. This cycle of reflection fosters continuous improvement and a sense of shared problem-solving.

Professionals should draw on ASHA telepractice guidelines to ensure that all teletherapy practices meet ethical and structural standards, regardless of whether the direct or coaching model is used.

Overcoming Challenges in Transitioning to the Coaching Model

Transitioning from a structured, direct intervention style to a more naturalistic coaching approach may present initial hurdles:

• Caregiver Hesitation: Some caregivers feel uncertain about adopting a more active role. Highlighting long-term benefits—such as improved communication beyond structured sessions—builds motivation.
• Gradual Integration: Shifting too rapidly can be overwhelming. Introduce simpler strategies first, then build toward more complex tasks as confidence grows.
• Regular Follow-Up: Schedule periodic check-ins where caregivers can ask questions. These conversations may reveal small tweaks that will streamline device use.
• Celebrating Incremental Gains: Acknowledging every milestone, no matter how small, reinforces the caregiver’s efforts and the value of the coaching approach.

Which Model is Right for You?

Selecting a teletherapy model is not a one-size-fits-all proposition. The direct model offers structured, short-term gains for AAC users, which can be important at the onset of therapy. However, the coaching model’s integration of everyday interactions often fosters deeper caregiver involvement, improves generalization of communication skills, and promotes lasting progress. Rather than clinging to a single approach, combining the strengths of both can yield the best of both worlds: targeted sessions paired with naturalistic reinforcement throughout daily life.

If you’re ready to discover how a high-tech speech generating device can further enhance communication for the individuals you support, explore the QuickTalker Freestyle™ high-tech speech generating device and how it can transform the communication journey for your patients.