OT from the tent: A creative space for teletherapy

by | May 27, 2020 | Blog

Today’s blog post is written by Lauri Adams. Lauri graduated from UCT in 2012, and completed her training in Ayres Sensory Integration in 2018.  She opened her private practice focusing on paediatrics and is based at various schools in Durban.  Today she shares her own experience of starting telehealth, and how necessity leads to wonderful creativity.

When lock down was announced we were lucky to have the opportunity to retreat to my fiance’s family farm. I was grateful for the comfort of open space, fresh air, the opportunity to exercise and we could truly enjoy special moments together as a family.

The move to the farm was not without complications, however. We now had to deal with diverse personalities under one roof and had to manage our different living habits. I had to juggle these trials with my other major challenge, which was taking the plunge into the world of telehealth. The concept of therapy using an online platform was completely alien and it took a lot of research and practice to get myself more comfortable with the idea.

Another major hurdle of life at the farm was the intrusion into each other’s work spaces. I needed to make an urgent yet resourceful plan. Ideas included: using bluetooth earphones, scheduling my online OT sessions at quieter times and escaping to the outside cottage. Sadly, through trial and error, these experiences did not work out, as I was not meeting the needs of the children and their families.

I put on my different OT hats to come up with a better solution. My key requirements for successful telehealth sessions were to have access to a stable internet connection, my own privacy and to provide a play space for the children where they felt safe and secure. Thus, the innovative idea of having a sensory tent in the garden was created.

My tent provided a great self-regulation tool for both me and children. As a therapist it helped to ensure confidentiality as well as reduce my exposure to external sensory input so that I could remain modulated, focused and “in tune” with the children’s needs. It also gave me with my own private space where I could dance, sing and be whole-heartedly connected to the children.

Subsequently, this enabled me to work successfully with the children so that I could guide and facilitate their functional performance and occupational engagement. More so, the children absolutely loved the idea of being provided a dedicated space that invoked a sense of peace and calm. This environment also enhanced their imagination and play experience. For some, it resembled the concept of a small, protective womb space, where they felt safe, contained and organized. This all nurtured their levels of comfort and willingness to participate in our sessions actively.

During this journey of telehealth, I began to explore more ways of providing calming sensory inputs. Firstly, I made sure that the lighting was low and that my voice was soft and reassuring within this space. I then advised the parents on ways of providing slow rocking motions to their child by tightly wrapping them up in a blanket and swinging them slowly from side to side (similar to the movement experience of a hammock).  Within the tent I included yoga mats, soft cushions, large bean bags, sheets, cardboard boxes and small chairs to encourage the children to be involved in pushing, pulling, climbing and crawling actions in order to attain further deep pressure inputs. There were also oral based resources (bubbles, straws, whistles) and tactile items (a shoe box containing soft sponges, stress balls, play dough and different textured homemade knitted animals which were filled with rice to add additional weight and calming inputs) that the child could request to open in times of need. These sensory experiences all contributed to organizing their bodies.

The tent has proved to be a very successful space for providing telehealth services. I have received positive feedback from the children and families as they truly saw the value of this form of therapy. Some parents even set up their own sensory tent for their child in the garden in order to model our safe space. It also allowed for parents to be more actively invested in their child’s development, growth and OT journey. This has empowered them to understand their child better and aided their relationship. It also helped to facilitate the functional carry-over of the child’s therapy goals within the home environment.

My online sessions have tended to follow a similar routine. This familiarity has allowed the children to feel more secure within our sessions. We often began with a check in activity, which included the zones of regulation. This was important so that the children could recognize and communicate their feelings in a safe and non-judgmental way. In turn, it aided their self-regulation and self-control. I then moved onto supporting their sensory systems in order to aid their modulation and motivation for the session. This often addressed vestibular, proprioceptive and tactile systems. These warm up activities also included brain exercises, movement breaks and sensory snacks, which helped to increase arousal levels, focus and organization. Thereafter, I targeted their underlying building blocks of development being postural control, visual tracking, bilateral integration and motor planning. After that, I worked on their key performance areas and occupational domains which where mostly in line with their school and home outcomes. This being: gross and fine motor skills, visual perceptual skills, activities of daily living, life skills, and performance in handwriting and reading.

The success of the telehealth has proven to be a surprise to many of the parents and even to me. Over half of my caseload is currently using this form of therapy with me. With the prospect of lock down persisting for the foreseeable future, I strongly advise any hesitant therapists and parents to give this a try. Telehealth has had a very positive impact in the lives of the children. It has helped to serve their sensory, behavioral, learning and emotional needs, especially during these uncertain times. I have really enjoyed this learning experience and look forward to connecting more with the children.

For those interested in my resources, below are the links and contacts:

If you have a creative way of doing teletherapy, or have something helpful, encouraging or new that you think we could share on our blog, please send your suggestion to saisi@uitweb.co.za.

 

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