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There are numerous barriers to the provision of tele-therapy for educational purposes.  Among the most challenging issues are Technological Problems and the level of Student Cooperation.   This Trouble Shooting Guide addresses these barriers.

Technological Problems

There are many technological challenges that may be a product of the platform used (e.g., Zoom, Microsoft Teams, Google Classroom, FaceTime, Skype, etc.) and the technical skills of the users (including you, the parent, and the student).  Other issues that may contribute to the challenges are the devices used (e.g., smartphone, tablet, and/or laptop/desktop computer), the operating system used (e.g., Windows 10, Apple iOS), and cell phone receptivity or internet broadband width.  Variations among these variables will affect the quality and consistency of interaction through this medium.

1. Platform Issues – Various platforms have different capabilities making them either quite basic (e.g., Microsoft Teams, Skype, FaceTime, Facebook Messenger) or sophisticated (e.g., Zoom). The basic platforms are good for one-way teaching (e.g., lectures, storytelling, guided movement, counseling, or consultation).  Zoom for example, is capable of more interactive back and forth instruction using videos, boom-cards, and instructional apps and games across multiple devices.  These capabilities offer significant instructional advantages; however, they require more technical skills from the teacher/therapist and even the parent/child.  The bottom line is that you must:
   1. Choose the platform that is best for the purposes you have in mind.
   2. Learn how to use the platform(s) you choose (e.g., through online training videos and practice).
   3. Know which web browsers and devices support your platform of choice (e.g., Zoom works best on a computer using Chrome as a web browser as opposed to phones/tablets that have reduced interactivity).
   4. Help the parents make appropriate accommodations, downloads, etc.
2. Anticipate that there will be problems based on the variation in devices, operating systems, web browsers, and the bandwidth available to each individual, and PLAN ACCORDINGLY. You will have to adjust your expectations based on the reality of the resources available in the student’s home.
3. Work through all these issues with the parent first before trying to teach your students.
4. Adjust your plans and expectations based on the tools and skills available. Technological hiccups during instruction have the effect of degrading the quality of instruction, as well as the willingness of the learner.

Student Cooperation

Tele-therapy necessitates the development of new skill sets for both you as a teacher (as you well know) and for the students as learners.  Provided your skills are at a point where you have started instructional tele-therapy, and you have taken the steps to facilitate the technology in your student’s home, your first job should have included teaching the child how to be a remote learner.  If not, you will have to back up (more on this in a minute).  Success is also dependent on building and sustaining rapport with the parent.  They are your allies in the instructional process – your eyes, ears, and hands.  They will facilitate or hinder your access to the student and they are absolutely key to your success. 

1. If you have both good access to the child and caregiver support, but you are struggling with maintaining student engagement and/or attention, you must assess whether the problem is:
   1. environmental (e.g., struggles with competing distractions, struggles with equipment interface), OR
   2. behavioral (e.g., the child doesn’t have the skills or motivation to attend).
2. If the problem is Environmental – based on barriers within the home environment, use the Tip Sheet I’ve developed for helping the parent set up the environment for success (https://bit.ly/3btkNpc).
3. If the problem is Behavioral – the child is struggling with sustaining attention and/or following instructions appropriately during instruction, I highly recommend that you use the Tip Sheet I’ve developed for teaching instructional control (https://bit.ly/3bzAECy).
4. The keys to success are mastery of the technology, having the parents as collaborative teaching partners, fostering a good learning environment, and well planned lessons that are realistic in terms of the technological limits in place, the capabilities of the child, and the demand load you place on the child.

Developed by Gerald T. Guild, PhD, Licensed Psychologist and Behavior Specialist

The use of Video Conferencing to teach young children is a new challenge for everyone involved.  In order for it to work, YOU and the teacher or therapist (instructor) MUST FIRST TEACH YOUR CHILD HOW TO LEARN IN THIS NEW WAY.  Teaching this new skill will likely be the first thing the instructor will want to work on.  Without the ability to attend to and participate in instruction, your child will not likely benefit from video conferencing.  The acquisition of this new skill requires careful planning and thoughtful instruction. 

Strategies that will help make this work:

