Teletherapy has been a valid form of treatment delivery for decades however it has never knock on our doors like it has in the past month. With the current pandemic many feel, that it “worth the try”. While others believe there is no way this will work. Providers have come to the teletherapy realm quickly to meet the current crisis providing school-based supports expected for children across the country. The same is true for many private therapists who are now reimbursed for teletherapy something that has been seen in only a select few states prior to COVID-19. To gaurantee that Teletherapy is right for your child you need to first ensure your provider has prepared themselves for distance delivery. Read ahead to discover questions to ask your provider and a proven method to eliminate caregiver concern and increase success. Secondly, you need to know what teletherapy might look like because let’s be honest the unknown is much scarier!
Step 1: This step is crucial for decreasing caregiver anxiety and increasing successful teletherapy sessions. Best of all, it's simple. Complete a 10-minute test connection at least 2 days before teletherapy starts with your child. This session should be one on one with your child's therapist. Your child does not need to attend this session but they may enjoy saying "hi!". This time will be used to tame your parental worries about connection, device compatibility and more. This is a great time to see your provider’s readiness and ask them questions about the program, treatment as well as the following crucial questions:
1. What modifications do you use during your session and how will you provide my child with the same modifications online?
Therapists use modifications all the time, physical proximity and environmental modifications are used to limit distractions, or provide a beginning and end to face to face session. Cue cards may be used such as, first then, stop or go. Communication or listening aids are often used. Distractions are limited in some way during therapy, so discuss a time of day when a caregiver can be present and home noises are at a minimum. Technological aids including volume boosters, heads sets and microphones may also be required. Time can also be modified while longer session in clinic may be possible, perhaps shorter sessions for teletherapy would be more appropriate. Visual timers are also used to encourage completion of sessions and provide children with a time frame of expected participation.
Therapists should be using the same modifications they use during face to face session to help your child be successful with teletherapy sessions. This is your time to make suggestions and tame your worries, so don’t be afraid to speak up. You are your child’s biggest advocate and you know your child best.
2. What type of interaction does the therapist want from you, or your child’s caregiver?
There are two main types of teletherapy delivery, coaching and direct therapy. Often a combination is used, however in teletherapy for children under two and sometimes older, the only appropriate type of therapy is coaching.
Coaching: Therapists who coach caregivers, will instruct the caregiver on what to do. Parents will need to set up a computer, phone or tablet angled to see a larger space where you can move and perform the activities your therapist suggests. This type of session will not require you to sit your child in front of a computer for the duration of the session however it will require 100% caregiver involvement. These sessions are especially useful for all children under three and a combination of direct therapy and coaching is often used for children under 5.
Direct therapy: Therapists who utilize direct therapy will have activities ready to target your child’s goals online through
the use of interactive games, visual and verbal cues. Most children will also need 100% caregiver support. Ask your child’s therapist to explain your role during the sessions. Some children may need a caregiver seated next to them for the entire duration. This should be discussed ahead of the session during the 10-minute test connection.
When sessions are completed with modifications and accommodations all children can be successful with teletherapy. However, you may find that the times, program, or demand in other areas of your life are too much. During this unprecendented time, decreasing family stress and increasing connection is a goal for every teacher and therapist around the word. When you find that teletherapy is too difficult for your family or your child it is okay to ask for modifications to treatment time, frequency or delivery method. Now is your time to communicate openly with your therapists and discuss these concerns. Remember we are all in this together, and we all want what is best for your child and your family.
Stay home and stay healthy!
Carma Shay MS CCC-SLP
Kenai, Alaska
Teletherapist and Independent Clinician