When COVID-19 began to affect the community in March 2020, CHD’s Early Intervention team quickly adapted the way they provide support to families so they could safely continue helping infants and toddlers meet important milestones and families integrate therapy into daily routines.
As it did for many others, the transition to telehealth seemed to happen overnight. It was a pivot in a very new direction, but one that would help ensure that many families could still receive the support they needed, even if it was temporarily through a screen.
Now almost a year into using a telehealth format, the Early Intervention (EI) team has been able to thrive despite unprecedented challenges and also witness how their colleagues and those they serve have taken to the new technology.
During this time, they have also continued performing evaluations for children, often at the request of concerned caregivers. Through CHD’s EI program, caregivers are able to self-refer at no cost and ask questions about their child’s development and whether they might need help learning to walk, talk, or reach other milestones.
Below are ways that the EI team has worked to provide an array of support to families during difficult times, and how they can continue to help:
Empowering parents.
One of the biggest benefits that EI Physical Therapist Diana Kenney has observed through using telehealth is that, while she may not be going into family homes physically to demonstrate therapy, it’s required her to guide parents and guardians through performing therapy themselves. To do this, Kenney demonstrates on a doll, and observes and advises as caregivers imitate the action.
For Kenney, this coaching method has required parents to be very hands-on during therapy, and its helped guide caregivers by giving them the tools and information they need in order to implement therapy into a child’s routine. Having this direct experience from their sessions with Kenney, caregivers can feel confident and prepared in their role in the therapy.
“We’re teaching parents, but we’re also empowering them to do the tasks that are going to help their child, and that makes all the difference in the world,” Kenney said. “As we help families put it into their daily routines, they begin to embrace it a bit more each time in a way that works for them. There are so many ways to integrate the activities that we want the kids to learn and be able to accomplish within the family’s routine, which is critical.”
In adjusting to this coaching format, Kenney said she loves being able to explain to parents that, while she (Kenney) helped lead the therapy sessions, the parents put the knowledge into practice and made the progress possible.
“I’m always amazed by the kids making progress, and I credit the parents who stick with it,” Kenney said. “In the process you become part of a supportive network for the family, but I love being able to explain to parents that they really made the impact.”
“We’re teaching parents, but we’re also empowering them to do the tasks that are going to help their child, and that makes all the difference in the world.”
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Diana Kenney, EI Physical Therapist
Boosting access through flexibility.
With some parents working from home, and many kids learning from home, many families are inundated with new in-home requirements with Zoom or similar platforms. Simultaneously, there’s a high demand for a given household’s broadband network with all the video conferencing.
With so many moving parts, EI Program Director Erinne Gorneault explained that some families may feel like they have to choose between needs for their children, and CHD’s EI team has worked to ease challenges as best as they can.
“We’re seeing parents juggling so much, and there are also inequities to acknowledge in our community, too, in regards to access,” Gorneault said. “There are families with multiple children, or some with single parents, who may have to choose between one child using a device over another, especially if they have other children in school.”
To help families work around barriers to therapy when they can, Gorneault said EI staff often meet with families in accordance with the families’ schedules. While those schedules might look hectic with competing demands, having the ability to conduct a session during a mealtime or play time—or in some cases, even during a bath—the team has been able to fit into families’ schedules in order to continue services.
“Our staff have been so creative and flexible with their families to make it easier on parents when there’s so much going on,” Gorneault said. “I think that helps parents feel a little more relaxed.”
Focusing on timeliness.
An important consideration when it comes to EI is that developmental milestones take place during a very specific and formative timeframe. As such, it’s especially important that missed or delayed milestones are identified and addressed, as these important years lay an important foundation for childhood—from social and emotional factors to education and learning.
EI Physical Therapist and Speech and Language Pathologist Helen Skerritt explained that intervention during such a pivotal time for a child can have a lasting impact, so the earlier families reach out, the chances of having the biggest impact increase.
“You can’t recapture this time for the child. The younger they are the bigger the difference we can make,” Skerritt explained. “They’re learning so much these early years. If we can get in there early, it makes a huge difference.”
Through her use of telehealth to continue therapy with families, Skerritt also said that, like Kenney, it’s helped her connect with parents and help them see the difference they can make. Though she said she misses seeing families in person, the current arrangement has helped some parents feel more comfortable working therapy into daily routines all week long—beyond their hour-long session.
“It’s helped me make that crossover between being the therapist who goes into the home and being a coach for parents.”
“You can’t recapture this time for the child. The younger they are the bigger the difference we can make. They’re learning so much these early years.”—
Helen Skerritt, EI Physical Therapist and Speech and Language Pathologist
Helping with milestones, and much more.
Just before the pandemic began to impact the community, EI Occupational Therapist Diana Moore and her colleague had held a session with one particular family. Fast forward 10 months, and Moore is immersed in that child’s progress while having become an extension of that family’s support network. In a recent session, the mother told Moore and her colleague they’ve been such huge help that she wanted photos of them to share with her child in the future and to remember the experience.
“We met this family one time in person before everything shut down. To know and feel that we’re still able to help that much was truly incredible,” Moore said.
With therapists with specialties ranging from speech, motor skills, feeding and more, CHD’s EI team is able to provide support in a multitude of ways. Recognizing that each child and family has its own unique circumstances, therapists are able to adjust each session accordingly in order to truly individualize therapy sessions to meet each family’s needs.
Beyond challenges related to developmental milestones, EI also provides support in helping connect families to important resources like diapers, clothing and food, too. And in addition to addressing developmental milestones, Moore explained that the team can also provide support with other behavioral obstacles that families encounter.
“Yes it’s important to monitor a child’s milestones and responses to how they do different routines, but it’s also important for families to know that we can help with other difficulties, too,” Moore said. “Some families may not think to reach out for support because their child is meeting milestones, but at the same time they are also having other difficulties when doing things like brushing their teeth. Beyond helping kids meet milestones, we can also help provide support with this type of difficulty, and really be there with them to bring peace of mind.”
Providing holistic support for the whole family.
As a program of CHD, the EI team also has access to an array of other resources and services that can provide support to parents and other members of the family as needed.
During recent therapy sessions, EI Program Supervisor Cindy Napoli said she’s also seen parents struggling with their mental health as the effects of the pandemic continue to linger.
“I’m especially concerned about our families’ mental health,” Napoli said. “While I’m not a mental health specialist, there are a number of moms I have on my caseload who are presenting with signs and symptoms of depression, and so, fortunately, I’m able to refer them within CHD for the support they need.”
Recently, in the span of one week, Napoli said she referred about five parents for supportive services. It’s become another resource to offer families during or after sessions.
“We’re very family centered,” Napoli said. “Yes, we see the child, but if a family member is struggling, we work to get them the resources they need, too. Beyond the developmental aspects of our work and milestone checks, we really care for the whole family.”