by​ Noelle Humphrey, MS CCC-SLP and Laura Paradowski, OTR/L

The Pivot to Telehealth


Pivot, that is a word to sum up what most of the world, if not all, needed to learn to do in 2020.  We as a Speech-Language pathologist and Occupational Therapist respectively were faced with this challenge as well.  We worked as members of a mobile interdisciplinary team of clinicians that provided assessment, training, and technical assistance to adults with Intellectual and Developmental Disabilities in Georgia who received Medicaid Waiver services. 


In March of this year, we were unable to continue to deliver this mode of service in individual’s homes due to COVID-19.  Luckily for our team, Georgia approved telehealth as a viable service delivery method In April.  So, we pivoted and learned as much as we could about how to utilize telehealth to conduct our assessments, deliver training, and much needed technical assistance (check out Rafi’s article on doing telehealth right here).  We definitely experienced some challenges along the way, but we persevered so adults with I/DD could continue to receive clinical services.  In truth, we were actually quite surprised with how much we were able to accomplish via this new service delivery model.  We have always viewed ourselves as dynamic clinicians who highly valued building relationships with our clients and were not sure how we could do that through the computer and technology.  We were pleasantly surprised how we were able to continue build rapport with new clients and caregivers and meet our client’s goals to increase overall quality of living.  We have assembled some reminders, tips, and strategies that other clinicians can utilize as telehealth services continue to be used.


Telehealth Tenets 


Telehealth RemindersAs our team began implementing Telehealth to deliver a variety of clinical disciplines including Occupational Therapy, Physical Therapy, Psychology, Nutrition, and Speech-Language Pathology, we learned some key foundations for delivering Telehealth:


  • The quality of services delivered via Telehealth must be consistent with the quality of services delivered in-person. If not, Telehealth is not a viable option to utilize for provision of services.
  • Telehealth is not a different service, but a different method of service delivery. It allows for flexibility and embraces individual outcomes and supports.
  • Telehealth requires careful planning to meet the individual’s needs and ensure success by requesting feedback.


Preparing for Telehealth


Preparing for TelehealthAs we began working with our clients with Intellectual and Developmental Disabilities for the state of Georgia, we learned how important it was to fully prepare for each session and to hold a Pre-Session conference with both our client and the designated supporter.  We used those sessions to work through the following key points:


  • Review the intent and goals of our session
  • Establish an agenda so that all participants would have the same expectations
  • Determine which part of the home environment would be best suited for the session and therapy goals
  • Decide upon the best time of day for the individual to meet the therapeutic goals of the session
  • Determine the best supporter/facilitator for the individual to complete the intended tasks of the session


Tips for Clinicians 


Telehealth Productive EnvironmentAs we continued to use this new service delivery, we learned how to troubleshoot the technology and provide the best possible environment to conduct our sessions.  Some of lessons we learned about how to ensure a productive telehealth environment include:


  • Make sure you are in a private environment
  • Check for good lighting without a glare (adjust blinds as necessary to allow natural light)
  • Ensure a quiet atmosphere without background noise
  • Be aware of your location background surroundings
  • Use earbuds or a headset to limit distractions




In closing, we hope that our lessons learned will be helpful for you as you navigate Telehealth with your clients.  As 2020 taught us, Telehealth is a great service delivery option that will continue to be important in these changing times.  We at CRA Learning will continue to build resources to help best support your practice.  Sign up to receive insights, tools, resources (link to our newsletter sign up etc.) and information about upcoming courses sent straight to your inbox or contact us with any questions.  Check us out on Facebook, Instagram and LinkedIn for updates and resources too!


Have you had experience delivering clinical services via telehealth to individuals with Intellectual & Developmental Disabilities? What were the biggest challenges you encountered?  Share your thoughts in the comments below!

For more interesting reads, check out our Insights Page to see all the articles we’ve published to date. Click here to head over to our courses page check out our variety of clinical and professional courses that we’ll be releasing soon, aimed at increasing your knowledge and skills to help you better support and serve individuals with intellectual & developmental disabilities. If you’d like, contact us to send over any questions, concerns, or feedback.

Rafael E. Salazar II, MHS, OTR/L

A co-founding member of CRA Learning, Laura is an Occupational Therapist who has been working on projects at the state level since 2012 transitioning individual with Intellectual and Developmental Disabilities from state institutions to community life. These projects included the closure or down-sizing of several state-run institutions for adults with Intellectual and Developmental Disabilities. Laura’s role in these projects included work to prepare the individual and the community for these life changing transitions. She continued to support these individuals throughout their transition to the community to ensure they were reaching their potential for independence and living a meaningful life. Laura has over 20 years of experience as an occupational therapist working with children and adults in a variety of settings. Laura considers herself a community clinician and uses her skills as an occupational therapist to empower children and adults with developmental disabilities to thrive in their daily lives. She has spent a great deal of her career learning and focusing on the area of sensory processing and regulation as it relates to functional performance. She also has a passion for using assistive technology for her clients in creative ways. Education: Laura earned a BS in Occupational Therapy from Creighton University in Omaha, Nebraska.

Noelle Humphrey, MS, CCC-SLP

A co-founding member of CRA Learning, Noelle is an Speech Language Pathologist that has worked on projects involving transitioning individuals with disabilities out of state institutions and facilities to residential environments within the community. She has over 20 years of experience working as a Speech-Language Pathologist in a variety of settings with both children and adults in CA, IL, MO, and GA. Her passion is developing low-tech systems for individuals to enhance their communication abilities to enable them to live as independently as possible and integrate into their communities to bring their own perspectives and talents. She was part of a team in IL that successfully closed Jacksonville Developmental Center from 2012 through 2014, transitioning over 120 individuals into smaller homes in various communities across the state. Education: Noelle earned a B.S. in Speech-Language Pathology from Marquette University in Milwaukee, WI and her Masters from Southern IL University at Edwardsville, IL