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How telemedicine helps children reach therapy goals

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Physical, occupational and speech therapy available

Many health care appointments have shifted to telehealth in recent weeks to promote safety during the coronavirus (COVID-19) pandemic. Children can benefit from telehealth, too. 

Here, Jessica Lynn, MS, OTR/L and Kristen Monroe, MS, CCC-SLP, of Children's Hospital of Richmond at VCU (CHoR),  explain how teletherapy appointments work and how it helps kids with physical, occupational and speech therapy needs.

What are the benefits of telehealth for physical, occupational and speech therapy appointments?

During this time when we’re unable to visit in-person, teletherapy enables families and therapists to continue making progress toward a child’s goals. It can also help your child reclaim a bit of normalcy and routine during an uncertain time. Engagement in familiar routines with people you trust is therapeutic in itself.  

Children are very accustomed to technology; some are even more engaged in teletherapy than in-person therapy because of their comfort with this mode of engagement. Another added benefit is that we can see children in their natural environment and provide you with ideas on how to use your own space and materials to carry over skills learned in the session.

As therapists, we miss our little friends and want them to know we’re still here for them and care about them.

Which therapy patients can benefit most from telehealth?

Most kids can benefit from teletherapy, although it may look different depending on their level of engagement and participation. Teletherapy isn’t a different type of therapy; it is a different way of receiving therapy.

Are there certain types of therapy appointments not available through telehealth?

Most of our therapy appointments can be conducted successfully via telehealth, but there are a few that require in-person visits. These include:

  • Visits consisting of manual therapy only (hands-on care involving joints and soft tissues)
  • Casting and splinting
  • Aquatic therapy
  • Alternative drive
  • Eye gaze
  • Feeding when child is at risk for choking or has a swallowing dysfunction

Each child has different needs. Some may benefit from having teletherapy visits weekly. Others might benefit from a combination of teletherapy and phone calls. Still others may benefit best from phone calls only. You and your therapist can discuss and decide which approach is best for you and your child.

What is the first appointment like?

The first appointment involves catching up and getting an update since your child was last seen. This might include discussing home programming that was previously provided during in-person therapy sessions and giving the therapist updated information regarding current performance and needs.

We understand that your child’s needs may have changed, so we want to collaborate with you to prioritize goals. We’ll also spend some time familiarizing you with the technology being used for teletherapy.

What types of activities can kids and parents expect during a telehealth visit?

Many of the activities will be similar to what we do in-person.

  • For physical therapy, this could be alternating between doing exercises and playing an interactive computer game.
     
  • In speech-language therapy, therapists can share their screen and allow your child to control the screen while playing a game to target speech sounds or language goals.
     
  • During occupational therapy, children may work with a therapist on brushing their teeth while standing in their own bathroom or complete a craft to address fine motor skills.

If your child would like to have some of their favorite toys or games ready to use, the therapist may be able to give you tips for using those toys to target therapy goals.

Is any special equipment needed?

Your therapist will provide a list of common household items that you’ll need for your session ahead of time. You won’t need to purchase anything special. It’s our job to be creative with what you have.

In terms of technology, you will need to have some way to make an audio/video call over Zoom. It is best if you can be hands free — such as with a laptop or by propping up your tablet or cell phone — so you can participate in the therapy session with your child.

Do you have any tips for parents to help make sure their child gets the most out of a telehealth visit?

  • Be present and use this as an opportunity to show what life looks like at home for your child. Please don’t worry about what your home looks like in the background. We are focused on your child.
     
  • Don't worry if your child doesn’t sit still or respond to what the therapist is doing. This is different for everyone and we will meet them where they are.
     
  • Make sure your computer or device is charged, and allow a few minutes to log in before the appointment. Have specified materials ready.
     
  • Look for ways to carry over learning after the therapy session ends. You are your child’s best therapist because you spend more time with him or her than anyone else.

Our telehealth page offers some additional tips for a great visit.

Are kids able to see their regular therapists and ask questions during the appointment?

In most cases children see their regular therapist. We want parents and kids to be active participants and feel comfortable providing input and asking questions.

How can parents help continue the progress made during telehealth therapy visits at home?

When prioritizing therapy goals to be addressed through telehealth, make sure you choose skills that are important and meaningful to you right now and will be realistic to address at home. What you prioritize now may be different from what you did before the pandemic. As always, frequent practice of emerging skills as well as incorporating mastered skills into daily routines are important parts of development and learning.

Life is very different right now and caregivers are expected to fill many new roles. Your therapist understands that and will help you find realistic ways to incorporate practice and exercises into your routine between sessions.

What are the challenges associated with virtual therapy appointments?

When using technology, we all have to expect the unexpected. We will work with you to address any technical issues that may arise.

Other challenges may include finding the time and space to have a private therapy appointment amongst all of the other obligations you now have. We understand that most families’ responsibilities and commitments have changed and will work with you to find a time that works for everybody.

What if a family decides they would prefer to continue in-person visits?

At this time, in-person visits are only available for patients with urgent needs. If teletherapy doesn’t work for your family, please make sure to communicate this with your therapist. We can still provide and update home programming via phone and/or email so you can continue working toward goals at your own pace. We’re here for your family and will do everything we can to support your child’s therapy needs and goals.

Learn more about our children's therapy

CHoR has the largest number of pediatric therapists in the region, all specially trained to care for kids. Learn about all of our therapy services, from assistive technology to sports therapy and everything in between.