According to the American Psychological Association, 38 percent of Americans say their stress levels increase during the holidays. 

Reasons cited include concerns about finances, overcommitting time and energy, family issues and conflicts, and unmet expectations about “happiness and joy.”  

“Now, factor in 2020,” said Leslie Dempsey, a Licensed Marriage and Family Therapist with National TeleTherapy Resources. “Stress levels are expected to escalate even more than ‘normal’ this year.” 

This is not only true for adults, but also for children who sense their parents’ increased stress. These children may channel this stress into their own behaviors.  

Practice Self-Care This Year 

During the holidays, adults may default to trying to make things as normal as possible, especially for children, Dempsey says. However, she counsels them to lean more toward self-care this holiday season rather than maintaining routine and tradition.  

Take elaborate holiday meals, for example. 

In many communities, socially distancing will remain the norm through the next several months. As a result, it may not be prudent to invite all the relatives (especially older family members and those with underlying conditions) to a large gathering. 

Instead, plan something simple for the immediate family, and then celebrate with a Zoom toast later so everyone can visit for a bit.  

Foregoing a family dinner, while disappointing, not only addresses potential contagion. It also reduces financial cost to the host family; the stress of cleaning, prepping and cooking in an already busy schedule; and the potential for family strife.  

This is an example of self-care that adults can choose with relatively little effort. 

Additional Needs of Children 

However, a child experiencing increased stress may be acting out in extreme or unusual ways or by being unusually subdued. Some additional support and professional counseling may be appropriate, according to Dempsey.  

She offers some quick insights into how counseling may be able to help:  

First of all, does the child understand the emotions he/she is feeling and how they can manifest physically and emotionally? 

For example, a child may not recognize that a heated flush to the face or a sense of pressure in the chest may be physical signs of mounting anger. They don’t understand there is only a brief moment between those internal warning signs to acting out in an external way like a temper tantrum. 

“After building awareness, we work with the child on communicating about their feelings,” Dempsey said. “We break things down into parts.” 

Such parts may include answer questions like, “What is he/she feeling?” Or, “Is there something in particular that triggers the emotion?” 

“We set goals, create strategies, and plan how they will respond to a situation with more healthy behaviors rather than reacting in negative ways.” Dempsey added. 

Being Proactive with the Needs of a Child 

For example, imagine a child spending Thanksgiving with his dad for the first time after his parents separate. 

Many emotions may be flooding his system: fear of the unknown routine; homesickness and separation anxiety; nervousness about being alone with Dad for days at a time; and worry about strange food, a strange bed, and a strange location. 

It might feel like a waterfall of worry, unease, and stress filling his head, his chest, and his tummy.  

Dad and child might suffer through the weekend, ignoring the tummy aches, the wet eyes and whining, and maybe even a meltdown, but some proactive counseling could make future visits easier for everyone.  

“We would talk through with the child what it feels like to miss Mom and what would make it feel better,” Dempsey said. “We would plan for a phone call twice a day; packing a scarf that smells like her in the overnight bag; bringing a favorite pillow and blanket from home.” 

“The goal,” she added, “is to satisfy the need to keep in touch with mom (within boundaries), while also creating opportunities for the child and Dad to connect and build new routines.”  

Checking in after the holiday weekend is a chance to debrief on how the child felt during the weekend, how they handled their emotions, and review what worked in the plan and what could be changed for next time.  

“In counseling, we find that — over time — the child has fewer tummy aches and outbursts,” Dempsey said. “They begin to communicate their feelings more readily, and proactively express what they need to feel better. It’s also a cycle that prepares the child for future changes.” 

The first time meeting a divorced parent’s new girlfriend or boyfriend, Dempsey says, is an example of something that could bring all that anxiety and stress experienced during the separation and divorce back into play again. 

Aspiring for More Awareness 

Childhood counseling isn’t something to be afraid or ashamed of, Dempsey points out. 

“We work with teenagers today that are much more self-aware and emotionally functional because they had counseling as a young child,” she said. “They are articulate about what they’re feeling and can express their needs more clearly and confidently.” 

As a result of their more refined coping skills, Dempsey said many present more maturely than their peers. 

“And, isn’t that kind of awareness and control something to aspire too?”  

Why is handwriting critical in the modern age of keyboarding?

According to research, manuscript is different than cursive, which is different than keyboarding. Each uses a different part of the brain, and each creates different pathways through the brain to fulfill a function.

Handwriting is considered a foundational skill and is important for many reasons: it engages the brain more fully, enhancing memory and improving retention, and it facilitates visual-motor skills like hand-eye coordination.

