How to use this guide
Teletherapy in PreK–12 schools comes with additional responsibilities, privacy considerations, and clinical expectations. Whether you’re a speech-language pathologist, occupational therapist, school psychologist, social worker, counselor, or mental-health provider, it’s important to stay informed about the standards and best practices that shape virtual delivery.
This guide is a quick overview of common do’s and don’ts providers can expect when delivering special education-related services remotely.
The do’s
1. Do track compliance with local laws and regulations
A teletherapist may need to navigate multiple layers of federal, state, and local laws and regulations, which may vary depending on their practice settings, the populations they serve, and where services are delivered.
At the federal level, the Family Educational Rights and Privacy Act (FERPA) applies when services are being provided in a school setting. FERPA protects education records, which include personally identifiable information (PII), therapy notes, progress reports, IEPs, and other related documentation. However, the Health Insurance Portability and Accountability Act (HIPAA) applies when providing services to patients outside of a school setting. HIPAA’s Privacy Rule, Security Rule, and Breach Notification Rule regulate the protection of health information (PHI).
Additionally, there are state and local requirements regarding privacy, telehealth, and licensing. School districts and educational agencies also have their own policies dictating how to safely store records and how to handle consent and access.
Licensure considerations also apply. Teletherapy can make it possible for providers to support students in multiple locations and states, which makes licensure an important factor to keep in mind. In most cases, providers must hold licensure in both their own state and the state where the student is physically located at the time of the session, including during temporary travel.
A helpful habit: Maintain a “jurisdiction sheet” in your records noting student location, local rules, and your licensure coverage. This can help make audits and documentation requests feel more manageable.
A note on state rules: Build in time to double-check state-specific privacy and telepractice requirements. Because rules can vary significantly by state, reviewing current board guidance and coordinating with state or district contacts can offer added clarity.
2. Do obtain informed consent appropriate for teletherapy
Consent requirements for teletherapy vary by practice setting. Teletherapists should know who’s responsible for obtaining consent and what that consent should cover.
In school district settings, consent typically operates on two levels:
- Educational consent for services, typically obtained by the school through an IEP, Section 504, or a general school consent form
- Consent for teletherapy or the use of technology, which may be handled by the school or, in some cases, reflected directly in the IEP, depending on state requirements and district policy. In some arrangements, the school retains responsibility for securing consent. In others, the provider may be expected to confirm that appropriate consent is in place
Teletherapy consent should clearly explain:
- What teletherapy is and how it works
- The benefits and limitations of virtual service delivery
- How privacy is managed in a home or school setting
- Technology risks such as session interruptions
- Who may be present during sessions and how this is handled
- How data is shared, stored, and protected
- Emergency procedures and mandated reporting obligations
Consent should be in place before services begin and revisited when circumstances change, such as a shift in student location, platform updates, or newly identified risks.
3. Do protect confidentiality, clinically and technically
Confidentiality when delivering therapy remotely requires planning and thoughtful execution. Providers should opt for FERPA-aligned platforms when working in school settings, confirm students’ locations at each session, and set expectations around privacy (e.g., use of headphones, room selection, background noise, and turning off nonessential apps). Recording sessions should never occur without explicit, documented authorization.
Minimize the use of email for any personally identifiable information (PII), and always store documentation in district-approved systems. Share only the minimum PII necessary information when communicating with team members.
4. Do prepare for crisis situations and technology failures
Every teletherapist should define a simple, reliable plan for emergencies and tech issues. Confirm the student’s location at the start of every session and determine whether an on-site adult is available. Keep local emergency contacts and district escalation procedures close by.
Students should know a cue (verbal or nonverbal) to pause or stop if privacy is compromised. If the connection drops, both parties should know exactly how to reconnect—or when to switch to a backup plan such as a phone bridge. Remember: crisis-related decisions must always be documented thoroughly.
5. Do document with teletherapy-specific detail
Documentation plays an important role in ethical teletherapy. Session notes should reflect both the clinical work and the virtual context in which services are delivered, including:
- Who was present (and within earshot) during the session
- The student’s physical location
- Any technology disruptions or privacy concerns
- How those issues were addressed
- Interventions delivered and progress toward goals
Completing documentation on the same day as service delivery can help keep records accurate and protect the integrity of the IEP process.
The don’ts
1. Don’t use generic tools built without privacy and security considerations
Some consumer video platforms may expose educational records and PHI. You should ensure the video platform you utilize is built with FERPA and HIPAA compliance in mind. Always use district-approved, encrypted tools.
2. Don’t practice across state lines without verifying licensure
If a student is out of state, even for a weekend, there’s a chance you might not be allowed to continue sessions. Always double-check.
3. Don’t ignore potential privacy challenges
Whether at home or school, shared spaces create vulnerabilities. Collaborate with caregivers or educators to find the best environment.
4. Don’t let documentation fall behind
Virtual work moves fast. Same-day notes protect continuity and support IEP teams.
Choosing a platform: features to look for
These do’s and don’ts can be easier to maintain with the right technology. The right telepractice platform can help providers support compliance, consistency, and high-quality delivery.
Providers may want to look for platforms that offer:
- Encryption, access controls, and audit trails
- High-quality, low-latency video
- Integrated notes and IEP-aligned progress dashboards
- Automated scheduling and reminders
- Multi-party session access
- Secure assessment tools and therapy materials
- Responsive, provider-first technical support
Presence: purpose-built for remote providers for schools
Presence is a teletherapy partner supporting PreK–12 schools nationwide. Our community includes speech-language pathologists, school psychologists, social workers, counselors, occupational therapists, and mental health providers. We support providers with secure technology, a collaborative professional network, and digital assessment tools designed specifically for school environments.
Whether providers are looking for full-time stability or flexible virtual opportunities, Presence offers structures that support ethical practice, strong collaboration, and modern, clinically sound workflows.
To learn more about teletherapy or how Presence can support your work, explore:
- Presence’s provider network
- Kanga, Presence’s platform for remote assessments and teletherapy
- How teletherapy can transform mental health services for schools
Building ethical teletherapy, one decision at a time
Telepractice for schools is shaped by a series of thoughtful, everyday choices: clear consent, secure technology, consistent boundaries, careful documentation, and respect for privacy at every step. When practiced ethically and responsibly, teletherapy for schools can help enable more equitable access to education for students with diverse needs.
If you’re a provider exploring flexible virtual opportunities or looking to connect with a professional community built for school-based work, learn more about the Presence provider network.
