Masterclass #2: How to Keep Kids Engaged in Their OT Telehealth Session

Hey, I can't hear you yet. I guess I'm going to have to shut the doors.

Can you hear me?

Yeah, now I can. Okay, I'm going to see if I can. Let's see. How do I change it so you can have the. Try to think. How do I make it so you can take control of this? Oh, we're recording. I forgot. Hello, everybody. I have it on automatic so I don't forget. Okay. Just trying to remember how to. How to make it so that you can.

Can you do it once the meeting starts, or is that something you have to, like, set before?

Well, maybe I thought I could switch it over so you could do it. It's okay. I'll just do it.

I'm not sure. I haven't.

There's a way I can make it so you can admit everybody, but I don't remember where that's at. Hello, everybody. Let's see. I'm gonna pin my video. That way the recording doesn't just look like a bunch of little boxes. Hello, everybody. Welcome. Hi, Janet. Hi. Hopefully everybody will be able to see them. It's so much more fun than looking at a black box. Just wait a few minutes for me to come on, you guys. While you're coming on, you can type in, like, where you're watching from and what your favorite activity was this week. That's always fun. Hi, Karina. Hi. Hi, Diane. Hello. Hi, Norma. I'm not sure. Dee Pankot. How do you say your name? I'm not sure.

Oh.

Outside Buffalo, New York. Is it hot there yet? It's been like 100 here lately. Hot.

We had a really hot streak where it was high 80s, close to 90. But then a cold front came through. And today and yesterday were pretty nice. Nice and cool.

I just saw in the news that New York's making everybody quarantine if they come to visit. Huh?

Yeah.

And there were some states. Connecticut, and. Was it New Jersey? Was that the other one?

Yeah. Yeah. But we started our mask wearing very early on.

Mm.

And it. And it paid off. So where we had the most cases, now we have the least cases. We had a little uptick the past couple days, but they expected that.

Yeah. They're Friday. They're. They're going to mandatory mass for 5 and up. I can't remember if it's over 5 or 5 and up, but it's in all public places inside.

Yeah, I think. I think it's two and up here. I think that's what I heard.

Wow.

Yeah. And everybody really complies with It. When you go to the grocery store, you don't see anyone without a mask.

We haven't had good complaint. Like, that's why they made it mandatory, because hardly anybody was wearing them.

Yep. I mean, people have different beliefs on whether or not they work well.

Yeah.

Something's cutting down the transmission, so. Doesn't hurt to wear them. You're protecting other people.

Exactly. Welcome, everybody. We're just everybody in. Go ahead and put in your. Where you're watching from. If you have, like, a favorite activity from this week. Put that in there. Pennsylvania. James from Pennsylvania. New York here. Okay.

Norma.

You'Re going to mandatory Mass. 11 and up. Interesting how they're all different ages, huh? Mm, Massachusetts. And Denver. Vancouver.

It'll be interesting to see what happens in the fall, whether school's open or not.

I know. I just. Honestly, I cannot imagine the kids wearing them all day because, I mean, I have to take a lot of breaks during the day and get it off my face for a few minutes, you know, how are the kids gonna be able to do that and wear them? It just. Especially the ones with the sensory issues.

Oh, yeah. And the school where I work, it's three stories and no air conditioning.

Oh, my gosh.

Yeah.

Everywhere. Challenging times, man.

I know, y'.

All.

You hope that you're gonna wake up from the nightmare.

I know. It's just. Well. And like our governor said, until there's a cure or a vaccine. And I'm thinking, wow, we could be wearing masks for years. That would be just incredible. I don't know. It's something else.

I have about 15 of them hanging on my gear shift, so I can switch them out.

Nice collection.

Yeah. Yeah.

My friend got one of those ones where it's a his face printed on it, and it looks cool. It looks so creepy.

I bought two that have a dog's face on them.

Oh, yeah.

They're from China, and they're made from some silky fabric that I can't even breathe through.

Oh, gosh.

Yeah. I put it on. I'm like, yeah, this was a waste of money.

I've been thinking about what could be like, the lightest, most breathable fabric that's still good. I know. I read one article on T shirt material being. Being pretty good.

Well, I bought some masks at a grocery store, and I gave my son one, and he said, mom, that looks like underwear, but it's, like, T shirt material. And I got one for myself. I put it on. It's really comfortable.