According to a study by the National Institutes of Health, handwriting is a critical doorway to better reading and comprehension, and it reinforces language processing skills. It creates pathways in the brain that recognize patterns and contribute to decoding, which is helpful in learning math, music, other languages, and advanced applications in science.

Handwriting Goals

In teaching handwriting, there are three goals:

1. Legibility: The ease in being deciphered and understood.
2. Frequency and Speed: The ability to engage in writing whenever needed and at speeds that allow the students to keep up when doing such things as notetaking and taking tests.
3. Fluency: The ability to express oneself accurately and articulately so that others understand.

“There are so many skills required for handwriting and it is a lot to expect from a 4- or 5-year-old child,” says Jessica Willey, an occupational therapist and therapy director for National TeleTherapy Resources (NTR). “So, handwriting starts with simple steps and builds on layers from there.”

Handwriting should begin with drawing lines: up and down, side to side, and diagonal. Lessons then progress to connecting those lines to form shapes, pictures and then uppercase letters.  This should involve a multisensory approach allowing children to learn through play and manipulation of materials.

How Occupational Therapy Helps

From observing even these beginning strokes, an occupational therapist can begin to see strengths and weaknesses in the multiple components of handwriting: posture and stability, fine motor skills, grasp and pressure, letter and number recognition, visual-motor skills, visual perception skills including spatial awareness, and sequencing skills for letter formation.

If a deficit in one or more of these components is identified, it may be time for the teacher and parents to consider consulting with an occupational therapist.

National TeleTherapy Resources specializes in providing teletherapy services, including occupational therapy, speech therapy, behavior intervention, adapted physical education and mental health services via video conferencing platforms.

When one of NTR’s board-certified occupational therapists begins working with a student experiencing difficulty with handwriting, they are able to meet with the student, parents and teachers online to determine which components of handwriting are presenting challenges and which areas are strengths for the student.

Through videoconferencing, the therapist can observe if the child’s core is strong enough to hold himself upright with the head, shoulders, elbow and wrist supported and positioned so that the hand and fingers can move as needed to form letters and shapes.

Simple changes like adjusting seating or adding supports can stabilize posture allowing the hands to move more freely. The OT will often introduce exercises to strengthen muscles and build balance.

Does there appear to be an issue with visual-motor or visual-processing skills? Games like Jacks, Seek and Find, mazes, and puzzles improve hand-eye coordination.

Does the hand hold the writing device properly? If they are grasping the tool too tightly or too loosely, the occupational therapist can help the child understand how to apply pressure effectively by strengthening the tiny muscles in the hand and providing the sensory feedback the student needs to increase self-awareness. The OT may also introduce adaptive tools such as pencil grips so the child can hold the writing utensil more securely and confidently.

In fact, Willey recommends teaching small children to write with a broken crayon or golf pencil instead of an adult-sized pencil.

“It teaches the child to hold the writing tool with the tips of the fingers instead of clutching it with the whole hand,” she says.

They can also consider adaptive paper to help the child understand letter, word, and sentence formation and how to apply them spatially.

“Many of us remember learning to write on paper lined like this,” Willey says. “It helps on many levels, including learning orientation, placement, size, and letter formation.”

But, the tool can be enhanced with additional cues like color or individual boxes to define letter spaces, stars to show how a capital letter ‘starts at the top,’ or even ridges in the paper itself to create a guiding channel and provide sensory feedback to help with orientation to the lines.

“Building language – verbal and written – is a complex process,” says Willey. “We focus on therapies and tools that help students connect the dots between their minds, their bodies, and their ability to communicate. Our therapists work together as a team and love what they do because they know they are creating a foundation for continued learning and lifetime success.”

To learn more about how the National TeleTherapy Resources team works with schools to provide virtual therapy and counseling services for children across the country, contact us today!

Fall is generally the time we think of in calendar terms as “back to school.” And, it’s a busy time for National Teletherapy Resources (NTR) because now is the period when teachers are evaluating their new students and noticing the challenges they may encounter. 

According to Sandy Broderway, MS, CCC-SLP, the owner and director of NTR, more than 6 million children need support to succeed at their education. 

“We’re seeing more demand as more children are diagnosed with learning issues,” she says. “In addition, fewer parents and teachers believe a ‘child will grow out of it,’ whatever ‘it’ is. Some deficits can create lifelong challenges if they’re not addressed through therapy.”  

The NTR-School Partnership 

National Teletherapy Resources specializes in working with schools to provide a variety of therapy services addressing speech and language; occupational deficits; behaviors, attention, and zones of regulation; and mental health issues. 