1. Set the Environment Up for Success. There are several extremely important objectives here:
   1. The instructor must be very clear with you about their goals, objectives, and expectations. You will be the instructor’s eyes, ears, and hands, so if you need help or support – please ask for it!
   2. Work through the technological barriers FIRST. Download the necessary apps and/or programs as guided by the instructor and be prepared to practice with the instructor before your child is asked to participate.  Getting the technology set up and working can be the most challenging step in this entire process.  Patience is important.  You should also know in advance what device will be used, how it will be used, and where it will be used.   
   3. Set up the environment in order to eliminate competing distractions. The specifics of this will depend on your child and your home, but your child will need a good learning environment (e.g., a quiet room, no siblings watching TV or playing nearby, and minimal access to distracting toys, etc.).
   4. The instructor may suggest using visual schedules, When-Then contingencies, and preceding the session with sensory activities that increase focus. The instructor should help you get these things set up.
2. The Instructor will likely want to start slowly and focus on making it fun. Once the technology is working, you know what to expect, and the environment is set up for success, the instructor will likely start by having fun with your child.  They will minimize demands so that your child learns that this video conferencing thing is fun and that their instructor is just as fun on the screen as in person.  The early sessions may be kept short (perhaps very short).  This will require pre-planning – you will likely have to help the instructor know what your child enjoys at home so that they can tap into those interests.
3. Use Positive Behavioral Strategies. The instructor will want to work out a plan for ongoing reinforcement of appropriate attending and participating behavior during the session.  You may be asked to provide those reinforcers during the session.  They may also suggest that you follow the session with a special activity, toy, or treat to reward their hard work (even if it was just play).  This too will require advanced planning and ongoing communication with the instructor.  Please understand that these rewards are for success during the session and that they are important tools in teaching this new skill set.
4. Demands will be placed gradually. The instructor will SLOWLY start folding in small demands as your child’s attending and participation skills improve.  The instructor should initially prioritize making your child feel successful during this new type of instruction.
5. Be Attentive. Both you and the instructor should continually attend to the child’s level of interest in the activities, his or her level of focus, and how conducive the environment is to learning.  It may be necessary to adjust and modify expectations throughout the session.  The instructor will try to end the session before the child’s interest and motivation disappears.  Also they will want to end it on a positive note.  Talking about how the session went, at the end of the session, will be important to the ongoing success of this approach. 
6. Continually Adjust Strategies and Expectations. It will be important to continually assess, adapt, and adjust the strategies, as well as everyone’s expectations throughout each session.  The same is true regarding the quality of the learning environment and the use of reinforcers. 
7. Have Fun & Make it Fun! Brainstorm games, the use of favorite toys, stories, and songs, as well as activities (including physical movement) that can be implemented while video conferencing.  Be creative, be silly, and remember that rule number one is: Have Fun!

Developed by Dr. Gerald T. Guild, PhD, Licensed Psychologist and Behavior Specialist at The Children’s League in Springville, New York and by Kimberly Guild, MS, SLP-CCC, Speech Language Pathologist at Cattaraugus-Allegany BOCES in Olean, NY

The use of Video Conferencing to teach young children, particularly those with disabilities, is fraught with many NEW challenges.  In order for it to work, the instructor MUST FIRST TEACH THE CHILD HOW TO PARTICIPATE ADAPTIVELY.   It is essential to prioritize gaining the instructional control of the student over implementing other IEP objectives.  Consider instructional control in this context, as a new skill-set that is foundational: necessitating careful planning and thoughtful instruction. 

Key Strategies:

1. Set the Environment Up for Success. There are several extremely important objectives here:
   1. Be explicit with caregivers about your goals, objectives, and expectations – they are your key allies and instructional assistants in this process (i.e., your eyes, ears, and hands) and you absolutely need them to work with you to make this happen. This is new to them too, so you must teach them how to teach, and you must keep them on your side.  They will need your guidance, support, and compassion. 
   2. Work through the technological barriers FIRST. Help the caregivers acquire the necessary apps and downloads, and learn the procedures necessary to video conference BEFORE attempting to meet with the child. Practice with the caregiver first, as these challenges must not be underestimated.
   3. Teach the caregiver how to set up the environment in order to eliminate competing reinforcers and distractions. The specifics of this will depend on the child and the resources within the home, but you must discuss with the caregiver what device will be used, how it will be used, where it will be used, and they must understand that their child absolutely needs a conducive learning environment (e.g., a quiet room, no siblings watching TV or playing nearby, and minimal access to competing reinforcers, etc.).  
   4. Also consider the use of visual schedules, When-Then contingencies, and prior to the session, sensory activities that will likely increase the child’s level of focus.
2. Start Small and Focus on Pairing with Reinforcers. Once the technology is working, the caregiver understands what to do, and the environment is set up for success, start by having fun with the child.  Minimize demands at first and just focus on making sure that they have fun with you.  Teach them that this video conferencing thing is fun and that you are just as fun on a screen as you are in person.  Remember to keep it short (perhaps very short).  This will require pre-planning, knowing what the child enjoys at home, and tapping into their inherent interests.
3. Use Positive Behavioral Strategies. Work out a plan for ongoing reinforcement of appropriate attending and participation during the session and follow the session with a contingent highly potent activity, toy, or treat.  This will require advanced planning and ongoing communication with the caregiver as they are the likely providers of the tangible reinforcers.
4. Carefully Approach Demands. Once you have a happy participant (which may take many short and fun visits), SLOWLY start folding in small demands – addressing skills they have already mastered at school.  It will be important to prioritize making them feel successful in order to maintain the child’s motivation.
5. Be Attentive. Continually attend to the child’s motivation, focus of attention, the environment, and the needs of the caregiver as you “work” with the child. Adjust and modify your expectations as the session evolves, try to end it before the child’s interest and motivation disappears (end it on your terms AND on a positive note), and debrief with the caregiver following the session. 
6. Adjust Your Strategies and Expectations Continually. Always assess, adapt, and adjust your practice, your expectations, the environment, and your use of reinforcers. 
7. Have Fun & Make it Fun! Brainstorm games, the use of favorite toys, stories, and songs, as well as activities (including physical movement) that can be implemented while video conferencing.  Be creative, be silly, and rule number one: Have Fun!
8. Ramp Up Demands Slowly and Carefully. As Grandfather Guild always said “The hurrier I go, the behinder I get!”

Developed by Dr. Gerald T. Guild, PhD, Licensed Psychologist and Behavior Specialist at The Children’s League in Springville, New York and by Kimberly Guild, MS, SLP-CCC, Speech Language Pathologist at Cattaraugus-Allegany BOCES in Olean, NY