Look, I know this whole situation we are in is weird. It’s hard to navigate personally and professionally. I’m not going to lie, the day before we started telehealth, I had a good cry and I was a bit panicked. It felt like the first day of my clinical fellowship year (CFY) all over again. I was feeling incompetent, anxious about the unknown, and just overall overwhelmed.
We’ve been doing telehealth for about three weeks now. Do I love it? Nope, I miss my kiddos. Do I hate it? Also nope. There are some aspects of telehealth I love and was not expecting to love.
Now, to preface all of this, I am a speech language pathologist (SLP) at an autism therapy center. The kiddos I see all have a diagnosis of autism spectrum disorder (ASD). They attend the therapy center either half or full day and I see them while they are in the clinic with their other therapists. They’re basically inpatient, if you want to make it simple. I go to their therapy rooms or they’re brought to me in the speech room and we do our speech or feeding therapy, then they go back to their therapy room. I rarely see parents, let alone get a chance to do therapy with a parent present.
So, sure telehealth isn’t my favorite. But it doesn’t have to suck. Stick with me here and I’ll share all the telehealth knowledge I have acquired in the past three weeks. Okay, please note the sarcasm. My telehealth knowledge is extremely limited and hardly worth sharing but my incessant need to find the positive in situations is something I definitely don’t mind sharing. I know, I know. Dani, cut to the chase. How can I make telehealth not suck? Glad you asked.
- Chill out with the plans. Look, you’re thrown off. Parents are thrown off. How do you think our kiddos feel? The smallest disruption in their routines can require some adjusting, so imagine how these kiddos must feel now that they’re home regularly and seeing us through a screen. It’s all new for all of us. So, chill the heck out with the plans. So often we have to adapt or toss out our plans anyways, so why would telehealth be any different? If anything, flexibility is even more important right now via telehealth. I always have a few YouTube videos pre-screened and pulled up on my browser, ready to use in case I need to. Don’t come for me, guys, but some of my sessions YouTube has been my primary material and reinforcement. Is it preferred? No, but it works more often than not so I have zero issues having a kiddo work on requesting “more” for a Blippi YouTube video (despite my absolute disdain for Blippi). So don’t be afraid to toss out the plans and embrace the natural situations that may arise during a telehealth session. (Great segue, Dani!)
- Go with what happens naturally. I would say about 50% of therapy with me is unstructured, specifically with my younger kiddos on the spectrum. If they are older, we’ll do table work, but if they’re younger I am all about unstructured therapy. The majority of my telehealth caseload consists of younger kiddos. I tell parents to take me where their child goes. Kiddo left the table? Pick up the laptop and off we go! Your normal routine at this time in the day is to run around the living room and decompress? Excellent, to the living room we go! There have been some beautiful language enriching opportunities that have come from just having a parent pick up whatever device I’m on and follow their child around. I will say this: I am constantly reminding parents this is what therapy would look like in the clinic. I will give them examples of what I do when we’re in the clinic, like jumping up and down or laying under the table like their child is. I also make sure I explain the why behind it. My favorite thing about this? Showing parents the ways in which they can encourage language development in every room in the house using whatever it is their child picks up.
- Coach, coach, coach. Model, model, model. Educate, educate, educate. Speechtherapypd.com hosted a fabulous webinar a few weeks ago. One of the clinicians who presented mentioned the parents are an extension of us. This has been everything. I will explain a therapeutic technique, model it, and then ask the parent to implement it. Truly, these parents have surprised me in the best way possible. I have loved seeing them just be completely on board and get out of their comfort zone. We have a fantastic opportunity to provide some extensive education for these parents and equip them with techniques they can use outside of therapy with us. If you’re not doing home visits, this can be hard! This is a great time to see kiddo and parent in their environment and show them how the most routine parts of their day can foster language development.
- Stay enthusiastic. We have an opportunity here to show our kids’ parents what we do with them. We can show them how loved and cared for and celebrated their child is when they’re in our sessions. Enthusiasm, especially for the smallest of things, goes so far with both our kiddos and their parents. This whole situation is uncertain and difficult and it’s hard to navigate. We all are feeling it. So being enthusiastic and excited despite the circumstances can speak volumes to our patients and their families. I can guarantee my neighbors are tired of hearing me screech, “Yay, buddy!” whenever a kiddo does something exciting. Be excited. Be enthusiastic. I promise you, it has the ability to create a ripple effect.
- Enjoy watching your kids’ parents during this time. I had a patient say “Mommy” for the first time during one of my recent teletherapy sessions. Watching this kid’s mom light up at the sound of “Mommy” was something I wouldn’t have seen otherwise. I watched a hesitant dad connect with his kid on a different level by just modeling for him a few strategies. Now that dad jumps right into our sessions, using therapeutic terms and telling me what strategies he’s using as he’s doing them.
- Set an end time. This is hard. Close the laptop. Set the phone down. Disconnect. This is harder to do when you’re working from home because nothing really changes. You aren’t leaving your office behind. It’s especially hard if you’re like me and you have a hard time stopping. If there are things to do, I feel like I have to do them and I have to do them NOW. It’s okay to turn the computer off and put the notes away. In fact, you should. Making sure there is something that is a transition away from work has been helpful. I take the dog for a walk at the end of my day or I change into my workout clothes if I am doing a PM workout. This helps me get out of work mode and into home mode, be it home workout mode or dog mom mode.
- Embrace it. Just embrace all of what comes with this, guys. Is it always going to be great? Nope. Guess what? That’s the way it is when we’re doing therapy in person, so why would our expectations be higher for telehealth? Embrace wearing sweatpants or yoga pants to work. Embrace the fact that Zoom will touch up your appearance for you so you don’t have to spend time doing makeup in the morning. My skin and eyelashes are thrilled to not have worn makeup in truly the past three weeks. Enjoy this time and quit trying to make perfection out of it. You know your stuff, it’s simply the delivery method that’s changing.
This is what has helped me figure out how to navigate telehealth in this weird time. Anybody else have any tips/tricks for others transitioning to teletherapy models?
Keep trucking along, fellow clinicians. You know your job and you know your stuff. We got this.