Son came in with one, and I think it's Kind of the same thing. It's like a white cotton. It's very light, very comfortable. I think they got it by Mart. Morgan, do you know. Do you know where she said, I think it's by Mart. I don't know if you guys have that store, but I haven't gone and checked it out. But it looked really light and comfortable. And they were cotton, so they were gonna tie dye them, which would be really fun. So it wouldn't look like underwear. That could be a fun project with the kids in the clinic. Make your own mask. Tie dye your. Yeah, that'd be fun. Don't use your underwear.

Well, I was thinking if it had a. If it had a little fly in the front, I could stick my straw through to get a drink. Yep.

Okay, we're gonna go ahead and get started here, I think. Although I just. Let's see. I'll just have to make sure. I was trying to make it so Morgan could. Morgan's on here. My OTA that she could keep admitting people in, but I couldn't figure out how to switch her to the switcher. To the. Whatever you call it, the moderator or whatever. Well, let's have to keep making sure I stop for a second and admit people. So. So welcome everybody. If you haven't already put in where you're watching from, I don't see any activities in there. Tell me your favorite activities this week too. What's been fun? And also if you're like, what percentage are any of you guys back to? Is it still all telehealth or, like, now we're mostly in the clinic and just a little bit of telehealth, so that'd be interesting to hear what you guys are doing.

Well, I was all telehealth then my blood pressure went sky high because I was having so many computer issues.

Oh, yeah.

So I'm off on disability now. But we were 100% telehealth.

Yeah. Yeah. We losing track of time. This is maybe our third week back. We only have a few that are doing telehealth now.

I was doing 10 sessions a day, five days a week. It was way too much. Too much. I mean, I'm almost 65, but I think that would be way too much for a younger person.

Oh, yeah, yeah.

So she said, well, I could take one away. I'm like, that's not gonna help much.

That's a lot.

It is.

