7 Benefits of Telehealth Feeding Therapy

My feeding therapy practice is entirely virtual (that's me above!). I see my clients over video appointments. This includes babies, toddlers, older kids, and of course their parents. I have been asked if this Telehealth feeding therapy model was created in response to Covid. The answer is no. I have also been asked if it works. The answer is yes! I can say with certainty that teletherapy works and there are many benefits to it above and beyond face-to-face appointments.

Telemedicine has been around for a long time. The late 1960s and early 1970s saw technological advances in computers that inspired the development of many healthcare information management systems. The pandemic certainly gave telemedicine a massive boost; however, virtual intervention has been growing in popularity for decades.

Pediatric Feeding Disorder (PFD) affects approximately 25% of normally developing children, 25-40% of medically complex children, 60-70% of children with Autism, and 80% of children with a cognitive disability (Feeding Matters, 2021). Unfortunately finding help can be extremely challenging for families. Telehealth provides families with more access to feeding assessment and therapy. 

How Does Telehealth Feeding Therapy Compare to In-Person Visits?

Research has been conducted on the benefits of providing Pediatric Feeding Assessments and Therapy via Telemedicine. Studies have outlined the following benefits:

• Total time spent for an appointment was reduced from ½ day to 1-2 hours
• Parents were required to take less time off work and had more availability for appointments
• Children demonstrated less anxiety associated with travel and visiting a clinic for an appointment
• Families who reported being isolated from support were able to access services
• Children were able to eat in their home environment vs. a more artificial clinic setting

The results of another study in 2021 demonstrated that pediatric feeding assessments conducted in family homes via telepractice were judged to be feasible, reliable, and acceptable to both clinicians and parents. Parents reported high levels of satisfaction with telepractice, with 76% reporting that the telepractice appointment was similar to a traditional in-person appointment. (Raatz et al, 2021)

1. Less Time Off Work, Less Travel, Less Cost

As a mother of child with medical issues, I know firsthand about the slog of getting your child to a medical or therapy appointment. Planning begins well in advance starting with mentally preparing or warning your child of the upcoming appointment. Next comes booking time off work and organizing who will look after or pick-up and drop-off your other kid(s) while you are at the session. Once snacks, activities, toys, and changes of clothes are packed...then begins the journey...traffic...parking...waiting room. This is particularly challenging and time-consuming for families that live far from the clinic.  As I mentioned, studies have shown that parents typically need to take at least 1/2 day off work to attend an in-person appointment. Telehealth provides parents with options. They are able to stay home for appointments and feed their child in their familiar chair, while using their typical feeding equipment and family foods. Parents are able to save money, take less time off work, and reduce everyone's overall stress.

2. Mealtimes in the Child’s Natural Environment

I believe that children learn best in their natural environment and feeding is best approached in the environment where the child routinely eats. When I previously worked in a hospital and feeding clinic, I could often achieve progress in sessions; however, parents reported that they were not able to duplicate this during mealtimes at home. With teletherapy, I have the opportunity to work directly with the child’s caregivers and coach them during their natural home mealtime routine - sometimes parents wear a hidden earbud so only they can hear me. Being present during actual family meals promotes carryover and is very effective.

3. Parents Take the Lead 

Like a clinic setting, teletherapy can include both direct therapy with child and/or a parent coaching model. With parent-coaching, I am able to provide caregivers with on-the-ground strategies to use during live mealtimes...like how to respond during mealtime power struggles.  If I can teach the parents live and empower them to take the lead, then their child will be receiving feeding support several times per day at every feeding time. In my opinion, this is much more impactful than once per week visits to a clinic to see a feeding therapist. I have always believed that parents are the expert when it comes to feeding their child and I am there to support them by sharing my knowledge and experience as a feeding therapist. Teaching parents what I know helps to build their confidence at mealtimes.

4. Less Anxiety for Kids

For younger kids experiencing the “stranger-danger” stage, I find that meeting me over the screen can feel much less intimidating. They enjoy waving, playing peek-a-boo, and giving high-fives through the screen. I use toys, puppets, and songs to engage little ones and they respond very positively without the “new person” fear that is often encountered with face-to-face visits. I have found in the clinic setting, kids are often fearful, and it can take my little clients several sessions to warm-up to me; however, with tele-feeding therapy they seem to feel less nervous, and we can get started with therapy and progress more quickly and easily.

5. Both Parents Can Participate

Another wonderful benefit of telehealth feeding therapy is that both parents (and often siblings) are present and available to attend our sessions. Instead of one parent staying home with the other kids and the other parent bringing the child to a clinic appointment, both parents are able to attend and learn about how to best support their child during feedings. Most of my online therapy sessions involve both parents, which is a wonderful and welcome change. Additionally, both parents need not be in the same location in order to join the session. With some families I work with, one parent will join from home, while the other signs-in from the office. Telehealth also provides an opportunity for a team approach where other pediatric professionals like Dieticians and Physicians can join the appointments.

6. More Access to Feeding Services

Telepractice technology improves the availability of feeding treatment. My online practice provides access to children and families in small towns or remote locations where feeding services are not available. I am able to see clients in every corner of the province. Families are no longer limited by geography.

7. Technology is Fun for Kids!

As much as we know that kids benefit from less screen time, it is also their preferred channel and I have found that technology has offered great advantages in feeding therapy. I am able to engage kids using screens and technology to support their feeding development. I can share my screen to teach parents about feeding equipment, food textures, and resources. My tele-feeding sessions use screen-based check lists, games, food homework sheets, and scoreboards to engage my clients in food therapy. The older kids and picky eaters that I work with love using technology to help with their feeding goals.

Like the rest of you, I’m so relieved that the pandemic is almost behind us, but tele-feeding therapy is here to stay. This past year or so has been a huge learning curve and adjustment for both clinicians, kids, and parents and I’m very proud of everyone. We have learned a lot along the way, and we have evolved. Telehealth is a gamechanger for accessing equal care and expertise regardless of location. Parents are happy to be taking less time off work and no longer needing to travel to appointments. The caregivers I work with have learned to embrace the role of the therapist and have truly benefited from parent coaching. I have seen them become more confident in their ability to help their child during mealtimes. It’s an exciting time.

References

International Pediatric Feeding Disorder (PFD) Conference, 2021 - Feeding Matters

Caplan-Colon, 2021: Coaching Parents on Feeding Techniques Via Telepractice

Raatz, et al. May, 2021: A time and cost analysis of speech pathology paediatric feeding services delivered in-person versus via telepractice

Raatz et al, 2021: Evaluating the Use of Telepractice to Deliver Pediatric Feeding Assessments)

Clawson, et al. 2008: Complex pediatric feeding disorders: using teleconferencing technology to improve access to a treatment program