Telehealth Occupational Therapy - Explaining what it is and my journey begins!

It has been a week of stepping out of my comfort zone and trying lots of things for the first time!

Did you see my first You-tube video? Have a look at how to encourage fine motor skill development using clothespins ie. pegs in Australia or Mandal in Turkish  (thanks @babaterapist on IG).----> Fine Motor Skill Development Using Clothespins You-Tube.

(My children are  partly-horrified and partly-proud that their mama is now a "You-Tuber" !) 

I'm also new to Telehealth Occupational Therapy and the sessions that I have had this week have been so much fun!

Whilst I'm new to Telehealth (or teletherapy), Telehealth is not new.  It has been widely used especially in rural and remote regions. The World Federation of Occupational Therapists released a position statement in 2014 which includes the following: 

Telehealth is the use of information and communication technologies (ICT) to deliver health-related services when the provider and client are in different physical locations. Telehealth may be used for evaluation, intervention, monitoring, supervision, and consultation (between remote therapist, client, and/or local health-care provider) as permitted by jurisdictional, institutional, and professional regulations and policies governing the practice of occupational therapy.
 
Telehealth is an appropriate delivery model for occupational therapy services when in-person services are not possible, practical, or optimal for delivering care and/or when service delivery via telehealth is mutually acceptable to the client and provider.

(World Federation of Occupational Therapists, 2014 Telehealth Position Statement). 

Put simply, Telehealth is a way for occupational therapists to use an online platform to deliver occupational therapy services.  Telehealth is a service delivery method.  You still get an OT on the end of the video call who provides clinical observations, assessment, advice, support, encouragement and applies their problem solving skills to assist your child to perform their activities of daily living. In fact Telehealth may be a video call with direct interaction with the child, it may be a phone conversation with a parent, it may be a parent sending through photos/videos for discussion with their therapist... there are lots of options. 

​Yes there may be more involvement with a parent or caregiver during Telehealth sessions. I see this as a good thing that families are engaged in applying therapy in the home. This is what OTs always encourage even when a child is being seen face to face.  There is little vantage if a child can learn skills when with their OT and then not carry it over into any other situation.   "Parent coaching" is something that OTs have always encouraged! 

Here are a few more detailed explanations and resources of Telehealth services:

• Move and Play Paediatric therapy - "What is Telehealth, and why should I consider if for my child?
• American OT Association - Telehealth Resources
• Parent Perspectives of Occupational Telehealth Intervention
• OT Toolbox - Telehealth platforms
• OT Toolbox - Telehealth activities for OT
• Your Therapy Source -  Occupational Therapy Teletherapy and  other related services.
• ​OT School House - Telehealth Podcast

Australian OT friends, you may be interested in :

• Karen Finnin (Physiotherapist) shares a wealth of information and experience on her website and through her FB group on practising telehealth in Australia. Here are some great articles to get started "How to get started with Telehealth" and "Data Security in Digital Practice". 

There are number of people who are also promoting webinars explaining Telehealth to therapists as well as as number of FB groups popping up! I'll leave it to your discretion to find one that suits you but always check your local registration requirements, insurance and practice standards. 

For parents,  here are a few you-tube videos (not mine) that show you some session examples: 

• Enable my child - OT telehealth session
• Presence Learning - OT telehealth session
• The Stepping Stones Work - Sample OT telehealth session

Sessions will look different for each child and each individual therapist will have their own "spin" on how they present things. 

I will be blogging my journey into Telehealth services and sharing what works for me and what doesn't! 

​I'm using "Coviu"as my Telehealth Platform and this meets data encryption requirements for Australia. Families join via a link (like a telephone number) and do not need to download an app.  Things I'm loving so far with this platform include the interactive whiteboard feature and the ability to share my screen or file (which then lets us jointly edit whatever I have shared). Some OTs have mentioned that they are using Telehealth on a tablet that allows them to write directly on the whiteboard and/or asking their families to do the same.   Connectivity has been variable and I can't control that as it depends on the client's internet connection.

I have a basic plan with Coviu so I can't speak about other features like waiting room music, multiple therapists, managing appointment bookings and recording sessions. I know that Coviu has the capability to do these things as well as being compatible with practice management software.  If you are interested in exploring this Telehealth Platform, I would suggest doing their free online webinar.  If you sign up to Coviu, I would appreciate it if you use my referral code: qt9v87. Thanks! 

This is how I've set up my Telehealth sessions. (Ignore my old desktop monitor and keyboard which I keep because it has some functions that my laptop does not).  I have raised my laptop on a monitor stand. I use a selfie light (purchased a long time ago on e-bay) to hold my phone and provide extra lighting if needed. I have my resources ready on my desk but out of view of the camera. I can adjust the laptop screen so that it can see the resources where I have the flashcards (Learning Without Tears cards). 

The children whom I'm seeing via Telehealth services are all children whom I have worked with for a long time. I think that this helps straight away as I have rapport and respect from them which has been built up over time.  

My first tips for starting Teleheath for OTs:

• Check registration standards in your state and country. 
• Check your insurance covers Telehealth services. 
• Make sure your device is raised up from your table so that the camera is at eye-level.  You want to be looking straight at the camera rather than down. 
• Play with the angles of your device so that your clients can see your face , your hands, your writing surface or your whole body as needed.
• Make sure you are well-lit with either natural or artificial light. 
• Practice with colleagues or family members. 
• Have your phone handy in case you need to contact families. This is new for most families so they may need a text reminder or another link sent so that they make the appointment. 
• Get organised! I sent out information packs to help inform families about Telehealth. This pack also includes asking families what items they might have at home which may be suitable for OT sessions. I've looked through my own resources to see what might be used and purchased some additional resources (I will share more about activities that I have tried in a future blog). ​

Whilst many of us are venturing into this new online world with some gusto, Telehealth services will not suit all families and all children.  That's ok too.  In a world without COVID-19, Telehealth would be offered in conjunction with other service delivery models including face-to-face occupational therapy.  It is a time of heightened anxiety, lots of unknown, families trying to juggle multiple concerns such as work, home schooling and health....for some Telehealth will provide a lifeline of support via their occupational therapist and for others it will be too overwhelming.  Some of my OT families have elected to have individualized home programs for their children.  This is a great way to implement therapy at home also!

Have you ventured into Telehealth for the first time as a therapist or parent? Let me know your experience with Telehealth!  How have you set up your work station?  What are your top tips for those starting out?  

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​Cindy is a registered occupational therapist practising in Sydney, Australia.  She has two growing children who are a constant source of inspiration and learning.  Cindy loves working creatively to help children to reach their potential, finding opportunities in everyday living and making learning fun. She is also addicted to making printables (even when they take a long time to complete).  Cindy is the author of the Occupational Therapy website and blog  Your Kids OT and Sensory Diet Activity Guidebook (ebook).  

Cindy is a member of the Functional Skills for Kids Therapy Team.  They have together published THE HANDWRITING BOOK, THE SCISSORS SKILLS BOOK and THE TOILETING BOOK.

​The information on this site is general in nature. The activities are safe for most children, however, you should consult an Occupational Therapist or health professional to address specific movement, sensory or other medical conditions. Affiliate links are used throughout this website to promote products I love and recommend. I receive a commission if any purchases are made through these links. Please see my disclosure policy for more details.

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