Real Therapy Behind the Screen: What Telehealth OT Actually Involves

Telehealth occupational therapy is more than screen time. Learn how online OT sessions can involve clinical reasoning, evidence-informed approaches, and real-time parent involvement—delivered in your child’s everyday environment.

What’s Really Happening During a Telehealth OT Session

Telehealth occupational therapy sessions are structured, purposeful, and grounded in professional practice. Here’s what may take place during a well-delivered session:

1. Real-time observation in the home environment
   Therapists observe how a child moves, engages, and responds within familiar surroundings. This can provide valuable context about routines, regulation, and participation in daily activities.
2. Live parent guidance and involvement
   Parents may receive in-the-moment guidance during sessions, helping them understand strategies and how these may fit into everyday routines.
3. Activities adapted to the home setting
   Therapy activities are often adjusted using available household items and spaces, supporting relevance and practicality without specialised equipment.
4. Support during emotionally challenging moments
   When difficulties arise during a session, therapists can help parents reflect on responses, cues, and supportive strategies in real time.
5. Collaborative goal-focused planning
   Goals are developed and reviewed using recognised professional frameworks, with progress discussed collaboratively and adjusted as needed.
6. Everyday materials instead of clinic equipment
   Sessions may use common items such as cushions, stairs, or toys already part of the child’s daily life, reducing barriers to participation.
7. Shared learning for families
   Telehealth sessions often place parents alongside their child, supporting understanding, confidence, and continuity between sessions.

When families think of occupational therapy, they often picture specialist equipment or a clinic setting. While these can be valuable, therapy is not defined by tools alone—it is shaped by clinical reasoning, meaningful goals, and the child’s daily context.

In telehealth occupational therapy, sessions are guided by evidence-informed practice and professional judgement. Therapists observe children in their natural environment, gaining insight into how routines, expectations, and surroundings influence participation and regulation.

Telehealth also allows parents to be actively involved. Rather than receiving information after a session, families may participate alongside their child, building understanding of how strategies can be applied within everyday life.

Activities are typically drawn from what is already available at home. This can make therapy feel more relevant and easier to integrate into regular routines, supporting continuity between sessions.

Telehealth OT does not replace clinical skill—it relies on it. Sessions are planned, responsive, and tailored to each family’s circumstances, offering a flexible way to remain engaged in therapy when attending in person is difficult.

“Occupational therapy is most effective when embedded in meaningful routines. The child’s natural environment offers rich information for clinical reasoning.” — Roseann Schaaf