THERAPISTS TO TELE-THERAPISTS

Applied behavior analysis (ABA) interventions are the standard of care for individuals with autism spec¬trum disorders (ASD). Typically delivered in-person, ABA interventions can increase adaptive skills and decrease maladaptive behaviors in individuals with ASD, including behaviors that may be dangerous to themselves and others.The coronavirus disease of 2019 (COVID-19) pandemic and measures imposed to curtail its spread have created unprecedented challenges to the continuity of care for our learners with ASD. Providers had to thoughtfully consider if, and how, to continue ABA services when in-person delivery carried a genuine risk to themselves, their staff, their clients, and caregivers. The whole world including the schools, organizations, and individual practitioners had to shift their practice to a virtual service delivery model keeping those considerations in mind. This new normal made it essential for us to maintain a commitment to providing evidence-based practices in our set-up at Autism Centre for Excellence (ACE) as well.When implementing services via Telehealth, we had to ensure that we are using the basic principles of Applied Behavior Analysis (ABA) and its practical application and using technology in teaching. While we were well versed with the former, implementing the latter was a herculean task for us. It wasn’t that we didn’t use technology before but using it as a sole medium to provide services was something that was a learning process for us therapists as well.One of the initial factors that we had to consider when starting the telehealth services was accessibility to technology. Our telehealth modalities were determined by the child’s current needs as well as families’ accessibility to technology. We had to be cognizant of the fact that not every family will have a spare device and high-speed internet for the learners’ sessions. We planned our sessions based on the availability of the device. For some students, we could start the sessions on zoom/ google meet on their laptops and for some, we had to use other mediums like WhatsApp © video calls. Our session planning, the stimuli we used, and our lesson plans were based on what modality of technology we were using for the virtual sessions.In addition to that, we therapists also had to prepare ourselves for using technology for the virtual sessions. Most of us left our work laptops at school on the last day because none of us imagined that we wouldn’t return for six months or more. A lot of us had to upgrade our internet plans to accommodate hours of zoom calls and virtual sessions.A major adjustment that therapists had to make was in terms of making our online programs and activities personalized and fun for our learners. All of us learned about various features of Microsoft PowerPoint and Zoom, the applications we’ve always used. Using hyperlinks on PowerPoint and whiteboard and breakout rooms on Zoom made our presentations and sessions more interactive and learner-friendly. We also learned about the wonderful resource- Boom cards and made our lesson activities on it. We knew our learners were missing going outdoors, so we tried using virtual tours to different places and it was a big hit with the children.Telehealth and virtual sessions have taken teachers’ multitasking skills to another level. At any given point in time, we have our PowerPoint presentations, YouTube videos, Boom cards, Token boards’tab open and we keep switching between the applications during the same sessions. That said, nothing can compare the in-person therapy and the joy of playing with the kids and being able to hug and tickle them.

GUNJAN GUJRAL,
BCBAJUNIOR PROGRAMME SPECIALIST