Remote speech therapy
Treatment Goals:
Explaining "professional terms" which are in the medical reports that parents have recieved.
Providing information and answering questions that arise from going through the reports on the child's functioning.
Choosing 2 to 3 specific language/ communication goals that the child can work on at home.
Providing oral as well as written theoretical explanations including examples and illustrations in regards to the best ways to promote the goals.
Target population for remote therapy:
The treatment process is for parents who's children have recieved a diagnosis of :
ASD
Developmental delay including delay in language
Language developmental delay, including speech impediments such as a Dyspraxia
The treatment will focus on families who have recieved a prognosis in the past few months (from January 2020) and are in the first steps of processing the news, and who still don't have therapeutic and educational help in the community.
Remote therapy protocol:
The therapist should contact the family by phone according to the list of all the children who have recieved a diagnoses in the mentioned time, and ask if they are interested in remote therapy.
If the family shows interest, they must sign an agreement form for remote therapy which will be mailed to them (an option of signing electronicaly should be checked). Since many families don't have access to printers and will have a difficult time mailing the forms back, familes should be provided the option to verbally confirm , and this should be documented in the file.
Explain to the family that the meeting will only take place with a commitment form from the HMO to the institute. Since this will take place according to the Ministry of Health guidlines, if a commitment form isn't sent, the meeting should be documented. Afterwards, the topic will be brought up with the HMO.
If the family does indeed show interest, try to make specific times and dates - a fixed time and day when the therapy meeting will take place. Try to fix a time that will work for both the family and the therapist - seeing as some kids aren't in their regular education frameworks. Try to be flexible under and understand the circumstances.
The meeting should take place in a closed room, with as little disturbances as possible.
On the initial phone call, when the time and date of the meeting is fixed, parents should be asked to go over the language report and the full report which they recieved in the diagnostic meeting , and highlight for themselves the following in perperation for the meeting:
Unclear terms
Questions about what is written in the forms
Other questions regarding their child's language on a daily basis
Other questions regarding their child's social-communication behaviour on a daily basis.
Remote therapy:
Opening - Reference the language report- Go over the child's functioning and explain the findings from the report, while answering the parents questions. Depending on the parents preferences, you can read the report word by word or only go over the parents questions.
Afterwards - Reference the full report (if the child has been diagnosed with ASD, also reference the "ADOS-2" diagnoses if relevant). Explain the information in the report in the same way, while allowing parents to ask questions throughout.
The next step is choosing therapy goals which are important to the parents for daily activity and functioning.
After choosing the goals to promote at home, the therapist will elaborate on promotion strategies which are relevant for the selected goals, and how to use these strategies at home.
Parents will be directed to video themselves interacting with their child as much as possible so these videos can be used during the therpay sessions.
The guidance will be over 12 telephone/video meetings (at least)
Each meeting lasts 45 minutes
First meeting - Reading the reports, explaining professional terms, answering questions.
Second meeting - Providing multiple options of a "goal bank" in relevant fields for the child and choosing 2-3 intervention goals at home - according to the parents preferences - mediated by the therapist and according to the child's developmental stage and functioning level.
Third meeting - Sending information to the parents prior to the meeting, so that during the session they have theoretical and written explanations in front of their eyes, to make it easier for them to follow what the therapist is talking about. During the meeting explanations will be given, as well as illustrations for the information which has been sent to the parents. In addition, parents will also recieve prior to the meeting illustrative materials according to the goals and the child's functioning level, and in accordance with the discretion of the clinician. For example: if the chosen goal is increasing collaboration in transitions between activities and increasing responsiveness to others : one qay to achieve this is creating a clear daily agenda. Send parents pictures of different activities which they can use to create a daily agenda together with their child. Another example: Language expansion: Using specific verbs : Send parents pictures of verbs, pictures of relevant applications, a list of relevant games, etc.
After the initial three meeting - follow up - Parents should share with you - have they tried? Have they succeeded? What didn't work? Where were the hardships? What did the child like - and what didn't they like? What worked and what didn't work? The clinician should provide guidance according to what comes up in these meetings.
During the follow up calls you can always update the goals accoring the progress the child is making - if a chosen goal has been achieved you can guide the parents on what the next step is in accorance with the normal development stages. You can also change goals which are inappropriate or that the parents are having a hard time working on. You can go over videos that the parents send you can give personlized feedback from the therapist about the manner of mediation, and what the parents are doing right and things they should be doing differently.