Teletherapy for the long haul

In Illinois, Early Intervention has finally put out guidelines to begin Face to Face therapy again. It's very limited as they say a therapist should only see 10 families face to face. Normally I would have seen 20 or more kids a week, so I would still need to do teletherapy too. Masks, gloves, changing clothes between houses, or wearing a gown or cover-up that can be changed between houses would be needed as well. There is a gray area if I'd need to provide masks for the clients as well. There would be a lot of upfront costs.

Since I am the one that cares for my family, and for my grandmother, I made the decision not to do Face to Face. So I'll be doing Teletherapy for the long haul. Now I need a desk which I'm getting this weekend. I can't be doing teletherapy from the couch or bed anymore. When I thought it was it was short term, it was ok. Now I really need to step it up.

I was on a Zoom call with therapists and got some good ideas to use in teletherapy. For kids that can be distracted by seeing you on the screen, you can have the caregiver put the device on a shelf or somewhere out of the kid's reach or view so the kid doesn't see the therapist. A shoe or egg carton can prop up the phone. Only the camera needs to be sticking out. The caregiver could wear earbuds so even the therapist's voice can't be a distraction either. The therapist can see what's going on and coach in a non-intrusive way. I have a niece in EI that can be shy with anyone of over video chat or someone she doesn't know that I think this could really work with.

Another suggestion was to only work on one strategy for each visit. Have the family write the strategy on the fridge to reference. Then they add a new strategy next week. Eventually, the family will have a list of strategies to use with the child. The therapist will have the same list and everyone can be on the same page. The downside to that is I feel like I have a list of strategies but I almost would need more to give them a new strategy each week. Although it is an idea I like and may help the family to feel more empowered. When we talk, talk, talk to them about what to do, we may throw too much at them to really comprehend. It may be overwhelming and some of them are drowning in enough with being stuck inside more and some worrying about how school will go in a few weeks.

I'm finding it a bit easier to do coaching with new families than with the families I had seen in person pre-COVID. New families kind of go with the flow, accept coaching more they don't really know anything else. The old families I had were used to me playing with the child so they seem to want me to entertain the child more over video. Even when I explain to them about coaching they seem to maybe feel weird about being on camera or something.

I do like that I feel like the families are getting more involved with therapy over teletherapy. They have no choice but to do the activities since I'm not in their home to directly do it. I realized maybe I was too hands-on when I was in the home. When/if I go back into homes I will try to be a little more hands-on and more coaching. I need to encourage the parents more, even if they are more stand-offish. If they can learn to play more and provide their child with a richer environment.

I'm excited about this new chapter. I even added a couple of news kids on my caseload. More and more families are going on teletherapy only so I can build my caseload back up. They are encouraging more teletherapy and less waiting it out for Face to Face. Now I can take kids from anywhere. So the kids in very rural areas will get services now. Nothing is going to be the same. Early Intervention is new and I'm thinking improved. I hope they keep teletherapy going, especially when more kids can get service with it.

As horrible as the pandemic has been and really hard. I think some positive will come from it as well. Forcing therapists to be more hands-off will give the families a better way to learn the strategies and empower them more to help their child. It's caused most people to slow down and spend more time with their families at home. It's given me the opportunity to do teletherapy and not put hundreds of miles on my car each week. I can be more productive not driving between houses, just clicking over to the next session. I can be more flexible for my families. Before I wouldn't have accepted an appointment at 4 pm. I want to be home to make dinner for my family and not be stuck in traffic at 5 o'clock. Now I can do it. I'm glad I can accommodate my families needs and still take care of my own family.

Let the fun begin!!