“Many school districts are understaffed, but the demand for speech, behavioral and occupational therapy is growing,” Broderway says. “Our team can step in to provide an effective and personal solution. And, this is especially important as we continue to distance because of COVID-19.” 

The conversation generally starts between the parents and the teacher. Either the parent advises the teacher of emerging or ongoing challenges, or the teacher notices something that isn’t being addressed.  

Setting Therapy Goals 

For example, teachers are often observing how well a child can stay on task, how well they’re reading and comprehending based on age, if they’re able to ask for what is needed, if they can hold a pencil or scissors adequately, or if their speech is easy to understand. 

If the child is demonstrating any impairments or deficits in speech, movement, attention or behavior, the teacher will initiate a Response to Intervention. This triggers a series of evaluations. 

In assessing and identifying therapy priorities, NTR recommends focusing on the education goals that will most benefit the student. 

“Using this information, we map out the approach to therapy guided by the outcomes that will make the biggest difference in improving the student’s performance,” Broderway says.  

Is Teletherapy Effective? 

People are often curious about the teletherapy platform, Broderway says, especially with something like occupational therapy, which is considered more hands–on.  

“It takes training to be able to communicate with the students and special equipment to effectively guide them through the exercises on a video platform,” she says. “For example, if we’re working with a student on handwriting, we have two cameras. One is for the face-to-face conversation and instruction, [and] the other is positioned on the hands so the therapist can see exactly how the hand and fingers are working with the pencil or the scissors.” 

“We talk through what changes are needed, and then watch the student adapt to and practice the movements.”  

Broderway says students are also more attentive during teletherapy sessions. The student usually wears a headset, which eliminates noise distractions, and the face-to-face interaction through the screen is more focused. 

“We believe – and research supports this – that teletherapy is just as effective as in-person therapy, if not more effective under certain circumstances,” she says.  

Teletherapy sessions happening in the home creates additional benefits. Another adult is often available to attend the session, watching and learning at the same time as the student. As a result, he/she can intervene when the child is struggling. 

“Timely intervention contributes to making regular progress,” Broderway says, “and prevents regression between teletherapy session.”  

Discussing deficits and challenges with teachers and therapists can be difficult for parents, Broderway says. “But, we have the best interests of the student at heart and believe that early and consistent therapy will set the child up for success for many years of education to come.”  

Learn the personal story about what inspired the creation of NTR.

Sandy Broderway, MS, CCC-SLP, is the owner and director of National TeleTherapy Resources (NTR). It’s a therapy practice that specializes in providing a variety of services to children via digital infrastructure rather than in person.

But, she didn’t make the decision to start an innovative business with only her head. She led with her heart.

A Personal-Professional Journey

When Sandy’s son, Brandon, was born, he weighed 2 pounds, 15 ounces. He was often ill as an infant, and when he entered the toddler stage, Sandy and her husband noticed some delays in walking and talking. He also had some vision deficits.

They immediately started occupational and speech therapy and were happy to see Brandon progressing over the years.

But, when he began kindergarten, things changed. Brandon struggled to stay on task and complete assignments. Sandy realized that the school may not be able to provide Brandon with all the attention that he needed.

“It wasn’t the school’s fault,” Sandy said. “They just didn’t have the resources. So, we moved to a district that had the resources we needed. And, I made a decision.”

Sandy decided to go back to school and get a master’s degree in Communication Disorders.

“I wanted three things from this degree,” she said. “I wanted to understand the challenges my child was dealing with,  I wanted to be able to help other parents in their journeys, and I wanted to help schools find a way to provide needed resources no matter where they were located.”

After graduating, Sandy worked in a variety of environments including hospitals, skilled nursing facilities, and schools. She was also approached by someone who wanted to develop a teletherapy practice, but the opportunity didn’t work out.

Over the next several months, however, her thoughts kept returning to the concept in relation to schools that lacked therapy resources.

Launching Telehealth for Kids

In 2015, she launched National TeleTherapy Resources, and today, she works through school districts providing teletherapy services to students throughout the country.

She credits her journey with Brandon in better understanding the dynamics involved in the child-parent-teacher-therapist relationship.

Today, Brandon is a thriving and active high school graduate who loves cars. People describe him as “smart, a big personality, and a great problem solver,” Sandy says. “Brandon has a big heart, especially when it comes to his younger brother.”

“He reminds me every day why I believe in this business.”

Advice for Parents

From a personal and professional perspective, Sandy has a few suggestions for parents recognizing that their child may need assistance with developmental issues.

Research

If you are noticing deficits, seek out information and resources. For example, if a child is slow to talk, take notice.

