The COVID-19 pandemic forced many professions, including occupational therapy, to adapt rapidly to the virtual realm. School-based OTs, in particular, faced many challenges in delivering services remotely. Now, a few years later, it’s crucial to recognize the potential benefits and opportunities that school-based OT teletherapy brings even outside of an emergency context. Let’s explore the advantages, considerations, and strategies for implementing school-based OT teletherapy beyond the pandemic.
The Advantages of Teletherapy
While it was challenging to adapt quickly during the pandemic, it’s clear that teletherapy school-based OT does have some advantages. For example, having teletherapy as an option makes it much easier to overcome geographic limitations: Teletherapy breaks down location barriers, enabling therapists to reach students in rural or underserved areas. I’ve worked in many districts that have trouble recruiting school-based OTs because of their location, including ones that have gone without OT services for months at a time due to these challenges. Teletherapy ensures continuum of care for these vulnerable students.
For students who are homeschooled or enrolled in a virtual school, school-based OT teletherapy can reduce travel time and cost. Families can save time and money by eliminating the need for transportation to and from therapy sessions in person. It also can offer these families more flexibility with timing and scheduling.
Students who complete school at home also may feel more comfortable and at ease in this environment, leading to increased engagement and participation during teletherapy sessions. And you also have the opportunity for increased family engagement with these students, which can lead to better outcomes and carryover.
Lastly, teletherapy has advantages for school-based OTs as well. If you are looking to work from home, this can be a great option that still allows you to work clinically. If you are raising children of your own, or have medical conditions that make it challenging to work in person, the flexibility of working from home can be hard to beat. Plus, who doesn’t want to skip commuting between multiple school buildings each week?
Considerations for Implementing School-Based OT Teletherapy
Your first step in implementing a school-based OT teletherapy program should be to understand state and federal laws surrounding teletherapy. In particular, each state has its own laws and regulations regarding telehealth and teletherapy. Familiarize yourself with the legal requirements and guidelines specific to your state before beginning teletherapy services, even if you’re accepting a position that has been utilizing them for a while. It’s so important to take the onus on yourself to understand the laws that impact your practice so that you can protect your license.
Speaking of licenses, that is one legal piece that is really important to get right with teletherapy. While one of the benefits of teletherapy is that you can reach students who may be located hundreds of miles away from you, it’s important that you have the correct credentials to be able to see them. Typically, it’s not enough to have a license where you are physically located. Most states will require you to also have a license where any clients are located in order to provide any telehealth services.
Another crucial piece before starting school-based OT teletherapy services is making sure you have Informed consent. Obtain consent from parents or guardians for teletherapy services, providing clear information about the benefits, limitations, and potential risks associated with teletherapy.
Next, make sure that both you and your students have access to the technology and equipment you need to have successful teletherapy. A stable internet connection is essential for smooth teletherapy sessions. You should also ensure that students have access to devices compatible with the teletherapy platform. If your student is receiving services at home and doesn’t have these, the school may be able to step in to help by providing things like hot spots, laptops, webcams, etc. Your school should also provide a teletherapy platform that meets privacy and security standards, safeguarding student information.
Another thing to consider is the location of your student. School-based OT teletherapy can take many forms. Your student may be homeschooled, enrolled in a virtual program, or simply attending in person at a school that utilizes teletherapy. Each of these situations will mean your teletherapy and plan of care, in general, will look slightly different.
Documentation and record-keeping are also important considerations. Just like in-person services, you should maintain thorough documentation of teletherapy sessions, assessments, progress notes, and any modifications made to treatment plans.
Lastly, one consideration you should always make is if a student is appropriate for teletherapy. While teletherapy can be just as effective, if not more effective, than in-person OT, it’s not the right fit for all students. Keep this in mind as you get to know the students on your caseload. If it’s not working out, you should feel empowered to be transparent about this and advocate for getting the student access to in-person services.
Strategies for Effective School-Based OT Teletherapy
Being virtual doesn’t mean your collaborative efforts as a school-based OT should stop. In fact, it’s even more important to be in regular communication with educators. Collaborate with teachers to align therapy goals with academic objectives and provide support within the classroom setting, whether that’s at home or in person in a more traditional school. You are still providing school-based OT even if a student is being homeschooled, and it’s important to keep that boundary in mind.
One of the best strategies for making sure school-based OT teletherapy is effective is embracing a coaching model. Since you can’t be there in person to model skills or provide hands-on support, adopt a coaching model that emphasizes collaboration, skill-building, and independence, enabling students and families to take an active role in therapy. If your student is at home, a family member should be with them to help facilitate the session. If they’re at school, a paraprofessional should be available.
Without this support, it’s very challenging to provide OT virtually, as many of us discovered during the pandemic. But with the help, it can be truly amazing. I’ve had many students actually make more progress through teletherapy than in-person school because their families were so consistent with providing carryover. So, if you are working a teletherapy position, make sure you advocate for this and explain why it’s important. I would say the only exception to this is if you are working with an older student who can follow multi-step directions independently.
Another strategy is to use your virtual resources creatively. Leverage digital platforms, interactive websites, and virtual games to create engaging therapy activities. Alternatively, home-based interventions that can be incorporated into daily routines are good to work in as well.
When it comes time to assess students virtually, you have a few options. Definitely still complete observations, just digitally. Conduct observations during classroom activities via video conferencing to assess functional skills and offer guidance. Choose standardized assessment tools that you can complete virtually as well. Many common school-based OT assessments now provide instructions for completing them via distance learning, including mailing booklets and protocols in advance if necessary. Alternatively, you might be lucky enough to work with a COTA who is at the school in person and can help complete assessments and observations that you can synthesize into a written report.
Lastly, consider focusing your continuing education on teletherapy. It is definitely a different skill set than providing in-person services. Stay updated on emerging teletherapy practices, ethics, and legal requirements by participating in relevant professional development opportunities. Luckily, there are many more CEUs based on school-based OT teletherapy now than there were before the pandemic.
As we move beyond the pandemic, school-based OTs have the opportunity to embrace teletherapy as a valuable complement to in-person services. The advantages of accessibility, flexibility, and family engagement make teletherapy a viable option for reaching more students and providing comprehensive care. Being aware of relevant laws, ensuring access to the necessary technology, effectively utilizing in-person support, and addressing the unique needs of students in virtual learning settings are all important considerations for school-based OTs practicing teletherapy. By embracing these strategies, therapists can maximize the effectiveness and impact of teletherapy while ensuring compliance with legal and regulatory requirements. Ultimately, teletherapy has the potential to revolutionize school-based OT practice, offering flexibility, accessibility, and the ability to reach and empower more students than ever before.
And if you’re looking for more info on how to provide effective school-based OT, be sure to check out The Dynamic School OT Course. There’s a whole module on teletherapy along with content on intervention, assessment, and legal considerations of school-based practice. See you there soon!