Sick Policy for Therapy Clinics: A Cold and Flu Season Guide

Every October the same text arrives before the first session of the day: "He has a runny nose, is that okay to bring him in?" Without a written sick policy, the answer depends on who picks up the phone. A clear sick policy for therapy sessions gives families one answer, protects your staff, and keeps the schedule from collapsing every time a cold moves through a classroom.

Start with what the CDC actually says

The CDC respiratory virus guidance, last updated in August 2025, covers COVID-19, flu and RSV under one set of steps. People with respiratory virus symptoms are asked to stay home and away from others. People can go back to normal activities when, for at least 24 hours, symptoms are getting better overall and there has been no fever without the help of fever-reducing medication.

For the next 5 days after returning, the CDC suggests added precautions, such as cleaner indoor air, hand hygiene, a well-fitted mask, distance or testing. The guidance notes those steps matter most around people at higher risk of severe illness, which can include siblings in your waiting room and staff with health conditions.

Quoting the CDC directly keeps the clinic out of the role of judge. Front desk staff can point to a public standard instead of debating whether a cough "counts."

What a good sick policy covers

Keep the written policy to one page. Most clinic policies need five parts:

• When to stay home. Use the CDC wording above, plus any rules your state licensing, payer contracts or school partners require.
• When to come back. The 24 hour rule, stated in plain words families can check at the kitchen table.
• How to tell you. One phone number or portal message, and a deadline, such as two hours before the session.
• What happens to the session. Make-up, telehealth swap or parent coaching call, explained before anyone is sick.
• Fees. State clearly whether illness cancellations follow your regular late cancellation policy or are exempt. Families resent surprises far more than rules.

Make-up sessions and telehealth swaps

A sick policy works best when the missed session has somewhere to go. Many clinics hold a few open make-up slots each week through flu season and offer them first come, first served.

Telehealth can also fill the gap. The ASHA Practice Portal on telepractice says telepractice should be of equal quality to in-person services, and that clinicians weigh each client's needs and comfort with technology when deciding if it fits. ASHA also notes that a trained family member can act as a facilitator, while warning about the extra load on care partners.

For a child who is too sick to engage, a short parent coaching call often works better than a full session on screen. Our guide to telehealth parent coaching that carries over shows how to structure one. Check payer rules for telehealth and make-up billing before you promise either option. The same planning that goes into a therapy snow day plan works for sick days: decide the backup before the morning it is needed.

Cleaning shared toys and AAC devices

Therapy rooms are full of things kids touch, mouth and share. The CDC guidance on cleaning and disinfecting community facilities explains the difference: cleaning with soap or detergent removes most germs, sanitizing lowers the germs left after cleaning, and disinfecting kills remaining germs. Surfaces should be cleaned first, because dirt can keep disinfectants from working. The CDC lists high-touch items like door handles, counters, desks and touchpads for regular cleaning.

A simple routine for therapy rooms:

1. Set a clean bin and a used bin. Toys go into the used bin after a session instead of back on the shelf.
2. Clean high-touch surfaces between clients. Table, chair arms, door handle and any shared tablet.
3. Follow the manufacturer for AAC devices. The CDC advises following the device maker's cleaning instructions for electronics and suggests a wipeable cover to make cleaning easier.
4. Disinfect after obvious illness. If a child vomits, the CDC says to clean first, then use an EPA-registered disinfectant per the label, leave it wet for the full contact time, and ventilate the room.
5. Wash hands afterward. Soap and water for 20 seconds, for staff and for kids when possible.

Check your state licensing rules too, since requirements for mouthed toys and sanitizer strength vary by jurisdiction. When a child brings a personal AAC device, clean only what the family has agreed to, and never with a product the manufacturer warns against.

Staff illness belongs in the same sick policy

Clinicians and technicians catch everything their caseload brings in. Apply the same CDC return rule to staff that you apply to families, and say so in writing. A sick policy that only covers kids sends the message that therapists should push through.

Plan coverage in advance: a short list of who can sub for whom, a template message for families when their regular provider is out, and a standing option to convert a session to telehealth if the clinician is well enough to work but not to be in the room. Consistency matters for autistic kids, so a quick heads-up with the substitute's photo helps the change land. Our post on RBT turnover and retention covers why steady staffing matters so much to families.

Give families a visual handout

A written sick policy is for the binder. Families need a one-page visual they can stick on the fridge: a picture row for "stay home" signs, a checkmark row for "ready to come back," and the clinic number in large type. Add a picture card for the child, too, such as "Today I rest at home" and "Therapy is on the tablet today," so the change in plans makes sense to the kid as well as the parent.

VizyPlan was built by an autism dad and an autism mom who is a licensed speech-language pathologist so a sick day can be a picture step in a family's routine instead of a surprise.

Share VizyPlan with your families so sick days and telehealth swaps are on the schedule, not a surprise. Families can try it free for a week. If it helps, they can keep going for $6.99/month or $59.99/year.

VizyPlan was built by an autism dad and an autism mom who is a licensed speech-language pathologist who needed something that did not exist. Explore VizyPlan.