Teletherapy in early intervention looks very similar to providing services in person, with teletherapy typically having more emphasis on parent involvement and parent coaching. It is a MUST that a parent/caregiver be present in order to best support the child when providing teletherapy in early intervention. Not only do young children often require support and guidance from an adult, but parent involvement is key in order to see an increased generalization of the child’s goals within activities of daily living. So how do we best support parents during therapy sessions in order to see more generalization of skills?
Parent Coaching: Steps You Can Take To Best Support Parents
Parent coaching is a very important part within early intervention teletherapy in order to best support our clients. There are many different techniques and ways of interacting with children that do not come as natural to parents; being able to provide education by illustrating various strategies and techniques will allow parents to be able to execute those strategies independently.
According to The Hanen Center, there are four efficient steps clinicians may take in order to best approach parent coaching in therapy sessions (McGill, 2020). These core steps include:
1. Getting the parent ready for learning: (McGill, 2020)
Providing parents with reading or video material prior to evaluations or treatment sessions will allow them to prepare and increase their understanding of the child’s goals. This step will not only help prepare parents but will also help you to prepare for your sessions and recognize questions parents may have prior to therapy sessions. Also, discussing goals with parents prior to treatment sessions is extremely beneficial. Following the evaluation, be sure to go over the child’s goals with the parents. You may even collaborate with parents in order to form goals together in order to form more functional goals for the child. Discussing goals with parents will help them understand what you are doing within therapy sessions and how those strategies/techniques will help their child.
2. Showing and describing the new strategy: (McGill, 2020)
Modeling strategies or showing parents videos of specific strategies will help them better understand how to use those strategies with their child every day. Explain what you are doing as well as why you are doing it in order to enhance parent’s understanding of therapy techniques. Many strategies and techniques may not come as naturally to parents, so be sure to thoroughly explain strategies while providing many examples.
3. Supporting the parent to try out the strategy: (McGill, 2020)
Do not be afraid to sit back and observe during teletherapy sessions with young children! One key component to parent coaching is allowing the caregiver to practice strategies while providing them with feedback. Being able to watch the parent interact with their child while incorporating all of the strategies discussed previously will give you, as a clinician, a good idea of what the parent understands and what guidance is still needed. Coach parents in the moment! While they are interacting with their child, give them praise when they use techniques or have successful moments while interacting with their child. Provide feedback during these moments to help them understand what they could do differently in order to enhance their child’s speech and language skills.
4. Collaborating with the parent to plan their next steps: (McGill, 2020)
At the end of each session, be sure to discuss ideas for home practice. Provide ideas of what they can try over the next week at home to continue supporting their child’s goals. Ask the parent what they thought went well during the session and what they think they could do differently next week. You may even have the parent read a certain blog post, listen to a podcast, or provide resources before the following therapy session.
Applying these four steps into your day-to-day early intervention teletherapy sessions will allow for caregivers to become more involved in their child’s therapy and allow for more generalization of goals.
Teletherapy for Early Intervention and Coachable Moments:
Here are some examples of coaching techniques to use in early intervention teletherapy sessions:
1. Making Requests:
Show parents how to use visuals to support the child in making choices. For example, a visual of a spider for “The Itsy Bitsy Spider” and a visual of a school bus for “The Wheels on the Bus”. Many parents do not realize how the use of visuals may enhance their child’s understanding along with expressive language skills. Incorporate visuals within sessions and explain to parents in the moment how the visuals help to support their child’s speech and language skills.
2. Hand-Over-Hand Support:
Children in early intervention may require hand-over-hand at times in order to first learn a new skill/gesture. Provide instruction to parents on how and when to provide hand-over-hand support. Show them when to fade the support to allow the child to complete the skill independently. Since we, as therapists, cannot provide hand-over-hand support during teletherapy early intervention sessions, jump in during the session to cue parents when to provide support! When parents provide hand-over-hand support without your cue, provide praise so they recognize that they understood when to provide support.
Demonstrate to parents how to use fill-in-the-blank while singing in order to increase the child’s vocalization. For example, you may sing, “Old McDonald Had a Farm….” and wait for them to vocalize “E, I, E, I, O!” Reminding parents to WAIT is an amazing strategy that may not come as naturally to them. You can use a visual cue to hint at parents during the session. For example, to pause and wait to see if the child will respond independently.
Explain to parents that there is no need to read every word on each page of the book! Demonstrate this strategy to parents. Show them how YOU read the books and guide them on how to best support their children while reading books at home. Demonstrate how to describe pictures with few words rather than reading every word.
5. BIG movements/facial expressions/reactions…FEW WORDS: demonstrate to parents how to use their own gestures, movements, and facial expressions to increase their child’s interaction. Using over-exaggerated expressions and exclamatory sounds helps children stay engaged and increase their participation within interactions. Remind parents to simplify their language, using fewer words when providing language models.
Including parents within early intervention teletherapy sessions helps to best support children toward meeting their goals. Understanding how to best support parents will allow for smoother and more effective therapy sessions.