Having always worked as a hands-on, clinical Occupational therapist with children, this sudden lockdown came to me as jolt ! ‘How am I going to see my kiddos?’, ‘I miss my ongoing sessions at our therapy center’, ‘How do I continue supporting and helping children and families for whom consistent therapeutic intervention is important’, ‘How do we do that while making sure we are still practicing social distancing in our effort to mitigate the virus spread’
So many questions….I was looking for answers, hopes and more creative yet meaningful ways to keep the work going! Thankfully the world is a smaller and significantly more accessible place due to the World Wide Web.
Having researched through lots of credible and research based online platforms I came across something called as ‘TELETHERAPY’. At first I was like ‘Huh!! This sounds fancy. But what is it? Does it really help? Will it bring a value addition to my kids and parents as they navigate through these days?
As I dived deeper into understanding and implementing it, I realized it is a wonderful new tool to keep the work going while still maintaining social distance until we are able to get back to our routines soon.
Here is my attempt to explain this to our parents. I have tried to provide comprehensive, true, research based information and understanding of Teletherapy and ways in which we can utilize it as an effective and efficient tool for our kids.
What is Teletherapy?
Teletherapy – commonly known as “telehealth” in the healthcare arena – is the online delivery of speech, occupational, and mental health therapy services via live, face-to-face video conferencing. Actually, most of us are already doing that in some form or the other without even knowing it. For example, if you are sending your child’s videos to your therapist and getting feedback on those, or if you use a secure texting platform to exchange messages about your home program, you’re already using telehealth. During therapy sessions, the student and therapist can see, hear, and interact with one another in real time, using webcams, headsets, and a live, synchronous online learning environment. If you’ve ever used Skype on your computer or FaceTime on your iPhone, you’ve used a similar type of technology.
How do we go about technical challenges? Will it compromise the therapy process?
It is commonly understood that there are technical problems that can arise due to the online venue that are nonexistent when the therapy session is in person. For example, it can be difficult for the child to connect and communicate with a therapist who is not in the same room together interacting face-to-face.
These potential technical pitfalls can be avoided through:
- A computer with a high-resolution web-cam or an external web-cam
- Sound input and output (this could be a built-in microphone and speakers or an external microphone and headphones).
While this may seem to be difficult at first, this will ensure that your teletherapy session will not feel all that different from an in-person, face-to-face encounter. - Also, we typically work with the parents and do a trial with them so we all get the hang of using these online platforms before they begin their first session.
- We will also guide you about creating a type of environment that is most conducive to success in teletherapy. Children should be set up at a desktop computer with a properly working webcam and in-computer microphone along with noise-cancelling headphones. An appropriate height desk and chair will allow a child to sit up straight with their hips, knees, and feet at a 90° angle.
Will online sessions decrease my child’s engagement compared to hands-on personal sessions like we always do?
Parents may be concerned that during online sessions it will be difficult to maintain the child’s focus and engagement. However, various ways in which we can ensure better participation and engagement is by:
- Preparing the child with a visual schedule
- Decluttering distractions around where you and your child are sitting for the video conference
- The therapist will plan the session to create a mix of movement based and table-top tasks to ensure better sensory regulation, incorporating really cool online games (which actually your child may find novel, more interesting and a welcome difference from his regular sessions)
- Giving lots of positive feedback verbally and visually through the use of emoticons.
- Also, online therapy offers a plethora of games, exercises, and more to engage the child.
How do I explain and prepare my child for this?
How can you help children understand teletherapy? When kids are used to seeing their occupational therapist in the classroom setting, clinic, or therapy, room, the transition to teletherapy can be a strange thing at first.
Here are tips to help kids understand virtual occupational therapy sessions:
- While the core aspects of therapy remain the same when sessions are completed virtually, you can explain to them that the computer will be their “learning portal” to help them participate in all the fun and educational activities that they would typically do in therapy.
- You may tell your child, ‘Since we can’t go to Miss Rachana (Or your therapist’s name), she is going to meet us and play with us on our computer’.
- The computer is our “creativity helper” through which they can play games, talk with their therapist, learn new things, and strengthen their bodies and minds! For younger kids, it may help for you to mention that there will be games with animals, superheroes, their favourite cartoon characters, sports, and more.
- Children may even view teletherapy as more exciting than traditional therapy, since they get to play games on the computer (something that is often viewed as a reward or leisure activity after their homework is done).
What areas would you work upon in teletherapy sessions? Can we continue the goals that we were working on already at the center?
Since the core aspects of therapy remain the same when sessions are completed virtually , some of the areas that we can continue to work upon through teletherapy are:
- Fine motor skills (such as using buttons, manipulating scissors, or holding a pencil)
- Writing, reading, or learning
- Gross motor skills (such as using muscles in the neck, arms, hands, and torso)
- Assisting with self-care, such as dressing, eating, and grooming
- Managing their emotions or behaviours
- Playing or engaging in leisure activities
- Organizing, planning, and completing tasks
- Interacting or communicating with other children, adults, teachers, etc.
The sessions will be conducted by the therapist already working with your child at the center. This would ensure comfort and familiarity for you and your child. Additionally this would mean that the therapist is best suited to make an optimal accurate goal based plan that you were already working with your child on prior to the lockdown.
The activities would be conducted in ways where the therapist will model the activity to the child, do it with the child, guide, help and empower you to actively be a part of scaffolding your child in person and hands on and you conduct it with them at home while the conferencing is on.
How much will this cost me?
Telepractice sessions are much more cost effective as compared to regular in person sessions.
Will online sessions compromise our privacy and confidentiality?
We take the utmost care in utilizing virtual platforms which will completely ensure that equipment and connections are secure and taking steps to make certain that unauthorized third parties do not accidentally enter the room during a videoconferencing session. We will send a prior consent-to-treat process and content. Of course, at any point you can ask questions to ensure ongoing affirmative consent
So, to sum it up…Just like everything else teletherapy also has its pros and cons.
The pros being: Improves access during time when we otherwise wouldn’t be able to do our OT sessions, Convenient: saves travel time and other logistics, kid-Friendly, computer-based activities are motivating for children, effective and convenient. Research has shown that the quality of teletherapy is on par with onsite therapy, simple, easy-to-implement technology is user-friendly for students and schools, while also being cost-effective and flexible.
The cons being; Lacking the in-person connect of OT, limitations in the use of certain kinds of diagnostic conditions, not everyone may have access to high quality internet and other technology needed for this.
I hope this helps you feel more comfortable and familiar with how teletherapy works. Of course, our hands-on Occupational Therapy is what we will always continue to do and love doing. However, in unprecedented surreal circumstances like these we are all trying to be problem solvers and make the best of the situation at hand. We are confident that together we will get through this together!
Stay Safe and Stay Healthy!