Okey dokey. I think we'll go ahead and get started. Just a reminder, it is being recorded so I can send you All a replay. And then I also uploaded into the level up the membership site, the level up Pedsot so replay will live there too. And I'm excited to help you all with a few tips. And some of the stuff I'm going to share with you is actually stuff that's come from the group too. So not just my ideas. So what we're going to do is we're going to go over some real life examples. I've broken it down to a seven step process for how how to make the sessions engaging, like seven things to be thinking about. I'll show you some video examples and you can make yourself a little tool. So if you have a pencil and a paper, we'll make a little tool so you can kind of have a way to organize your thoughts a little bit and then we'll do a little recap. And so just first a little about me. In case you don't know me. I'm Mary Koska, ot of 31 years and the last 11 have been in my own private practice, a sensory integration clinic. Before that was 17 years in schools and I've had a couple years birth to three and then the spattering of everything else under the sun. So you know, skilled nursing facilities, rehab, travel, therapy, all that good stuff. So a little bit everything. And I have been creating a bunch of different groups and so I have a private practice pediatric OT private practice group. I have the sensory savvy parent group, I have the telehealth group that you guys are all in. Friends of Ohana ot so just some different groups. And my business name is Ohana Occupational Therapy. So if anybody wants to look at my website it's ohanaot.com and let's see what else can I tell you about me, my passion, you know, I love all the kids, but my passion is the sensory kids that's really honed in on. I like a challenge, I like figuring them out. It's fun. And I really enjoy empowering other therapists to be skilled in that area and also to have their own practices because even though it's a lot of work, there's nothing like having clinical freedom and being able to do your best work. So it's really fun. And I have a couple of boys that one has graduated from college just this year and another one that's got another year and husband and a mom that is 81 that just moved out of the house. She had her own apartment and we snowmobile up to our house so she finally doesn't have to do that. Anymore. I live up in the mountains in Washington state. So when we made our transition to telehealth, it was really fast. It was like 48 hours. It was super quick. And so we did it really intensely for about 10 weeks. And now we're about 80% full in our clinic and we still have some telehealth going on. So it was a real fast learning curve and we all learned together and helped each other. So it's been pretty neat. I definitely, before having to do it, didn't really have a good opinion of it because they had. We have a real shortage here. And they. And I had heard that the school was doing telehealth, and I was like, that can't be any good. Yeah, it's very negative. So. And then all of a sudden I'm doing it, so I found out it can be really great. So there's a lot of neat things to, you know, make it. Make it engaging and fun. And in some cases, we made better progress than we. Than we were making in the clinic. So you just. You never know. By the way, as we're going along, if you have any questions, just type them in the box and you can talk in the chat and you can talk to each other in the chat. And Morgan, my OTA wave, so they know who you are. Morgan, she'll answer questions that she can answer for you, and then she's going to collect the other questions and then she'll ask them at the end. So I can just answer what the main questions are, but if they're kind of easy questions to answer, she'll just answer them for me. So I have. Where was I? Yeah, I couldn't really imagine it. And then it was just such a great experience because I love a challenge. I love being creative. I didn't like the financial stress of, you know, all of a sudden, all the changes, but got lucky and got the. The PPP money. So we were able to put. I was able to have my staff really work on a lot of the. Learning a lot of stuff so that we could do a lot of online things and figure things out. So it's been really fun. And that, you know, helped us develop the membership side and all that, so we were able to put our energy there. So I have two amazing codas, Jen and Orlando. They're just fantastic. And Morgan's my OT aide. And then I have a couple other support staff, Haley and Maddie. And so I have just this amazing team. So when people are like, Mary, how do you do all this stuff? Well, I Don't do it all. I have a lot of people helping me, so they're super awesome. So first I'm just going to tell a couple quick stories that will drive home some of the points I'm going to make later. I think no matter what, the most important thing in your session is connecting and being present and to not ever forget, no matter how long you've been doing it, that we are in the middle of a worldwide pandemic. And so the most important thing is to check in, check in and see how they're doing. And you're going to get more engagement from the parents, from the kids if they know you care. And, and we'll get more into that later, but I just want to tell the story of what happened. So I was checking in with this mom and come to find out right after our session. The week before, her husband had had a fall and he was three hours away in ICU on a ventilator. Severe tbi. She was a boy with autism and she couldn't go see him. I mean, it was just like crushing. I mean, I. So she just started telling me all this stuff. I'm like, forget this session. I need to help this mom. And so, you know, as I'm figuring everything out and realizing that, you know, she was able, she went, she brought her son with and got one person to watch. I know she got one short visit in, in the whole week and she hadn't been to see him and it didn't go very well. Like the boy really needed to stay home. And so that night I got a hold of our autism support group in our community and got them to wrap around her, got somebody to. And then they, they took over it and then they got somebody to do some respite for her and she got over to see him and it just was crazy. But I mean, I never in a million years would have realized how important it is to really see how they're doing right from the start. And then, and we'll talk about it more, but in a fun way too. Just, you know, what'd you do this weekend? Or just. We'll get more into that later. But I just wanted to help tell that story. And it's not in making it engaging is really. A lot of it is just having fun, you know, having fun like you would in the clinic, but in a little bit different way. So I had a 16 month old that I was working with and it's a. If you're not muted, go ahead and mute your thing. Anyway, so we're like playing peekaboo, you know, I'm trying to get