A fourth grader joins from the library, with an aide beside her. Twelve minutes into the session the connection drops. It comes back three minutes later, and the session ends two minutes early because the next student is waiting. Nothing in an ordinary note form has a place for any of that.
Virtual sessions do not need a new kind of note. They need the same note plus a handful of facts that only exist when therapy happens over a screen. This guide pulls those facts from two professional sources, ASHA's telepractice documentation checklist for school-based SLPs and AOTA's decision guide for virtual school OT. Your district's own forms and your state's rules come first.
What the two checklists have in common
Both sources start from the same idea: the note should show what was delivered, how, with what support, and what the student did. The overlap is large.
| Item | What the guidance says |
|---|---|
| Minutes delivered | ASHA: for each interaction, document the number of service delivery minutes, and note if that number differs from what the IEP specifies, with a rationale |
| Date and times | AOTA: log attendance, including the date and the start and end times of the session |
| Type of delivery | ASHA: document the type of service delivery, such as in-person or virtual |
| Technology | ASHA: document the type of telepractice technology used |
| Progress on goals | ASHA: document the student's progress on the IEP goals addressed in the session |
| Student behavior | ASHA: describe the student's behavior, such as engaged or distracted |
| Environment | ASHA: list environmental factors that may have affected the session, such as distractions by others in the room |
| Contact with the team | AOTA: record communication with IEP team members outside sessions |
Facts that belong only to virtual sessions
ASHA's telepractice page adds several points that matter in a note. The clinician should confirm the student's physical location at the start of each session and obtain a local emergency contact number. Session locations and who is present at each site should be documented. Any modifications made to treatment, and their effect on the student's performance, should be documented. And the clinician should confirm and document the security features of the platform.
For schools, the page also says telepractice delivery should be documented in the IEP and discussed at IEP meetings. If your students receive virtual services and the IEP does not say so, tell your supervisor, because the note cannot fix that.
The facilitator
Many school telepractice sessions use a person at the student's end, such as an aide, a teacher, or a parent. ASHA's checklist asks the clinician to document the supports provided to that person, how engaged the person was during the session, and the effect on session outcomes. This is easy to forget. If an aide sets up the screen, cues the student, or collects the data, the note should say so. It tells the next reader how much of the student's performance depended on who was helping.
Before the first session
The checklist also lists preparation that should leave a paper trail. In ASHA's list, those items include:
- obtaining parental or caregiver informed consent, and filing a copy in a secure place;
- documenting all attempts to obtain consent and all communication with administrators;
- identifying technology access barriers and keeping detailed records of the attempts to solve them;
- documenting initial and ongoing contacts by phone, email, or a district-approved platform;
- reviewing the student's IEP accommodations, modifications, and supports; and
- reviewing district or state guidelines on documenting progress.
AOTA's guide adds that clinicians should review district requirements for documentation and should keep consent forms for virtual delivery when the district or local education agency requires them.
A sample entry
Notice what is not in the entry: no guesses about why the connection dropped, no comment about the student's home or school, and no names of other students.
Wording for technology trouble
| Instead of | Consider |
|---|---|
| "Bad internet" | "Connection dropped 9:17 to 9:20. Reconnected on the district platform." |
| "Student not paying attention" | "Student looked away from the screen several times. Reminded to face the screen twice." |
| "Session wasted" | "13 minutes delivered. Audio failed at 9:18 and could not be restored. Make-up to be scheduled." |
Record what happened, and what you did. Leave out blame.
Privacy in a virtual session
Telehealth adds new routes for student information to leak. ASHA's guidance on documentation in schools says email and text are generally not secure for discussing student information, and that recorded conversations need documented consent and district approval. AOTA's guide says to keep attendance logs and documentation confidential under FERPA. Practical consequences:
- Use only the district's approved platform and account.
- Do not take screenshots or recordings of sessions unless your district's policy allows it.
- Keep other students' names out of the entry, even if you can hear them in the background. See FERPA and session notes.
When billing is involved
AOTA's guide says to obtain and comply with state and local billing procedures for Medicaid, to document objective facts that can be substantiated by records, and to sign only the billing documents for services you rendered or supervised. Whether telehealth is billable, and under what conditions, is a state and district question. Ask your billing office before you assume.
For the basic structure of the note itself, see SOAP notes for school SLPs. For recording the times, see start and end times in session notes. Terms are in the glossary.