You should always speak to the paitent prior to the meeting in order to offer a continuum of care with the use of remote therapy. 

If the family shows interest, they should be signed for agreement for remote therapy which will be sent to them. Since many families don't have access to printers at home and will have a hard time returning the forms, they should be given the option of verbally agreeing, and this should be documented in their file. 

If the family shows interest, a therapy meeting will be made. 

Remote therapy meeting:

On the agreed upon date and time, the Physiotherapist should contact the family after going over the child's file. The conversation should take place in a closed room, with no disturbances.  

Introduction:

First of all, remind the parents:

• The call isn't being recorded

• If relevant, a commitment form from the HMO should be sent 

• Try to organize the best possible environment for the call (rug/matress), and recommend a quite room if possible, and if necessary additional equipment (if needed in the prior session). 

Opening:

Ask about the child's general health and the family during these uncertain times. 

Shortened history:

• Ask for a report of how the child is doing in regard to the different developmental fields in which the treatment is focusing. 

• Ask to focus om motor abilities which are at the base of the need for physiotherapy.

Treatment:

• The physiotherapist should listen to the parent's description and their questions, ask guiding questions to fully understand the situation. According to the child's situation guidance should be provided. 

• In a video call ask to perform basic tasks which are appropriate for the child's developmental delay to assess the current status and progress from the previous session. 

• Guide the parents about daily activities and specific exercises they can do at home. 

• Follow the implementation of the instructions , and guide them where needed. 

• The guidance and exercises should be given according the child's status and progress. 

Conclusion:

• Make sure the parents understand the instructions and exerecises they have been given. 

• Make goals towards the next meeting.

• Tell the parents about relevant sources of information. We are working on a series of online visual tools which will be of use in guiding the common types of treatment , which can be sent to parents. 

• Ask for feedback about the treatment they have recieved, listen and learn from what the parents reply.

• Document the meeting in the medical file.

• Document in the office file, and make sure the commitment form and the agreement form are attached to the child's forms. 

• If the parents show interest in remote therapy, schedule a new appointment 

Nira Kravar, Director of Physical Therapy

Shlomit Nissim Gazit, Senior Physical Therapist and Clinical Instructor

Child Development Institute, Southern District Health Ministry, Beer Sheva