on the screen, hard to get on screen but I'd be like, you know, doing that or she was like moving her tongue around and I moved my tongue around. So it wasn't a whole lot different than if we were just right there together. And then I was using a doll to help mom know what to do with her to help work on her core. So there's just so many different things you can do. Even though there's a screen there's a lot of ways to draw them in and you know, working on handwriting there's so many things you can do can write a story together, never ending story back and forth and with teenagers just and we'll get into this a little bit more but really just making it meaningful. One of the teens with autism that I've worked with his meaningful activities more to his mom was getting him to tolerate a blood pressure cuff and ekg. We had been doing hands on activities and watching videos and stuff to get him used to that kind of thing. But we actually made the most progress through telehealth which has been really surprising. So for the first time we've been, she's been trying to get this to happen for a whole year and we've been really focused on it in OT for quite a few months. But our breakthrough was during a telehealth session at home that she finally got him to put the blood pressure cuff on. So that was really exciting. So you just, you just never know. Some of the breakthroughs are going to happen even when you're not in the clinic. Alright, so the seven, I'll just tell you, you can write these down the seven and then I'll go into more detail. The seven things I told you. The first one, connect, be present is really important and the second one is making sure it's meaningful which OT should be anyway. Just you know, making sure that it's something that they're interested in. Number three is shared control. So I don't drive the whole session. I really like shared control. So we'll get more into depth in all of these but can be taking turns selecting activities, that sort of thing running with their ideas, child directed, therapist guided. So the child has something in their mind and then I just, I don't try to pull them back away from whatever's in their mind. I just take what I want to work on and try to make it work together. So we'll talk more about that, how to do that and then number four is Making it a just right challenge. The quickest way for a kid to disengage is for them to not feel successful or to feel bored. And that's whether we're working with them in telehealth or whether we're working with them, you know, in person. But that's how we lose them. They're either bored or they think it's too hard. So that, you know, for all our kids is always such a. I call it the tightrope. Walking that tightrope, that's the challenge. That's the skilled part of what we do. Right? And then number five is making it interesting and entertaining. And I'm like, my superpower is being super chill. I am not like the most dramatic animated person, but I have to just make myself be that way. I have to liven up and be a little more fun than I normally am. Especially with the screen. You gotta kinda step it up a little bit. So five was interesting. Entertaining. Six is kind of a step up from that. Just really having fun and being silly. So it's a little step up from interesting and entertaining. Throwing some fun and silliness. And then number seven is making sure there's variety and something unexpected. So we're going to talk about suspense. Works really good. So those are the seven. And so we'll go into a little bit more depth. In depth with some examples of each of those. So connecting and being present. If my head is down and I'm writing something down, boy, didn't I just lose you? Totally. So if I am kind of shifting my eyes and looking over here or I look at my phone, I completely lost you. Right. So I like to look away from the screen a lot because it hurts my eyes, but I do it when they're not looking at me. So if, you know, go get that pillow. And then I look out the window or shift my eyes. But like, when the kid's there, you got to be like, completely with them or you're going to lose them totally. So don't multitask. To do this, I have to look down because I'm looking at my notes. But you definitely want to not do that, so. Especially with a parent. But this is true for kids, too. To show that you care when you check in on them and see what's new, What'd you do this weekend or whatever. The way to show you care is to go three questions deep. So just one question. Oh, how, you know, how was the weekend? What's new? Okay, let's do this. You want to go three Questions deep. So. So they say, oh, we got to go to the river. Oh, cool. Who'd you go with? Or, you know, what did you do? Just go three questions into it. Then you can move on. But if you get three questions in, then you actually care. So that's a little trick that I've learned that's pretty neat. So connecting with little ones, like, I kind of showed you, you can do really a lot of the same things that you normally do to play, like, peekaboo or just, like, all that imitation or making funny sounds. With sensory integration. Kids, I think the big fear is like, oh, what do I do? And they're just, like, melting down. And it's so hard because I can't control the environment and all this stuff and all hell's breaking loose or whatever. It's okay. It's really okay to observe because just think you just got a window into their life so you don't have to feel like, oh, man, I got to control every moment here. So the parents struggling, you're watching it go down, just kind of sit back and go, wow, this is an opportunity for me to coach them through this. This is. So instead of like, oh, man, I just lost control of my session. Think of it as an opportunity. And I've had ones that have gone like that. I mean, the phone's under the bed, and I'm talking to the kid under the bed, or they're under the covers or they ran out the room or whatever. You know, if they. If they're really, like, if they've left and they've checked out and you've really lost them. You know, I've taken that time to just talk, talk to the parent, but then coaching them through it. And I've had some great experiences with that. So I think the thing is, you have to just realize you didn't fail. It's an opportunity to just see what things look like. Because a lot of my kids, I never see their meltdowns in the clinic because I can control everything. So that's okay if that happens. I think with teens, it's important. I think the thing that's so hard for them is, like, they're not with their friends. They're with their family. I mean, when you were a teenager, how much time did you spend with your parents? You know, so I think, like, seeing how they're doing emotionally and checking in and, you know, how are they staying connected to their friends, and that sort of thing is important. So some ideas for making it meaningful for parents. Some of the goals that we had like before may not be appropriate