There have been many questions in recent days about teletherapy and how to incorporate telemedicine into occupational therapy interventions. Today, I’m excited to share resources and information explaining what is teletherapy, strategies to help kids understand teletherapy (when they are used to their OT seeing them in the classroom or clinic…), what exactly teletherapy looks like, and more resources. Here are specific occupational therapy teletherapy activities for early intervention, kindergarten, early elementary, upper elementary, and middle school ages.
Broadly speaking, telemedicine (also known as telehealth) refers to the use of technological tools within medical treatment. This general definition includes computer programs that create home exercise programs (HEPs) for patients, shared portals for electronic medical records (EMRs), and secure messaging systems where patients can communicate with their therapists or healthcare providers. Telemedicine has now been used with a variety of populations, health disciplines, and diagnoses. Disciplines such as nursing, medicine, pharmacy, psychiatry, and psychology are all able to provide a variety of medical and mental health care for individuals without seeing them in person.
What is teletherapy?
When technology is used within the therapy world, these services are called teletherapy. Teletherapy involves therapists providing care virtually over a computer platform. Occupational therapists in particular are an integral part of the teletherapy movement, as these professionals can provide virtual care for pediatric, adult, and geriatric patients with a variety of physical and mental health conditions.
Here is an explanation of the various teletherapy platforms for occupational therapy services that may work for delivery.
Occupational therapists working with children in both school-based and outpatient settings can use telehealth to deliver many of the same treatments they would use during in-person treatments. These interventions include activities, exercises, and testing to help children who have difficulty in some of the following areas:
- 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 behaviors
- Playing or engaging in leisure activities
- Organizing, planning, and completing tasks
- Interacting or communicating with other children, adults, teachers, etc.
help children understand teletherapy
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 and difficult thing. 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, this change can be difficult to explain to children, especially children with disabilities. If children have received in-person therapy services before, 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.
For children who have no experience participating in any kind of therapy services, you can call the computer their “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, superheros, their favorite cartoon characters, sports, and more.
Parents, guardians, and teachers can explain to children that this type of therapy helps everyone learn and practice what they need. Many children particularly love hearing that they could be talking with a therapist from anywhere in the country, and parents can say that teletherapy is taking them to a whole new world with new and exciting experiences!
The success and ease of a child’s transition to teletherapy is often dependent on their prior experience with technology, specifically computers or tablets. Children who use these devices will likely have a more intuitive understanding of programs, since they probably have used some similar programs to play games or work on certain school assignments. Some 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).
Tips to make teletherapy easier for children and their families
Moving from in-person therapy services to teletherapy can be a difficult transition. If you are looking for tips on how to make teletherapy easier for children (and their families), read on.
Therapists and other healthcare professionals can test the computer programs and teletherapy platforms out with parents and children before they begin their first session. Some situations are time-sensitive, such as many children moving from in-person therapy to teletherapy due to sudden concerns surrounding coronavirus, and may not allow for this level of facilitation. However, this type of guidance will ease the implementation process and make all parties more comfortable with these types of therapy services.
Therapists should educate parents, guardians, and teachers about the 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. When using this computer, children should be stationed at an ergonomic workstation with a desk and chair that are the appropriate height for them. An appropriate height desk and chair will allow a child to sit up straight with their hips, knees, and feet at a 90° angle.
A child’s back and knees should both be flush with the back of the chair, and their feet should rest flat on the ground. If you do not have a chair that allows for this, you can place some books or a box under their feet to reduce strain.
Additionally, the computer screen should be eye-level to prevent them from craning their neck or using poor posture. Not only will these tips prevent a child from experiencing unnecessary injury or muscle aches, but this position also helps children to remain alert and attentive to focus on the task at hand.
Getting Started with teletherapy activities
Here are a few ways to help with the implementation of teletherapy:
Many children can benefit from teletherapy services, and most aspects of teletherapy are not all that different from traditional therapies. Children in both types of therapy complete evaluations, participate in games, activities, and tests, and receive feedback about the work they do. Teletherapy applications contain games to strengthen a child’s ability to see, write, learn, express emotion, communicate, behave in a socially appropriate manner, and more.
To start a teletherapy session, children will typically log in to a “school building” or something similar. Once in this building, children can enter various “rooms”, each representing places they can access such as, “homework”, “reports”, “therapist’s office ”, and more. Once children are ready to begin their session, they will access the therapist’s office and video chat rooms should pop up so they can see a small image of themselves and a similar image of their therapist.
Once the session begins, therapists may need to guide children to click certain buttons to engage with the program and play games. The focal point of the screen will be the games, tests, and lessons, but the screen may switch back to a larger image of the therapist throughout the session if they need to demonstrate something to the child or get their attention.
Similarly to the rest of the session, children will access their homework by entering a certain room. Much of their homework will resemble or be the same as some of the lessons they complete during therapy sessions. These lessons will be provided by the therapist, who determines skills that children must further develop through additional practice. Children will receive particular guidance if they are assigned new games or activities to complete for homework.
Using hands-on Activities in teletherapy
In the classroom or clinical settings, occupational therapists work with kids in hands-on activities. Moving to the virtual setting can be a big question for therapists who are wondering how to use manipulatives and hands-on activities in a virtual setting. Here are some strategies on how to work with manipulatives and activities during teletherapy. In other words, this is what teletherapy “looks like”:
Many children must get used to the absence of many of the arts and crafts supplies, handheld games, and other toys that they are used to using in traditional therapy. However, teletherapy is not entirely virtual. Many teletherapy sessions require some of these same objects to help strengthen a child’s fine motor skills and reach developmental milestones, such as manipulating scissors and drawing certain shapes. Here are specific ways to work on fine motor skills in teletherapy.
However, some children with disabilities or learning impairments may have difficulty accessing and using these objects (also called manipulatives) throughout therapy sessions. For this and other reasons, most schools or outpatient clinics have “e-helpers”. These e-helpers are usually teaching assistants or rehab aides, who are present to assist with tasks and manage technology as needed. These professionals play an integral role in facilitating the teletherapy process for children who may struggle with the transition or the implementation.
However, these e-helpers are not always present in schools or clinics that are understaffed or do not have the resources to assist with this step. In this case, additional resources are extremely helpful in preparing children for this sometimes new and overwhelming experience.
resources to help kids understand teletherapy
Amazon affiliate links are included below.
With the rise of telemedicine, there may soon be a day when all people are receiving medical services virtually. Until then, this concept may be difficult for some children to grasp, especially those living with disabilities and those who are accustomed to traditional school-based therapy or outpatient rehab. Thankfully, there are resources available to guide children through this process and learn skills that make them stronger and more confident.
Why is there a person in my computer? is a child’s guide to understanding what teletherapy is and how it can help with a variety of medical concerns. This story follows Andrew, a child with visual deficits who is having difficulty playing hockey, performing well in school, and working on his art. He meets a therapist named Brittany who guides him through his first teletherapy session, and he loves it! This picture book helps children understand what teletherapy is, what makes it different from other therapies, and how it can help them live better lives. Children may also enjoy the supplemental activity guide complete with coloring pages, fact sheets, and more!
This blog post was written by Brittany Ferri. Brittany is an occupational therapist, author, and teletherapy professional. She is passionate about education, health promotion, and disease prevention for all. Brittany currently practices in community-based teletherapy for two platforms, one that serves pediatrics (geared toward mental health diagnoses and developmental delays) and one that serves adults. For more information, visit her company’s website at www.simplicityofhealth.com