“A child’s ability to say ‘my name is….’ is foundational to his or her communication skills in the future,” Sandy explains. “It opens the door to forming relationships.”

Embrace Tech

Don’t be afraid of technologies and assistive devices. Be open with the people who surround your child (teachers, other students, and their parents) about what those devices do and how they help.

“Ask to do a show-and-tell in the classroom about a wheelchair or an Alternative/Augmented Communication device,” she said. “It builds understanding, curiosity and empathy in classmates.”

Welcome Differences

Understand that every child (regardless of ability) learns differently and at a different pace. Any gain is a great gain regardless of pace.

Follow the Joy

Find the things that the child loves and does well. It brings joy, builds confidence, and creates the opportunity for the family to engage more fully with the child at many levels.

In Brandon’s case, it was golf. He began playing with a friend, Sandy says. “He had an amazing swing. He eventually took lessons, joined the golf team at school, and competed in tournaments.”

Participate in Therapy

Participate in as many therapy sessions as you can. Understanding what is being done and why it’s being done is critical to moving therapy from an hour or two a week to incorporating strategies into your everyday lives.

Practice Patience

If you’re frustrated, they get frustrated. If they’re frustrated, they lose confidence and quit.

Be an Advocate

Finally, be an advocate for your child. Don’t always assume that an approach that works for another student is the right approach for your child. You know your child best and know best how they can and will succeed.

Partner with NTR

If you’re a teacher, school administrator, school therapist or parent who would like to learn more about how National TeleTherapy Resources collaborates with schools to improve outreach and help more kids through occupational therapy, speech therapy, or other related services, contact Sandy today.

Call her at today at 844-NTR-LINK, or email her at info@ntrlink.com.

They say necessity is the mother of invention, which has certainly been true as it relates to the emergence and acceptance of teletherapy during the current health crisis. 

And, while turning to an online, virtual environment for therapeutic needs isn’t a new concept, speech-language therapist Sandy Broderway points this may be the only option for some right now – particularly young people affected by COVID-related school closures. 

Yet, Broderway says many school districts are so overwhelmed with the wide array of changes they are working to implement, from cleaning procedures to safe student transportation to accessibility of digital resources and the health safety of their students and teaching staff that their therapy teams aren’t yet equipped with the tools or a plan to begin offering remote services to those who need it. 

“Vulnerable students’ personal and developmental needs have only been heightened by the world’s experiencing a health crisis,” says Broderway, founder of National TeleTherapy Resources, an organization that partners with schools to offer telehealth services like speech-language therapy, occupational therapy, behavior therapy, mental health services, and so on. 

“Unfortunately, many children may not be getting the therapy treatments and mental health services they need simply based on the lack of time in school. With fall schedules still in flux within many districts across the country, this isn’t a problem that will likely get solved in the fall.” 

That’s where Broderway and the National TeleTherapy Resources (NTR) team can step in and help. 

Having practiced teletherapy for more than a decade, Broderway understands the best practices and advantages of using this model as well as the challenges schools face, both leading up to and during the start of the 2020-21 school year. 

And, it’s the NTR team’s mission to partner with schools to assist them in better providing the essential services of speech-language therapy, occupational therapy, behavior therapy and mental health services to their students. 

Is TeleTherapy Effective? 

Of course, as schools work out strategies to provide these services to students with caseloads that are quickly backing up, their goals continues to be based on providing critical services effectively. 

Can therapists and counselors achieve this through virtual connections? 

Of course, Broderway says. 

“When the well-being and success of our children are at stake, it’s always fair to question the effectiveness and legitimacy of any new methods that may or may not affect treatments,” Broderway says. “Fortunately, various researchers have studied virtual therapy and have reached similar conclusions: that teletherapy is effective and beneficial.” 

For example, one study released earlier this year in the journal “Disability and Rehabilitation” evaluated the effectiveness of “tele-speech therapy” on the recovery of patients with a stutter. 

Not only did this research conclude such therapy was effective for patients “irrespective of age, gender and education background,” but more than half the patients reported the experience as being highly satisfying. 

Another study published four years earlier in the International Journal of Speech-Language Pathology concluded that “telepractice does not appear to have a negative effect on rapport between [speech-language therapists] and pediatric clients.” 

Click here to read additional studies about teletherapy. 

How We Can Help 

“During a time when school districts and therapy teams may feel their hand has been somewhat forced into a solution like teletherapy, these studies offer a level of comfort in knowing students won’t be negatively impacted from the change,” says Broderway 

“And, since our team’s been operating virtually for years, we’re able to help these departments transition safely, effectively and securely toward this direction.” 

