Telehealth in Rural and Underserved Early Intervention Settings: OTs’ and Physical Therapists’ Perceptions Early in the COVID-19 Pandemic

PURPOSE: The COVID-19 pandemic has highlighted the need for an alternative method of therapy delivery in the rural and underserved pediatrics settings, namely in this case through telehealth. Research exploring provision of telehealth services provided by pediatric occupational and physical therapists was substantially limited prior to the start of the COVID-19 pandemic. The purpose of this study was to explore the perceptions of occupational and physical therapists on the implementation of telehealth in the early intervention setting. This study queried if therapists working in early intervention believed they were prepared to effectively and efficiently use telehealth in all aspects of their work.

DESIGN: The research team designed an original mixed-methods survey. Target measures of examining opinions, level of comfort with telehealth, telehealth use and training, factors affecting telehealth use, and the impact of telehealth use during the COVID-19 pandemic were explored. Participants were recruited via email to complete an electronic survey and needed to be an occupational therapist or physical therapist with an early intervention caseload.

METHOD: Qualitative and quantitative data were collected via anonymous survey link. Qualitative responses were coded by common themes agreed upon by the research team. Qualitative and Quantitative responses were compared between occupational therapists and physical therapists. Minimal differences between responses were identified.

RESULTS: This research emphasizes the high demand and need for continued education and training in the use of telehealth when providing early intervention services. Qualitative data indicated that telehealth was rarely used by occupational and physical therapists working in early intervention prior to the COVID-19 pandemic. Data reflected that participants could see telehealth as a service delivery model post-pandemic, but additional training, education, and support would be needed. Quantitative data collected confirmed the qualitative data findings and specific supports were identified including: webinars, IT support, mentoring, and in-person training.

CONCLUSION: This research significantly impacts the practice of occupational therapy and physical therapy by providing additional foundational research in the area of the provision of early intervention occupational and physical therapy services using the telehealth service delivery model. Additional research on this topic would assist in expanding access to the professions of occupational and physical therapy into rural and underserved areas. Findings indicate specific knowledge and skills gaps that must be addressed in order to have an efficient and effective therapy team who use telehealth with their pediatric patient population.

References

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Tenforde, A. S., Borgstrom, H., Polich, G., Steere, H., Davis, I. S., Cotton, K., O’Donnell, M., & Silver, J. K. (2020). Outpatient Physical, Occupational, and Speech Therapy Synchronous Telemedicine: A Survey Study of Patient Satisfaction with Virtual Visits During the COVID-19 Pandemic. American Journal of Physical Medicine & Rehabilitation, 99(11), 977–981. https://doi.org/10.1097/PHM.0000000000001571

Wallisch, A., Little, L., Pope, E., & Dunn, W. (2019). Parent Perspectives of an Occupational Therapy Telehealth Intervention. International Journal of Telerehabilitation, 11(1), 15– 22. https://doi.org/10.5195/ijt.2019.6274

Zylstra, S. (2013). Evidence for the Use of Telehealth in Pediatric Occupational Therapy. Journal of Occupational Therapy, Schools, & Early Intervention, 6(4), 326-355. https://doi.org/10.1080/19411243.2013.860765