In response to the COVID-19 pandemic, in Spring 2020 OTA the Koomar Center (OTA), developed a novel program to deliver Sensory Integration occupational therapy (SI-OT) and speech and language pathology (SLP) services via telehealth. This telehealth model uses a multi-faceted approach to intervention and includes direct intervention, observation, consultation, education, and coaching to collaborate with families to meet their individual needs and goals. As the clinic was unaware of any research on the provision of SI-OT via telehealth, OTA conducted a program review to examine if this model could meet four program goals.
Information was compiled from clinical statistics, record review of a small number of intervention sessions, comments from parents in response to an anonymous survey on possible clinic reopening, and an anonymous survey completed by all OTs providing telehealth services.
Goal 1: Continue to provide quality intervention and support to clients and families
Therapists and parents both perceived SI-OT services provided via telehealth as a worthwhile service to provide when in-person services are not available. During the initial 13 weeks that telehealth services were offered 73% of clients who engaged in telehealth services participated in six or more sessions (mean = 9.5). Therapists overwhelmingly agreed that providing SI-OT via telehealth was appropriate., As one OT commented “… Parents are making incredible leaps in their understanding of their children, their children’s needs, and how to be more playful, empathetic, and understanding of their child’s internal experience. Many of them are learning to set better boundaries and are really embracing who their child is. They are learning how to set a just right challenge, how to build in lots of verbal/auditory supports, and how to focus on their child’s strengths and success …”.One parent of a client receiving telehealth services commented “…we were skeptical at first that this could work, but [therapist] has REALLY been miraculous and inventive at engaging him in play and sensory activities and in modeling for him and us what he can do. We are so grateful–it is really the thing making the biggest difference for us in these hard days.”
Goal 2: Maintain and build on relationships
A large majority of therapists believe their relationships with families have improved since beginning telehealth sessions and report overall greater engagement with families when they provide telehealth services in comparison to typical in-person services. When asked about family engagement, one OT commented “Increased family engagement – parents who were unable to bring their children into the clinic for work are able to engage in sessions at home. Able to explain rationale behind therapeutic activities in “real time.” “
Goal 3: Prevent regression
Almost all therapists reported the ability to target previously written goal attainment scaling (GAS) goals through telehealth in addition to goals that a client could not access in the clinic. The majority of therapists reported a slight improvement in overall client goals during this period. One parent commented “OT tele-health sessions with (therapist name) have been very successful. She is full of ideas and ensured that we continue making progress in this tough situation.” One OT reported, “Significant increase in carry-over, parent empowerment, independence in creating new ideas from both child and parents.”
Goal 4: Build on what the family was currently doing to support engagement, participation and communication in everyday tasks and activities.
Working directly in the home environment through telehealth has allowed for family members to actively facilitate and participate in the telehealth session. This experience allows them to practice therapist recommendations with supervision, making it more feasible to replicate the recommendation independently in their daily lives. One parent reflected, “I actually think that telehealth is a wonderful opportunity for us parents to learn how to help our children better and what a sensory diet actually entails.” A therapist commented “I have 3 families whose parents are extremely involved in their telehealth sessions and the parents are making incredible leaps in their understanding of their children, their children’s needs, and how to be more playful, empathetic, and understanding of their child’s internal experience. Many of them are learning to set better boundaries and are really embracing who their child is.”
This program review indicates that OTA the Koomar Center’s SI-OT telehealth program achieved the four goals established during program development, suggesting that telehealth is a feasible, acceptable, and effective SI-OT service delivery model.