Moving Beyond the Pandemic Mindset
When many people think about teletherapy, they immediately recall the pandemic when services shifted abruptly to remote formats with little training, preparation, or resources. However, teletherapy has been an established service delivery model for decades and continues to expand access to occupational therapy services for individuals who might otherwise go without them across both school and healthcare settings.
As an occupational therapist, I have provided teletherapy services to brick-and-mortar schools unable to secure an on-site therapist in remote areas, as well as to virtual and homeschool charter schools. While it may seem surprising that I have only met one of my students in person, I have felt like part of many families’ lives for years. Some families spend hours each week with me when I am supporting multiple children, and those long-term partnerships become meaningful and deeply collaborative.
The Learning Curve: Transitioning to Teletherapy
My initial transition to teletherapy more than nine years ago was challenging. I had to adjust to not being able to provide physical materials or use hands-on support to guide movement. This required a shift in how I communicated with staff and caregivers, many of whom were unfamiliar with occupational therapy and unsure how to support sessions in the home.
Over time, I developed structured parent education resources to help families understand therapeutic goals, strategies, and how to support carryover between sessions. This collaborative approach has become one of the greatest strengths of my teletherapy practice.
Why Teletherapy Can Be Highly Effective
In my experience, teletherapy can be highly effective when implemented intentionally. I have observed meaningful progress in students that I do not believe would have occurred without this service delivery model. One of the greatest strengths of teletherapy is the natural integration of caregivers into the therapeutic process.
Parents and learning coaches observe sessions in real time and are better equipped to support skill generalization throughout the week. This allows therapy strategies to extend beyond the session itself and into daily routines. I am also able to recommend targeted activities and tasks for families to complete between sessions, which is often more successful when caregivers are present, informed, and confident in how to support their child.
Helpful Tools and Resources for Teletherapy
The following tools can support engagement, skill-building, and shared-screen interaction during teletherapy sessions:
Digital, Shared-Screen Activities
- Digipuzzle.net
- Typing.com
- Boom Cards
- PBS Kids
- YouTube (used intentionally for guided activities and movement breaks)
Printable and Digital Supports
- Printable worksheets for visual-motor integration, handwriting, and executive functioning
- Digital worksheets for guided completion during screen sharing
Handouts and Parent Education
- Standard School Based OT handouts (writing, visual perceptual strategies, sensory breaks, etc.)
- Subscription based sites that provide materials for structured practice and carryover (i.e. Tools to Grow, The OT Toolbox, etc.)
Using Student Interests to Drive Engagement
Teletherapy offers unique opportunities to embed intervention into meaningful, motivating activities. Some sessions focus on study skills or strategies to manage stress before a test. Other sessions center around play as an intentional therapeutic tool.
I often invite students to teach me how to play their favorite games. It allows students to give me directions using maps and explain strategies. Recently, I learned how to play Dungeons & Dragons as part of therapy sessions. The planning, writing, attention, problem-solving, and social communication required within the game create rich, functional opportunities to address executive functioning, written expression, and self-regulation goals in an engaging, student-centered way.
Relationship-Centered Care in a Virtual Space
Teletherapy has allowed me to develop strong rapport with students and families in ways that are often different than in-person services. Because sessions take place within the home, I prioritize being respectful of each family’s environment, routines, and needs on any given day.
While I enter each session with a plan, I remain flexible. Sometimes the most effective intervention is adjusting the session to meet the student’s immediate emotional or academic needs. This responsiveness strengthens trust and reinforces therapy as a supportive, collaborative process rather than a rigid service.
Final Thoughts
Teletherapy is not a replacement for in-person care. It is a powerful service delivery option when implemented thoughtfully and collaboratively. By partnering closely with families, embedding intervention into daily routines, and prioritizing meaningful engagement, teletherapy can expand access, strengthen carryover, and support real-world functional outcomes for students and families alike.
Author: Karlyn M. Goodman, OTR/L
