What is Teletherapy and is it effective?

An Examination of the Effectiveness of Online Occupational Therapy 
Tele-Therapy Services

Tele-therapy is remote delivery of therapeutic interventions. It can be provided to clients through various telecommunications technology such as video conferencing applications or a tele-therapy platform such as Valeo.

In comparison to face-to-face therapy the affordability and convenience of tele-therapy is a huge draw for most clients. However, effectiveness of online therapy is one of the major concerns that clients might have when deciding upon which modality to choose.

Valeo Therapy

Valeo provides engaging direct online therapy services for children in need of help. Highly trained therapists at Valeo work with parents and caregivers to support children cope with various difficulties and challenges.

Valeo provides therapists and clients with a video conferencing platform, designed specially to cater to the needs of children and parents working with speech-language, communication, occupational and mental-health related difficulties.

Occupational Therapy

Occupational therapy entails assessment and treatment of difficulties with motor skills, sensory processing and self-regulation. An occupational therapist uses specialised treatment plans and strategies to help clients develop, improve and maintain the skills needed for functioning independently in daily lives.

There might be many reasons why a child might be in need of occupational therapy such as delayed developmental milestones, difficulty with motor skills, sensory processing issues and emotional self-regulation.  

Effectiveness of Online Occupational Therapy

Tele-therapy has been successfully used to provide occupational therapy to children in various parts of the world. Various studies have been conducted to compare virtual provision of therapy to traditional face-to-face therapy and most of the evidence from research suggests that it is as effective as therapy provided in person. Not only is virtual therapy effective in achieving functional outcomes but it is also time and cost saving in comparison to other modalities. Research supports the use of Telehealth as a service delivery model in occupational therapy. (Kairy et al, 2009; Steel et al, 2011) Additionally in case of specific interventions and with some populations, tele-health may result in better outcomes than the traditional in-person services (Kinley et al., 2012; Taber-Doughty et al., 2010).

There is increasing evidence that many OT services are amenable to a tele-health service delivery model as it can improve access to occupational therapy services and prevent delays in receiving care. (Cason, 2014)

A cross-sectional study on the use of Telehealth for the Provision of Occupational Therapy explored whether occupational therapy practitioners (OTPs)  found it to be an effective service delivery model that should be a permanent option for providing occupational therapy services. Out of the 230 respondents, 176 (77%) supported tele-health as a substitute for in-person services while 179 (78%) supported tele-health as a permanent option for occupational therapy service delivery (Dahl-Popolizio et al., 2020)

In order to study the effectiveness of tele-health in occupational therapy for children under the age of 16 the satisfaction with tele-health services was evaluated. It was concluded that there is an adequate amount of evidence to support the use of tele-health in paediatric OT. (Zylstra, 2013)

Videoconferencing technologies designed for personal and professional use are being widely being used by people especially during the pandemic. As a result, caregivers and health-care providers are gaining awareness and knowledge of using technology for occupational therapy and tele-rehabilitation. As per research, increased awareness and personal use of videoconferencing technologies will likely lead to increased acceptance and willingness to explore these technologies for the delivery of occupational therapy services. According to Cason, tele-rehabilitation can be used to facilitate assessment, communication, collaboration, coaching, role-release, and coordination of care especially when it comes to early intervention in occupational therapy (Cason, 2011).

Virtual Assessment and Evaluations

Experienced occupational therapists usually design a comprehensive treatment plan after initial assessments and evaluations. Specialized occupational therapists use a variety of formal and informal assessment tools to obtain a comprehensive picture of a child’s occupational difficulties and delays.  

Following initial assessments and evaluations an OT selects appropriate targets for therapy and treatment strategies based on the intervention goals to be addressed during sessions. These assessments and evaluations can be carried out online with the same effectiveness as the traditional face-to-face assessments.

Hill et al. explored the feasibility and effectiveness of an Internet-based tele- rehabilitation application for the assessment of motor speech disorders. According to the study the online assessment of motor speech disorders using an Internet-based tele-rehabilitation system is feasible. It was suggested that with additional refinement of the technology reliable assessment of motor speech disorders over the Internet is possible. (Hill et al., 2006)

According to Schultheis & Rizzo virtual reality has the capacity to allow for creation and control of three-dimensional built environments. This allows virtual reality to offer evaluation and intervention options that are not even available with the traditional occupational therapy (Schultheis et al., 2002).

Virtual Treatment

As per research carried out by Clark et al. a comprehensive and a coordinated, tele-rehabilitation program can provide functional outcomes following a stroke. Services that require a two-way video-conferencing solution demonstrate promising results in providing adequate results. It was concluded that tele-health services can be used as an alternative or an adjunctive to traditional therapy services or can be the only option for the provision of occupational therapy.