for right now because what was hard before may not be hard now. You know, maybe it was transitions, but now there's hardly any transitions. So that's, that's going okay now, but maybe it's something completely different. So a really easy question is, say what's hard now? What's hard? And then that might lead you to something you're going to address in that session or a goal that you're going to change. With one parent, we went totally on the wiping for a bowel movement track that that was. They were really working on that now, so we kind of shifted to that goal. So what's hard right now is a good one. And even asking like kids that can answer it, it's interesting to hear what they say, what's hard. So for making it meaningful for little ones, I think really getting when you're interacting with the parent, helping them, you can model, like I said with the dolls, but you can do things like, okay, here's like, say you're trying to get him to engage a child in tummy time and you can direct them to be like, okay, you lay on the floor, get eye to eye with your child and they can just prop up the phone or the computer somewhere so you can see. So I'm not a big proponent of like, you gotta sit in front of the computer. You can place it in different places so that you can do things that are gonna work a little bit better. With my si kids, the thing that's made it like really engaging for the kids is them getting something that they love. So getting their favorite stuffed animal and including that in the activities has been just a hit every single time. And then their actual pets too have been really good. So we've done everything from like a fine motor activity. We ended up the child was distracted by their new kitty and wanted to play with the kitty. So I'm like, oh, bring me the kitty, I want to see too. So instead of being like the parent, trying to get him like to not pay attention to the kitty and come back to me, I used that and I'm like, I want to see the kitty. What'd you name him? Da da da da. Do you have any choice for him yet? Oh, we can make a pom pom and then progress to the goal that I wanted, which was completing a multi step task, a fine motor task and paying attention. So we just took some time to live in that what he was interested in. And then I took what I wanted and did it. That way so that that works really well. So pets and stuffed animals are really great. You can also kind of use it as a incentive. Like if, say, they want to show you their new little chickie or something, you can say, oh, great, you can do the first. Then first we're gonna do this, this and this, and then that'll be the thing we do at the end, you can go get your pet and show me. So with, with some. I'm really trying to, like, cover like the little ones, the handwriting kids, the SI kids, the older kids, because a lot of people write me and say, well, is this going to apply to this, this and this? I'm trying to give lots of different examples for you guys. So for, like the handwriting kids, if they showed you something or told you about something, you can use that for them, what they're going to write about. So you could have them describe, if they wanted to describe their pet that they showed you. Or depending on the level, like, maybe they're just working on letters. Oh, your doggy's name is making it up. Like, boo, Boo. Let's make a letter B starts with B. Just work it that way. And then I really think with handwriting, I always prefer multisensory. If you can do it, you know, any time you can do something more, multisensory is going to be a lot better. So three taking turns, shared control. So there's, there's a lot of ways you can do this. Like with a parent, you can, you can share this control or expertise by, you know, you show me what you've been doing and then, oh, wow, that's a great idea. I love that. You know, you really want to give them a lot of affirmations on what they're doing. Well, and then you can say, oh, you could also try this. Having the child copy things that you're doing. You can. Simon says has been like, such, like the best. When I was. Did anybody see the interview I did with Hadra in Pakistan? Anybody watch that? If you haven't watch it, I posted it and it was so, so fun because we're both going like, yeah, Simon says that's been working. Really, you know, we're just like going back and forth having like the same experience on different sides of the world. It was so fun. But Simon says has been a big hit for her too. But that's something is really great because you really can share the control and take turns and they can get you doing, like, goofy things and then you can choose things that are going to actually make them work. On their goals. So they really enjoy making me look really silly, which is great actually. So yeah, for elementary and teen kids taking turn choosing activities, you can like choose them at the beginning and make some kind of like schedule or you can just take turns. But definitely having them be part of that decision making makes it a really big difference. Tempted to read all these comments, but I'm just gonna keep going. We'll do that at the end. So number four, just right challenge. So that's the real art and science of what we do. As OTs. I think we take it for granted that that's such a skilled area of what we do. And so we're scaffolding or we're upgrading or we're downgrading in the moment. I also think it's what makes it challenging to research what we do because what we do in a session is never what we thought we were going to do because we're constantly adjusting it so that they'll be successful. And I really have found with my kids, especially the boys and it's been fun like listening to Adam, the ot. I've heard him say the exact same thing. Calling it levels is so. Works so well. Like ah, you just did level one. That's so awesome. Oh, let's see what you know, be like what's. Usually they're asking me well what's level two? And then you add something to it and they're so thrilled if they can get up to like level 7 or level 10. You know, just like a video game. So really making sure you know, starting with something that you know they're going to be successful at and then make it and then increase the levels of the challenge. And I think that that really translates really. I have found that really translates really well into telehealth. So you can. And also just working on self regulation. Working on you can do some self regulation things at the beginning or at the end of the session to help make sure that you keep it at the just right challenge so they're not getting stressed. If you watch the other one I did, I was talking about one of my favorites is dragon breathing. So you just take a breath and and then they do it to you and you're like ah, you blew me back. It's good. It's a nice visual one. It's really fun. I like doing that one. Visual schedules. I've done them on the fly. Like the one where I was helping the kid clean up his desk in his