HCTMD06Schools in the United States are required to supply specific specialty services such as speech, occupational and physical therapy under the Individuals with Disabilities Education Act (IDEA). Because of their geographic locations and sparse populations, many rural communities do not have these specialties. The alternative of traveling to metropolitan areas where these services are more readily available is hard on the children and their families. INTEGRIS Health and the Hugo Public Schools collaborated in a two-year speech teletherapy pilot study to test speech therapy services delivered over two-way, interactive videoconferencing. The effectiveness and satisfaction of this mode of delivery was measured. A comparison of lost therapy time due to technical difficulties was also made. Steps taken to develop and implement the school teletherapy program, outline of a typical session, perceptions of rural administration, clinical outcomes, lessons learned and future applications will be discussed.