End of 2018....

     We all have great plans, and then bam life.  In 2018, I had planned to increase my writing and to provide more content for people on a number of topics.  Wow... That plan was an EPIC fail.  Though, this year has brought a number of challenges that I expected and many that I did not. 

      As an update, I did graduate from UTPB, with a masters degree in Special Education.   I did start a EdD program.  My family and I did survive one of the worst Typhoons, #Yutu, in history.  So while this year was lacking in blog posts, it was not without adventure and challenges.  This blog may have taken a back seat to a Masters, EdD and a typhoon, it is a work in progress.

Here are some photos of just after the storm.  As of this writing, my apartment is still without power and water.  We are close to 60 days.  Life continues.

Adventures in Online Occupational Therapy by Alison Durocher

**** Editors Note- Alison Durocher is a featured contributor to Texhoma Teacher and a
Professional Occupational Therapist with experience working with people in person and online.
Texhoma Teacher appreciates her contributions to the blog as they provide a different perspective.
Her articles are being published under this username until I can figure out how to move it
directly to a username of her own. This article will be updated when that change occurs. ****

My career as an Occupational Therapist has been one of constant transition. The nature of my spouse’s work means that we relocate about every 2 years. This translates to many, many different positions for me. I have worked in hospitals with multi-disciplinary teams, in schools and in homes. I have worked in urban settings and rural settings, from the largest city in Canada to a town of 15,000, three-and-a-half hours from civilization. I have worked where there are almost 100 OTs to where there are 4. Recently, I even volunteered in India for several months to experience occupational therapy outside of North America. As you can imagine, starting over every time becomes exhausting after a while. So, when I saw an opportunity to provide Occupational Therapy services online, I figured I needed to check it out! Occupational therapy services online… How does that work, you say? Well, I had no idea either! And so this year I began my adventure! As with any job, there are aspects I love and aspects that are very frustrating. So here’s my summary of ‘the good, the bad, and the ugly’!

The Good
As an online therapist, I get to work from anywhere! As long as I have a good Internet connection, I can work. It allows me to maintain the same caseload of schools, no matter where in the world I am living or traveling.

It allows for consistent service to rural and remote areas that might not otherwise have regular access to speech and occupational therapy services. As long as the school has a decent computer and a DSL connection, we can make it work! Some students respond very well to having their therapist on the computer. For students with autism spectrum disorder (ASD), we know that they often respond better to an image on a screen, than to a person in the same room.

Online therapy also allows me to easily show videos, play interactive games, and record parts of sessions to show parents and teachers later.

The Bad (The less good?)
As I am not physically present in the school, it is more challenging to develop rapport and relationships with the students and staff. I also must rely on school staff to print out worksheets and assessments and have materials ready for my sessions. This is more work for the staff than if I was there in person. Of course, some creative teachers have given me access to their networked printers, which allows me to print materials from my house to their printers! Very cool stuff!

Because I cannot provide hand-over-hand support, I have to rely on the aides (eHelpers) to provide additional support and modeling. This is an exercise in ‘brain gymnastics’ for me. I have never had to talk someone through assisting a child with fine motor tasks, without being able to model directly with the child. While my directions seem very clear to me, apparently they can be open for interpretation! If nothing else, OTs are experts in task analysis, so sometimes I just have to take a step back and start from the beginning, this time explaining it differently.

The Ugly
Online therapy or telepractice, relies on technology. It’s great when it works, but it’s frustrating when it doesn’t. Sometimes connections are slow, or the child moves out of the view of the webcam, or the webcam freezes, or the headset stops working, or my favorite… There is an Internet outage in my city or theirs! Of course, many of these technical issues can be resolved and you become more proficient at troubleshooting as time goes on. But that doesn’t mean that you won’t sometimes be rolling out theraputty with the child and have to ask the eHelper to describe what the child is doing, because their video is frozen.


Final Thoughts
Overall, I would still rather be practicing in person, but when that is not possible online therapy is a good alternative. Ideally, I would teleport myself to all of the locations on my caseload, but technology isn’t quite there yet… and I don’t really want to find out what a teleportation glitch looks like! When everything is working smoothly and I have an attentive eHelper, it doesn’t feel that different than practicing in person. When the teacher steps out of the room for a minute and the child decides to hide under the desk… that’s when we have to get creative! It’s an adventure for sure, but a rewarding one. As technology improves, it’s an option that will only get better and better. Having seen firsthand the lack of service available to some remote and rural communities, I am very hopeful that online therapy becomes a more popular option.


So, what do you think? Do you want to come on the adventure with me?