room and I just drew it on a piece of paper and Held it up just like stick figures, just old school. And you can even cross off things. I mean, a lot of people are doing the shared screen. There's a lot of stuff you can do shared screen. I am not that high tech yet, so. So I don't have a bunch of ideas for you on the shared screen, but there's a ton that's been posted in the group, so take a look at that. So visual schedule. So a lot of this stuff is stuff we do anyway. It's just thinking about how to do it in telehealth. So number five, interesting, entertaining. So for the little ones, just going right back to your song play translates great into telehealth. So my favorite song for little ones that they always seem to get engaged in is the. Well, it's called Slippery Fish, but I always call it Little Fish that, you know, it's like little fish, little fish swimming in the water. And you're like, oh no, it's been eaten by an octopus. An octopus. So look that one up on YouTube. I think it's actually called Slippery Fish. I simplified the words for myself because I couldn't remember all the words. So I call it Little Fish. And they're all swimming in the song. They're like lurking, doing different things. But for me they're all swimming. It's easier. But you know, doing any kind of song, play Itsy Bitsy Spider, all that kind of stuff is going to be more visual. Finger puppets are really good for some of the older kids that we're working on their thumb flexion extension. All we did was put like a face on the thumb and just we were doing this kind of thing with the faces. Finger puppets. If you share your screen. There's a lot of books that are being read on YouTube. So some people have done that. I haven't actually tried that yet, but it looks like a pretty fun thing to do. You could also just hold up a book and read it to them. So one thing we've done a lot with our kids, our elementary school kids and SI kids is having just playing with the screen with the stuffed animals. So like we have the shark puppet. So he like comes up and, you know, just like making things visually interesting. Like it's coming in this way or. Or with one kid we were doing like little drawings. Actually, this was just all spontaneous. He drew a playground. We were doing cutting and drawing and I drew stuff and then we were holding it up and he was holding his up. And then he decided to be a therapist. So he drew himself as A therapist and then telling me what I had to do. And all we did was just hold those things up and then play with them that way. And that was really fun. So I think the thing is like with the telehealth it has to be like visually engaging. So that's kind of where I'm going with some of this stuff. Oh, this will be fun. I'll show you guys this right now, the handwriting song. So, you know, 31 years, you get so many gems and I wish I could give somebody credit for this one. If you guys don't know this one, you're gonna love it. It's so fun. So this is the handwriting warm up song and I want. I'm gonna put it on so I can see everybody. I want you guys to do it with me. All right, you ready? So you'll need a pencil. Wait, I gotta make sure I have the pencil or a pen. Alright, so you ready? Can do with me. So just sing. Just do the motions because you won't know the words but so are your hands up high. Gotta put them up high, everybody. Can you reach them to the sky? Can you press them to the floor? And do it once more. Can you bounce in your chair with your hands up in your hair? Are your hands up high? Can you press your hands together till you count? 2, 4. 1, 2, 3, 4. Press even harder and get ready for more. Put the pencil in the palm of your hands and move it to the tips and do it again. Inch up to the eraser and down to the lead. Do it once more exactly how I said. Tap three times on the table. Flip it if you're able. Now you're ready to, right? And please don't judge my singing. I am not a singer. It's taken me a lot of courage to sing in front of people. Did anybody know that one? I know the tune. Isn't it awesome? I love that one. So that's a good one for telehealth because it's very visual. So on this, on the thing of like making it interesting, entertaining. So also for the handwriting kit kids, I think I haven't done this. I've done it with my own kids because we do it on holidays. We'll do these like scavenger hunts. But I think this would be super fun to do with handwriting kids. So putting a sibling or a parent on. On a hunt for clues. So they would have to write the clues and so the first clue would be like say they had to go to the pillow on the couch so they. The clue would be however they wanted to write it. But maybe it's square and it's soft and it's in the living room or something. But they'd have to write the clue and then they'd go put that clue like under the pillow. So then the person goes, the mom or the brother or whatever would go to that. And then, then that clue that's under the pillow is going to lead them to the next place. So I think that would be really a fun fun if I had about. I don't have a bunch of handwriting kids right now, so if I had handwriting kid I would do that. I think that was so fun. So just sending somebody on to different and then helping them, helping them, like come up with the clue. And you could make this really simple or you could make it more complex, depending on their skill levels. I think that would make it meaningful, engaging, because it would be in the house. And then the last clue could be some kind of prize of some kind. Who knows what. Just something silly, a toy or something. I guess I'll just do a little personal aside how this came about in my family for holidays. Just for fun. Share the story so my dad was really, really sick, like many years ago, maybe 11 years ago or something. And he. And it was Easter and I really wanted him to get to see the kids get their Easter basket. We had these fishing poles and all this stuff. So I'm like, well, I want to have it like in the room where he's at. So. But then I was like, that be kind of weird to be just like, let's just go in Pop Pop's room for the Easter basket. So I thought let's make it fun. And maybe it was my dad's idea actually, because we sat down and we wrote these clips clues together and we sent them all over the place. And then the final, like finding Easter basket was in his room. So it was really fun. And then every year, and then he did pass away because he had cancer and then. But then we just like they always wanted to do that. So even now that they're in their 20s, we still have to do these like extravagant scavenger hunts and sometimes it sends them all over the mountain. And the last couple times I made them write their own clues for each other because it was getting to be too crazy for me. But it's just like turned into a crazy thing. But it's really fun. It's a fun thing to do and you can make it really simple. What else we got? How are we doing on time? Pretty Good. Okay. Writing