It is widely believed that pediatric physical therapy is all about being hands-on with your patient. However, telehealth can serve as an optimal tool in resolving many common problems that physical therapists, especially pediatric physical therapists, struggle with.
Telehealth is not a “therapy” in and of itself. Rather, it is a delivery method for therapeutic intervention, and it’s one that succeeds in ways that traditional therapy application cannot.
Change can be hard to embrace, but I believe that telehealth has a very relevant role in the therapy and medicine arena. Here, we’ll explore specific benefits and strategies to help you start reaping the rewards of telehealth with your pediatric patients.
The Benefits of Telehealth to the Pediatric Population
In addition to the general benefits of telehealth (convenience, on-demand, no travel, no exposure to illnesses, etc.), there are a few more that are especially helpful when working with pediatric patients.
Simplicity of scheduling
Those of us in pediatrics interact closely with the families and caregivers in children’s lives, which requires additional scheduling efforts to ensure everyone can be in the same place at the same time to discuss the care of the child. This kind of coordination can quickly become very complicated, particularly if the child’s health needs cause additional strain, whether that be logistical, emotional, or both.
Telehealth visits can be invaluable for a family experiencing challenging circumstances, as they can include everyone responsible for providing care to the child without the additional stress of travel coordination, balancing conflicting schedules, and any undue stress that may occur otherwise. Virtual visits can expand the child’s support system by allowing extended family, caregivers, additional practitioners, separated parents, educators, and others to sync up for the benefit of the child.
Investment from Families
Telehealth creates a unique opportunity for therapists to observe issues in real time and problem-solve with the family to come up with solutions. This collaborative approach offers space for therapists to “coach” the parents and caregivers by providing ways in which they can take a more active role in their child’s care.
Virtual care removes the therapists’ hands from the equation and enlists the help of the parents or caregivers’ hands instead. This gives them an opportunity to practice and get more comfortable with physically administering the exercises and activities during therapy, which translates to better competence and compliance throughout the rest of the day when the therapist is not present.
Observation of the Home Environment
Those who have provided care in any type of home health setting know that the information you can glean from seeing a pediatric patient’s home environment is instrumental in developing an appropriate and effective therapy plan. It is also true that children sometimes behave differently when someone outside the family is physically present.
With telehealth, children are more apt to act as they normally would. This lets us get a glimpse into daily life, seeing what the child’s typical positions are during movement and rest, their activities, and how their caregivers are handling them physically (i.e. body mechanics). Virtual visits also create the opportunity for therapists to see and problem-solve spatial issues in the bathroom, at the table, and in the bedroom. Online visits are a chance to be a fly on the wall!
Tips for Successful Transition to Telehealth in Pediatrics
Flexibility and the ability to “go with the flow” are essential for practicing with the pediatric population in any delivery method. Telehealth simply emphasizes the requirement for this skill. Issues will arise, and when they do, you must adjust your ideas to ultimately achieve what is important to the child and their family.
Rely on your observational skills as the basis of assessment and treatment. Assess the child and the parents through non-verbal cues to determine when breaks are needed. During the rest breaks, you can give gentle feedback, summarize, talk about what is coming up next, or get input from them on concerns or questions.
Have you ever felt in a rut or on autopilot when planning treatment sessions? I have! Telehealth can be an amazing outlet for creativity by removing the constraints of “traditional” plans of care.
Think outside the box when tailoring treatment sessions to the telehealth delivery method. Brainstorm new and fun ideas that will target your patient’s functional goals within their home setting. Collaborate via telehealth with other professionals participating in the child’s care to provide a more holistic approach to the therapy plan.
Prepare an Outline of the Session
Preparation is crucial to the delivery of virtual pediatric physical therapy sessions that are both fun and effective, and it is one aspect of telehealth that can make or break your virtual visit.
Having a well-thought-out game plan will streamline your session. While this doesn’t require a minute-by-minute itinerary, it does require a “skeleton” that includes:
- What you are going to focus on
- How that applies to the child’s goals
- What materials you and the parents or caregivers need
- A few ideas for what to work on before the next session
Communicate clear, concise instructions and expectations. This plan will give you confidence and a sense of calm that will transfer to the child and the family.
Summarize the Visit
Follow-up with a written summary of the session in a few short sentences, plus one or two key activities or homework items for them to focus on until the next session. Less is sometimes more!
Virtual delivery models require the parents/caregivers to take an active role in their child’s treatment, which can cause families to become overwhelmed and forget what you told them. A quick written reminder or clear visual can be a great way to ensure understanding and less pressure to remember everything at the same time.
Takeaways for Sticking with Pediatric Telehealth
Pediatric telehealth does require a unique approach to ensure successful treatment, but this should not be considered a deterrent. Instead, try viewing it as a challenge to grow as a therapist and professional. Is there going to be a learning curve? Yes! But once you get comfortable with moving to more of a coaching/teaching model, you will be able to push yourself to new levels in creativity and treatment.
Frequent self-reflection can help you evaluate the session: What went well? Where did challenges arise? How can you improve the session for better results next time? Telehealth requires a change of mindset for both the provider and the patient, but it is a valuable tool to add to our skill set. You may even find hidden strengths that you can leverage to provide even better care for your patients!
We are more than just our hands. Practicing pediatric physical therapy via telehealth opens new opportunities to convey the wealth of knowledge we have!
For additional guidance and strategies on the successful implementation of pediatric telehealth, MedBridge instructors Rubi Buxton and Jared Vagy offer a three-course series on pediatric telehealth that will improve your confidence in approaching the assessment and treatment of infant, toddler, and school-age populations.