Depending on a school district’s level of experience and need, the National TeleTherapy Resources team can help in translating therapy and counseling services to a more virtual program, provide additional therapists and tools for meeting need and demand, improve student attendance, and navigate related laws and regulations. 

“But, as I like to point out, our ultimate focus isn’t on the school or the therapist or even the teletherapy platform; it’s to help the kids and make sure they’re getting the services they need to soar in life,” Broderway says. 

“It’s because of this that we provide schools with the highest levels of service possible – from simple training to providing our full scope of services.”  

During this COVID-19 era, school counselors and therapists of all types – including speech-language and occupational therapists – have been forced to rapidly adjust to the virtual environment.

Also known as telehealth or teletherapy, this is the therapeutic model with which National TeleTherapy Resources speech-language therapist Sandy Broderway is most familiar.

And, having practiced teletherapy for more than a decade, she understands the best practices and advantages of using this model as well as the challenges schools face, both leading up to and during the start of the 2020-21 school year.

“So many schools are asking their current therapists to learn telehealth on the fly,” said Broderway, founder of National TeleTherapy Resources, an organization that partners with schools in offering telehealth services like speech-language therapy, occupational therapy, behavior therapy, mental health services, and so on.

“Our organization’s been working all these years trying to increase awareness of teletherapy and the benefits of incorporating virtual services into special education programs,” Broderway added. “And then, seemingly overnight [due to COVID], there was quite a change where more schools are viewing teletherapy as a possible way of reaching and treating more kids who need specialized services.”

But, despite this change of heart and the realization in the potential of teletherapy, schools from wide rural districts to more populated urban areas have experienced a rapid learning curve, which has led to multiple challenges.

Fortunately, National TeleTherapy Resources offers solutions that can help schools and districts of all sizes to overcome the challenges they have faced due to COVID-19, which will no doubt continue to affect districts well into next school year.

Some of these challenges include:

Challenge 1: Translating Therapeutic Services to Virtual

According to Broderway, one of the first struggles schools and their therapists/counselors encounter when entering the virtual world is how to effectively offer treatments through a computer screen.

“Speech-language therapy, and especially occupational therapy, can be very complex and hard to wrap your mind around how to effectively offer it online,” she said.

THE SOLUTION: National TeleTherapy Resources has been partnering with schools to train their on-site therapist(s) on how to develop teletherapy in their districts and how to most effectively deliver services to the children who need it.

Challenge 2: School Resources

With in-school education temporarily suspended and therapists scrambling to develop solutions for continuing services for students in need, many school caseloads have become backed up. The inability to offer in-school group sessions has only compounded the issue.

“This made it so therapists who often already have greater caseloads than they can handle now have to play catch-up, and do so with more one-on-one sessions,” Broderway said. “This can become completely unmanageable.”

THE SOLUTION: When resources are lacking, or they simply need help catching up, National TeleTherapy Resources provides schools with additional therapists and tools.

“As people go back to school, there’s going to be a lot of compensatory sessions to be made up because of COVID,” Broderway said. “We can help by providing therapists to help the schools during this time. Having a team of therapists who don’t have to travel from school to school, we’re able to cover more sessions in a shorter time.”

Challenge 3: Attendance

Children and their families are already having to adjust to schooling at home. Ensuring children in need are able to attend their virtual therapy and/or counseling appointments can become an issue – one that can hold back progress and development, possibly affecting other aspects of their education.

THE SOLUTION: National TeleTherapy Resources ensures students, parents and guardians get regular reminders of appointments, from a day out to as close as 30 minutes before the start of sessions. The team also helps schools determine, and overcome, potential barriers causing kids to miss their appointments.

Challenge 4: Compliance & Service

As Broderway’s been working with some schools who are transitioning over to virtual therapy and counseling, she’s noticed many encounter compliance issues.

“It’s a monumental job to transition from on-site to online services almost overnight,” she said. “Add to that the complicated laws and regulations, and it’s no wonder schools are finding this difficult to navigate.”

Also, many of the larger services and platforms lack the level of personalized training and services needed by schools and the kids they serve.

SOLUTION: Broderway said all online tools used by National TeleTherapy Resources are HIPAA (Health Insurance Portability & Accountability Act) and FERPA (Family Educational Rights & Privacy Act) compliant.

As for service?

“Our ultimate focus isn’t on the school or the therapist or even the teletherapy platform; it’s to help the kids and make sure they’re getting the services they need to soar in life,” Broderway said. “It’s because of this that we provide schools with the highest levels of service possible – from simple training to providing our full scope of services.”