A range of evidence indicates that interventions for a variety of conditions delivered by video conferencing platforms produce similar outcomes to treatment delivered in-person. According to a study by steel et al. levels of patient satisfaction with tele-rehabilitation are also very high and that the formation of a good therapeutic alliance with therapy using virtual platforms is possible.

The efficacy of using tele-health services for providing early intervention services has also been established. In a study by Kelso et al.  families receiving early intervention services in a rural program participated in a study to test the feasibility of receiving intervention services over the Internet with a two-way video conferencing system. Parents reported satisfaction with this method of delivering services in a child’s natural environment.

In a research that followed patients with complex feeding disorders that require specialised clinical management and occupational therapy. Half of the children were effectively treated via tele-health technologies and the other half required more intensive care via admission to the in-patient program. Children using tele-health experienced cost savings, as well as less significant disruptions. Both parents and health-providers expressed a high level of satisfaction with tele-health use for therapy. Improved skill and confidence as a result of consultation with the specialists was reported by the health-providers (Clawson et al., 2008).

Conclusion

Advancements in videoconferencing and networking technologies in the current times presents us with opportunities to deliver different services to people in the comfort of their homes. Tele-therapy is a great way to provide occupational therapy services to patients at home or at school with greater ease and effectiveness. Research conducted to assess the effectiveness of virtual therapy services have shown promising results in favour of such delivery models for occupational therapy.

Valeo is such a platform designed by therapists to make your lives easier as it promises to provide quality occupational therapy to your children through interactive and engaging video-conferencing platforms in the comfort of your homes.

References:
  1. Cason, J. (2011). Telerehabilitation: An Adjunct Service Delivery Model for Early Intervention Services. International Journal Of Telerehabilitation, 3(1). https://doi.org/10.5195/ijt.2011.6071
  2. Cason, J. (2014). Telehealth: A Rapidly Developing Service Delivery Model for Occupational Therapy. International Journal Of Telerehabilitation, 6(1), 29-36. https://doi.org/10.5195/ijt.2014.6148
  3. Dahl-Popolizio, S., Carpenter, H., Coronado, M., Popolizio, N., & Swanson, C. (2020). Telehealth for the Provision of Occupational Therapy: Reflections on Experiences During the COVID-19 Pandemic. International Journal Of Telerehabilitation, 12(2), 77-92. https://doi.org/10.5195/ijt.2020.6328
  4. Hill, A., Theodoros, D., Russell, T., Cahill, L., Ward, E., & Clark, K. (2006). An Internet-Based Telerehabilitation System for the Assessment of Motor Speech Disorders: A Pilot Study. American Journal Of Speech-Language Pathology, 15(1), 45-56. https://doi.org/10.1044/1058-0360(2006/006)
  5. Kairy, D., Lehoux, P., Vincent, C., & Visintin, M. (2009). A systematic review of clinical outcomes, clinical process, healthcare utilization and costs associated with telerehabilitation. Disability And Rehabilitation, 31(6), 427-447. https://doi.org/10.1080/09638280802062553
  6. Kinley, A., Zibrik, L., Cordeiro, J., Ho, K., & Lauscher, H. (2012). TeleHealth for Mental Health and Substance Use: Literature review. BC Ministry Of Health, Mental Health And Substance Use (MHSU) Branch. Retrieved 9 February 2021, from https://med-fom-ehealth-office.sites.olt.ubc.ca/files/2013/04/TeleMental-Health-Literature-Review-FINAL.pdf.
  7. Schultheis, M., Himelstein, J., & Rizzo, A. (2002). Virtual Reality and Neuropsychology. Journal Of Head Trauma Rehabilitation, 17(5), 378-394. https://doi.org/10.1097/00001199-200210000-00002
  8. Steel, K., Cox, D., & Garry, H. (2011). Therapeutic videoconferencing interventions for the treatment of long-term conditions. Journal Of Telemedicine And Telecare, 17(3), 109-117. https://doi.org/10.1258/jtt.2010.100318
  9. Taber-Doughty, T., Shurr, J., Brewer, J., & Kubik, S. (2010). Standard care and telecare services: comparing the effectiveness of two service systems with consumers with intellectual disabilities. Journal Of Intellectual Disability Research, 54(9), 843-859. https://doi.org/10.1111/j.1365-2788.2010.01314.x
  10. Zylstra, S. (2013). Evidence for the Use of Telehealth in Paediatric Occupational Therapy. Journal Of Occupational Therapy, Schools, & Early Intervention, 6(4), 326-355. https://doi.org/10.1080/19411243.2013.860765