Telepractice Challenges for Children with Significant Special Needs

Recently, I have heard many clinicians complain about having to work with a child with severe disability via telepractice. I have to confess, I once thought it impossible to conduct therapy this way, but it is working out better than I expected. Parents have been so kind to allow me into their homes. The idea of telepractice is easy when you have a child that does not have severe disability and can sit through the entire session without you having to jump up and down. My hat goes off to the parents that I have been zooming with for the last 3 weeks. We have had some good days and some bad days and through it all, most of the parents have remarkably stayed calm and are willing to work with me, despite all that they have to juggle on a daily basis. I can say I am thankful I stuck with it, because we are now finding things that work.

At the initial start, keep your goals simple, keep your energy high and take every moment as it comes. Make parents your partner, encourage one another and be consistent. Tune out the doubts and the noise around you and focus on what you want to accomplish with your client. Your therapy or teaching should not be any different,  except you have a new partner, someone who loves your client  beyond measures. It is an amazing opportunity for your clients to generalize skills quickly. When planning your lesson, keep in mind that the family may need to prepare things in advance, therefore, send your activities early.

This week I had such a fun time seeing clients use their AAC to play with siblings and also make sensory toys. Here is a fun activity that I used this week. How I did it: I sent the following instructions to the family 2 days prior to my lesson.

Dear Parent,

We are going to make therapy fun by making sensory bottles that your child can play with   during his schoolwork. During this activity, we will work with your child on the followings skills:

  • Following 1-2 part directions ( In, one, more and all)
  • Taking turns
  • Using AAC to make sentences and also to request turns.

Please  kindly assist me in getting the following items ready for our lesson.

  • 3 empty plastic water bottles and peel off the label (for each family member)
  • place 4 tablespoon of oil in a cup with a lid
  • food coloring (different colors)
  • Put 4 cups of water in a cup with a lid or 2 cups
  • 1 cup of dry beans (put in the bottle)
  • I sheet of foil ( to cut and put in the bottle)

Further Directions:

  • Put all of the above items in a big baking pan and put to the side that child cannot reach.
  • Make sure that we have nothing reachable at the work area, only the child’s sensory toy.
  • Next place our other toys in a clear box so child can request as needed.
  • I will guide you step by step.
  • While working, I will remind you when to his reward on his chart.
  • When he has earned 5 stars, he gets a 3 minutes break and it will allow us to cleanup and get ready for our next activity.

fun 2015-01-21 022Uduak (Udie) Osom holds a Bachelor’s and a Master’s degree in Speech and Language Pathology from San Jose State University. Udie has served students of all ability levels from preschool through grade 12, for over 20 years. She is very passionate about neuro-developmental disabilities and social-cognitive disabilities. She is the owner/director of Innovative Therapy Services, a pediatric speech, language and social skills clinic in Santa Clara, CA. She can be reached at

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