Date Presented 3/30/2017
This case study explored the efficacy of telerehabilitation in a private school–based setting for two at-risk youths. Both children improved overall performance within their environments. Timocco software was a successful method of telerehabilitation in the at-risk school environment.
Primary Author and Speaker: Varleisha Gibbs
Additional Authors and Speakers: Sara Benham
Contributing Authors: Jennifer Abraham, Julie Mathew
PURPOSE: This case study explored the efficacy of telerehabilitation, or the delivery of rehabilitation services through the use of technology, in a unique private school–based setting for at-risk youth. Evidence reveals a positive impact on at-risk children’s health and functional abilities when interventions are presented across context and delivery models (Kingston, Mihalic, & Sigel, 2016). Yet, various organizational challenges create limitations in the creation or continuum of evidence-based programs for at-risk youth. Methods that decrease cost, temporal, and geographic constraints allow at-risk communities to remain in their natural environments while receiving needed care. Telerehabilitation allows occupational therapists to partner with students, families, and teachers virtually for urban communities of at-risk youth (Gibbs & Toth-Cohen, 2011). The authors aimed to explore if the use of a specific telerehabilitation program, Timocco (Akron, OH), in the at-risk school-based setting would improve school-based abilities as measured on the Bruininks–Oseretsky Test of Motor Proficiency (BOT–2) and qualitative measures.
DESIGN: The authors selected the population for the study via convenience sampling from a school for at-risk youth in Trenton, NJ. The operational definition of at-risk students was students who lived with a single adult and demonstrated an economic need. The inclusion criteria identified children between the ages of 3 and 12 yr who had received a past occupational therapy evaluation and referral from a consultant previously contracted at the school within a 2-yr time frame. The authors identified two occupational therapy doctoral students to provide training for classroom teachers on the Timocco software. Two at-risk students participated in 20 in-school Timocco sessions and pre and post data collection using the BOT–2.
METHOD: The BOT–2 was administered prior to the 20 Timocco activity sessions, as well as on completion after the 20 sessions to assess motor performance, specifically in the areas of fine motor control, manual coordination, body coordination, and strength and agility. Teacher report and review of the recorded Timocco performance revealed qualitative data.
RESULTS: Both students improved their overall performance, revealed in the test scores of the BOT–2. Furthermore, the Timocco software was a useful service delivery platform for telerehabilitation for the school. Hence, the students revealed enhance school performance. Teachers saw the benefit of the program and of occupational therapy–based services.
CONCLUSION: Occupational therapy should be included in environments servicing at-risk youth. With cost, time, and geographic constraints, telerehabilitation platforms must be explored. Current state and federal policymakers are seeking evidence and guidance in the area of telehealth for rural and urban communities. More research is needed for occupational therapists to provide guidance and support for our services being included in the discussion. This case study provides a launchpad for such efforts.
References
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Criss, M. (2013). School-based telerehabilitation in occupational therapy: Using telerehabilitation technologies to promote improvements in student performance. International Journal of Telerehabilitation, 9, 39–46. https://doi.org/10.5195/ijt.2013.6115
Gibbs, V., & Toth-Cohen, S. (2011). Family-centered occupational therapy and telerehabilitation for children with autism spectrum disorders. Occupational Therapy in Health Care, 25, 298–314. https://doi.org/10.3109/07380577.2011.606460
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Kingston, B. E., Mihalic, S. F., & Sigel, E. J. (2016). Building an evidence-based multitiered system of supports for high-risk youth and communities. American Journal of Orthopsychiatry, 86, 132–143. https://doi.org/10.1037/ort0000110