clues for teens. I've definitely found like getting into their music really helpful. So finding out what music they like playing that you could use the music in lots of different ways. A first then. Or you could do it as could write about the music or you could do freeze dancing to the music. It depends like what your goal is, what you're trying to do. Maybe you're working on chores or something. But they get to play their music while they're doing the chores. But what kid doesn't love for you to hear their music? My son. When he was in high school, I had a long drive with him and he loved all this music that I could not stand. All this rap and stuff. And I listened to it for like three hours and he just thought that was the best day of his life. What a good mom I was. I was just like, I'm just gonna listen to his music. And you know, they just feel so valued when you actually do that. So it was torture, but I did it. I think it's because my Mac is older. I cannot do this cool virtual background thing. Some reason I can't do it. But the people that are doing it, it's so fun. You can look like and you can put up your own videos, your own pictures. You can do the. The ones that are in there to select from. But the virtual backgrounds I think would be really a fun way to especially. Well, really everybody all the ages. But if you're able to do that, I think that would be a fun way to just kind of spice things up a little bit. So six fun. Let me know if this is. If this is going good so far. Am I going too fast? Are we doing okay? Doing great. Okay. Cool. One person says great Jade. Thanks. I can't tell if I'm like talking too fast or whatever. Alright. So fun and silly really. I put this as birth to three but you could really do it with anybody. But just making funny, funny noises and goofy, goofy sounds when you're working with them. I always do it with brush and squish. I'm like, oh, you're squeaking. Or you know, just being goofy. I've seen a lot of people just go crazy with like I am. I don't know if I'm lazy or what, I don't know. But I just do not go to these great lengths that some people are doing. But hey, more power to you if you do it. But silly hats and you know, different outfits. I've seen people dress up like different characters. I mean some people are just Going to town, but, you know, just something unexpected. They're kind of bored and, you know, show up looking like Elsa. You know, hey, that would be a little more fun, but, you know, just silly glasses or just doing something unexpected, you know, it's just something unexpected. I guess that's the next one. 7. That one would be silly. Okay, definitely. With the kids, I like to get them, especially the elementary kids, get them moving. So I really do not like having them sitting at the screen. So we do a lot of, like I said, like, free stands. Simon says just activity. There's so many activities in our group, and now they're organized. And, hey, can we all just give Morgan a shout out for organizing everything? Yay, Morgan. Thank you. She does all the. She does, like, she's categorizing everything so they're tagged. She's summarizing everybody's, like, household activities, sending them out to everybody. She's doing all that great stuff. So where was I? I distracted myself. Yeah, I just. I just like to get them moving, doing stuff. So I know where I was going with that. The laundry basket. So, you know, doing things like get the laundry basket and hold the towel or the broom and pull around the room or sit on the blanket and get pulled around, or put. Push a war, tug a war. I try to do most of my session without them right in front of the screen. So let's see, where am I? And, you know, keeping it multisensory, engaging the senses. The little boy that was working on the wiping, and this was all very spontaneous because I found out what's hard right now, and that wasn't his goals, but it wasn't our focus at the time. But I'm like, oh, hey, let's work on it. So. So we just got a cookie sheet and some toilet paper and some shaving cream. And we just. We found out, you know, I asked him, what's hard? Why don't you want to do it? And he's like, I want to get on my fingers. Like, okay, let's practice with shaving cream. So we just practice on, like, how to get it on his hand. Like, make a little toilet paper. Next time you go to the bathroom, pay attention. How do you put toilet paper on your hand to wipe? It's very interesting. Like, some people just do a big bunch. I do this, like, little pocket thing. Everybody does something different. But, like, we just figured out, like, how do you get the toilet paper on your hands so that it won't your fingers? So I'm like, okay, so gotta Wipe up this shaving cream and then we're gonna see if you got any on your fingers. And so that's what we did. So you can do all those kinds of things with telehealth too. And then mom was like, oh, you ready to try it? And he's like no. And I'm like, well, you know what you could do is next time you're in the bathroom, you can just at least put it on your fingers. And so put the toilet paper in your fingers. So. So baby steps. Where are we? Go outside. You do not have to stay in the house with telehealth. So many of the parents just do it on their phone anyway. Go outside, do chalk obstacle course, have them show you what's in their yard. I had one little boy take me under a bush that was his favorite, favorite peaceful place. Show their garden. You do not have to stay in the house. Oh, and for teens, you know, some of them are doing this like TikTok dance stuff so they could like teach you some moves and then you can, you know, do some kind of fun, silly things that way. There's a lot of like online games and there's a lot of things you can screen share with. I personally haven't gone that route. I just, I personally just am not really into, you know, having them do more screen time games. But I'm not against it. It's just not what I've been doing. But there's a lot of people that have been sharing a lot of cool stuff that in that direction. So I think it just depends like what's going to motivate and interest your child and what are you working on and what is the goal. So for seven variety unexpected. So for like the little ones, you know, you can do little voices, like funny little voices with your animals. I can remember my dad doing the Cookie Monster to this day. You know, when we were little and it was so funny and then we'd have the Cookie Monster in our car and then he'd be doing it to like the car next to us and the kids would be cracking up. You know, just stuff like that. It's super funny. We already talked about changing the background. Okay, so this is something that was kind of fun that I did. It's kind of have fun to have a surprise, like a surprise visitor on your call. This is a telehealthy thing you can do. So we had, we have this little boy that he gets everybody in the clinic to do things with him and whether it's basketball or.

