He won't do that at home!

While working in an outpatient rehab center, many of the parents expressed one concern. It was something along of the lines of, “My child does great with you here, but I can’t get him to do the same at home.” As an occupational therapist (OT), I understand very well the difference the environment makes in someone’s functional ability. 


Now, let’s compare the home environment and the clinic environment. 

  • Scenario 1: The child walks into the therapy room where there’s a table with 2 chairs, a trampoline, a swing, and a ball pit. He immediately goes for the swing and the OT follows the child’s lead and does gross motor activities (in combination with sensory integration) for the first half of the session. The second half of the session, the OT has the child sitting at the table working on handwriting and other fine motor activities. At the end of the session, the mom walks in and is very surprised to see the child sitting so nicely and following instructions. 

  • Scenario 2: The child gets home from school and his mom checks his backpack. She sets up the dining room table for homework time and tells him to work on his uppercase letters. Meanwhile, the older brother is watching TV and mom heads into the kitchen to start dinner. The child gets up and the mom tells him, for what feels like the one hundredth time, “Sit down and do your homework! Why is it that you sit so nicely in OT to work on your letters, but you won’t do it here?!?!”


As moms, we all know, there are always a billion things going on at home. The example above, implies that the child was distracted by what was going on the living room and in the kitchen; and probably many other things too. In the therapy room, there were other distractions too. I mean, a trampoline?!?! How fun is that?!?! Was the child able to work on handwriting with the OT simply because he got all the fun stuff ‘out of his system’? Should the mom at home, just let the child watch TV and cook dinner before doing his homework? Probably not, but we will discuss some possible solutions in another post. 

The bigger question in my mind at the time was, what exactly was happening in these children’s home. Did I need to do a home visit, to gain insight into the home environment? How would a parent feel about their child’s OT coming into their home? There had to be a better answer...


By connecting virtually with the families, I was better able to understand what exactly was going on in the home and provide more individualized solutions. Now, we take it a step further by completely eliminating the clinic environment and working directly in the child’s natural environment.


Telehealth sessions have many advantages. Here are some other situations that I encountered while working at the rehab center:

  • The waiting room experience - If you’ve even sat in a pediatric waiting room for more than 5 minutes, you know that many children will not sit still like we want them to. Now imagine a child with autism, who has sensory sensitivity to sounds (for example). The waiting room probably feels  as loud as the music at a night club. Telehealth eliminates the waiting room experience. 

  • The siblings - Parents with multiple children have to either find a babysitter while they go to therapy appointments or go through the frustrations of getting everyone in the car to drive the clinic. Telehealth eliminates both of these concerns.

  • The weather - Many families cancelled sessions due to rain. It can be challenging enough to go out with a child and then add inclement weather and that’s a recipe for disaster. There’s not need to cancel your appointments due to rain when you’re cozy inside your home connecting with your OT via telehealth. 


These are just a few examples of the benefits of telehealth. Connect with an OT online today!


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