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  • Writer's pictureStacy Crouse

Providing Early Intervention In Teletherapy

It's the million dollar question: How do you provide early intervention in a teletherapy setting? You can't sit on the floor with the child. You can't play with toys with the child. You can't use the child's natural environment to facilitate speech and language... or can you?


Parent Coaching through Teletherapy

Initially, it can be very hard to visualize an early intervention session taking place through a screen. It might feel unnatural (and sometimes seemingly impossible) for very young children to attend to a therapist on the screen... and that's ok!


As SLPs working with very young children likely already know, coaching parents and caregivers is the way to go. Helping them model and facilitate language using everyday routines and play is still the most beneficial way to deliver early speech therapy intervention, even in a virtual setting.


A mother playing with her daughter during an early intervention teletherapy session

Older toddlers and preschoolers may be ready to engage with both the parent and the teletherapist in an early intervention session. See how the child responds and go from there. It's not failing if the child doesn't engage with you. What matters is that the parent is learning how to promote their child's speech and language development in the session and way beyond, too!


Structure of an Early Intervention Teletherapy Session

You may (or may not) be surprised to learn that the structure of an early intervention teletherapy session is not much different than that of most in-person early intervention sessions.


Plan the session (with the parent if possible).

Ahead of time, determine the activities and strategies that you'll use to work on the child's goals. Of course, the parent's input on the activities is very valuable. Ensure that they'll have available whatever materials will be needed for each activity.


Greet the parent and child and ask open-ended questions.

After a warm hello, ask the parent how things have been going at home. Listen to any concerns, follow-up on previous topics, celebrate their successes, and encourage them in all of their efforts.


Model and explain the activity.

Explain the purpose of the activity in terms of what the desired outcome is, how it relates to the parent's goals for the child, and why that's important. Demonstrate the activity by showing what it will look like, modeling language that can be used, and talking through the facilitation strategies that may be utilized to help the child be successful.


Coach the parent as they lead the activity.

Turn the activity over so that the parent is the primary facilitator. As they do the activity with the child, provide feedback to the parent. Examples include praising the parent for using a language elicitation strategy, offering some alternatives, pointing out the child's response, or brainstorming ways to modify the activity's demand or difficulty.


Discuss the next steps.

For each activity, talk with the parent about where the child is on the skill and the next steps in their progress. Some parents may benefit from specific ideas that they can continue to work with their child at home before the next session while others may be able to apply what they've learned more independently.


Early Intervention Activities for Teletherapy

When it comes to planning virtual early intervention, no activity is off the table... literally! From water play to sensory bins, it's all still possible in teletherapy. As long as the parent agrees to the activity (and has the means to provide it) and it's appropriate for the child, it can be a teletherapy activity in early intervention.


Toys and other Manipulatives

Kids aren't the only ones that get to play with their toys in teletherapy... you can too! Make the video feeds full screen so that you and the child/parent can see each other well. If you want to be super techy, use a document camera to show your toys. Otherwise, just hold them up to the webcam.


A few teletherapy activity ideas include:

  • Puppets and finger puppets

  • Colorful containers

  • Play-Doh

  • Bubbles

  • Stuffed animals

  • Baby dolls

An SLP using finger puppets in an early intervention teletherapy session

Clothing and Accessories

Wearing or bringing bright and colorful clothing and accessories can also draw students in, make them laugh, teach vocabulary, and spur lots of language about various topics. Some ideas include sunglasses, fun hats, masks, goggles, umbrellas, coats, gloves, bags, and jewelry.


Movement Games and Routines

Don't be afraid to get up and move! Your kids will love that too. Play finger plays and songs like Itsy Bitsy Spider, 5 Little Ducks, and Where is Thumbkin are still great activities for young children. Other traditional games like "so big" and "peek-a-boo" can be used by you or the parent. Hiding in and out of view on the screen makes it extra fun!


Activities on the Screen

Some kids may be able to participate in activities presented on the computer screen, at least for a bit. With young children, those activities need to be age-appropriate, engaging, and interactive.


Things that move

Images that move on the screen will draw kids' eyes to watching. Having control over the speed of that movement is very helpful, otherwise it tends to go way too fast for modeling and eliciting language.


Many Boom Card decks have bright, movable parts. In this nursery rhyme Boom Card deck, pictures can be moved around as the story is told. A child's communication attempts (gestural or vocal) can be reinforced by immediately moving the pictures.


A young girl and her mother doing a nursery rhyme Boom Card activity in a teletherapy session.

ABCYa has several simple "Make a" activities that incorporate movable pieces to digitally create things like a robot, pizza, or face.


Sounds and Music

Most young children love listening to sounds and music, so those are great elements to incorporate (if your platform allows you to share sound). Similar to the movable images, it's nice for the parent or SLP to be able to control the audio so that it can be started and stopped for language facilitation.


Of course, there are a million kid-friendly song and dance videos on YouTube (always preview first). Even if you can't share the audio through your teletherapy platform, you can still sing to create your own music.


This deck of Boom Cards includes 10 children's songs that you can sing (or play the built-in audio) as you move the bright images around the screen.


An early intervention music Boom Card activity for a telepractice session

Books

What kind of SLP would I be if I didn't mention books? Of course you can use physical books in your teletherapy sessions, but it's often easier for everyone to see if you present the pages on your screen. You can check out digital books from the library, buy your own e-books, or find book read-alouds on YouTube.


Green Screen Backgrounds

Real talk– I do not have experience with this one. BUT I have seen it work beautifully to engage young students. Having a bright background behind you that you can interact with opens itself up to a huge variety of fun and funny activities.


Benefits of Using Telepractice for Early Intervention

Now that we know how virtual early intervention can look, let's look at a few of the benefits that it offers.


Parent Involvement

As mentioned, the parent coaching aspect really puts parents in the driver's seat of their child's development– which is right where they should be. Involving parents improves carryover to other meaningful contexts throughout a child's day.


Access to Services

Teletherapy is a convenient alternative when distance or other travel factors are at play. For families in rural areas, teletherapy offers a way to access services that might not be available locally. For some parents, transportation difficulties could impede their ability to attend early intervention services.


Similarly, teletherapy allows children with significant medical needs to still receive early intervention without being exposed to common viruses that provides might unknowingly be carrying.


A Natural Setting

Early Intervention should take place in a child's natural environment, and it doesn't get more natural that the child's home! The child's everyday objects and routines can be easily utilized to ensure that therapy is relevant and individualized.


Tips for Early Intervention Teletherapy Sessions

  • Be animated and enthusiastic (but not too loud) to draw them in.

  • Use a large video feed layout so your face is bigger for them to see.

  • Ensure that your face is well-lit.

  • Assure parents that it's okay if the child is not able to remain seated and focused for the entire session, and that you can easily work around their need to get up and move.

  • Use your screen to share helpful visuals with the parent when you're explaining strategies or ideas.


Conducting early intervention through teletherapy can seem very foreign at first. SLPs may need to slightly modify their approach to putting an even greater emphasis on parent coaching than they normally do when working with very young children.


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