| The Daytona Beach News-Journal
Kylie Garcia lifted one small foot onto a step stool and placed another on a diaper box. The 3-year-old then climbed up on a toy chest and prepared to leap onto the floor. When she landed, she stepped over a few rolled-up towels and t-shirts.
The makeshift obstacle course was part of her remote physical therapy sessions. Kylie, who had stopped attending in-person sessions amid the coronavirus pandemic, depended on different household items to strengthen her leg muscles and improve her balance.
Her mother, Stephanie Garcia, had scrambled to put together the makeshift obstacle course to prevent her from falling behind. It seemed to work: Kylie made tremendous progress in the time she spent inside her Palm Coast home.
“If I didn’t sit in or be involved in any way, I don’t think she would’ve done as well,” Garcia said. “With the physical therapy, I would actually do it with her to kind of show her what she needed to do. Otherwise, she would’ve been lost.”
Garcia and other parents of children with autism have been forced to assume the roles of occupational, physical and speech therapists over the past several months. Easterseals Northeast Central Florida, a nonprofit that provides services for people with autism and other disabilities, decided to have its patients transition from in-person to remote therapy earlier in the pandemic to protect them from infection. While most of the children have since returned to in-person therapy, some continue to watch their therapists from behind a screen.
Inside his New Smyrna Beach home, Carson Chesley attempted several push-ups, sit-ups and planks in front of a screen. His physical therapist watched as he completed the tasks, all of which were meant to help him build muscle and improve his coordination. His mother, Melissa Chesley, sometimes stepped in to help when his planks began to look like yoga poses.
“If I’m not sitting there in the room, there’s no way to really know that he’s even participating,” said Chesley, who serves as the chief financial officer for Easterseals. “For example, if I walked out to get him a drink of water or something, he can just be sitting there staring at them and not doing what they ask. He can get kind of off focus and so with me sitting there, I can kind of direct him back to what’s happening with them. It’s difficult for them to control the situation because they’re not there.”
While some children have experienced few challenges with their remote therapy sessions, their therapists have sometimes struggled to adjust to the online video calls. Physical therapists, who use tactile cues to help children perform tasks correctly, said they have had to depend on parents to that for them.
“When you’re doing a session in person, it’s easy for you as a therapist to give your own tactile cues, to touch them on their stomach to teach them to pull their core in,” said Jill Baxter, a physical therapist assistant for Easterseals. “A lot of what we do in physical therapy is through touch and feel, so that was something that was really difficult for me when we switched to telehealth services. We were relying on them to look at us for cues, so we can kind of tell the parent, ‘Hey, just touch him on his stomach to give him the cue to pull his belly in.’”
At her Port Orange home, Kariliz Bussart made a snowman out of Play-Doh and a pyramid out of blocks, all things her occupational therapist asked her to do to help improve her fine motor skills. Her mother, Jazmine Vazquez, watched as the 4-year-old moved from one task to another, each one requirin control of her small hands and fingers.
“It helped me understand what she needed, so I could help her outside of therapy,” Vazquez said.
Children whose parents are involved in their remote therapy sessions make much more progress than those who lack support. Several therapists noted that it also benefits parents to see what happens during the sessions, as it shows them what basic techniques can be used to help their children at home.
“They kind of get a sense of why we do certain things because sometimes we give them homework or give them suggestions and they don’t see the follow through,” said Kim Jackson, an occupational therapist for Easterseals. “I think when they actually see it working in the therapy sessions, it makes them more inclined to continue doing it at home.”
Months before she decided to keep her daughter at home, Garcia admitted she was wary of the online therapy sessions. She thought Kylie would fail to listen to her therapists when they appeared on the screen in front of her. She never suspected that Kylie would meet all her goals for physical therapy, even with a makeshift obstacle course.
“When it was first offered as an option, I was worried that in doing it at home, I wouldn’t be able to get her to participate in anything,” Garcia said. “That was one thing I thought would be a challenge.”