The ihear[R] Internet Therapy Program (ihear) provides effective, individualized, and interactive therapy that is tailored to each child's specific needs through a secure, high-quality Internet connection. The program brings listening and spoken language services directly to schools and families. The foundation for ihear is based on the St. Joseph Institute for the Deaf (SJI) philosophy of education developed throughout a 175-year history of working with children with hearing loss in the St. Louis, Missouri, area. As an educational institution, SJI believes that listening and spoken language can best prepare children for inclusion in the societal mainstream, and that this goal is best met when professionals partner with families beginning in infancy. Technology, innovation, and best practice, as measured by Internet Therapy Outcome Tracking System (iTOTS) and along with SJI's dedicated and expert faculty, are the foundations of the program. The ihear program closes the gap for families and schools by giving them access to specialists trained in developing spoken language through listening. Through the coaching process, families and professionals are developing skills that can be implemented in the child's natural environment and preparing children with hearing loss for inclusion in their community, home, or school. Tools that determine the efficacy of the coaching process are under development in ihear. The ihear program will continue to analyze outcomes in order to set the standards for best practice in telepractice.