You know, who.

I'm talking about Morgan. Whether it's basketball or a dance party or something. So he's in love with the secretary and the aides, and he just rounds everybody up. And so when we start doing telehealth and it was just like the one person, he's just kind of like, where is everybody? So you can have somebody else pop on that they're attached to. So we had our receptionist, Haley. We're like, we have a surprise visitor in the last five minutes, but you gotta do X, Y and Z first. And he's like, who's the visitor? Like, somebody you really love. So just kind of like having some incentive. And he was so happy. So then she pops up on the. You know, she comes in just for the last five minutes, and, oh, my gosh, he was so excited to see her. And this is like, you know, when we abruptly had to, like, all be apart from each other and be on Telehaus. So you can do all kinds of interesting. You could be like, I know when Jen was doing hers at her house, her dog was like, such a major reinforcer. It's like, you know, she's like, okay, when we get this done at the end, I'll get. I'll get. Oh, my gosh, I forgot Jen's dog's name. I can't remember. But anyway, she would go get them. And then that was like the fun thing at the end. And they loved it. So with handwriting, you can mix things up or typing. A lot of kids will like, I've had just like, little kids do this too, where they want to write yes and no in the chat box. They just want to answer questions that way or whatever. So let them. That's fun. You could work on keyboarding that way with the older kids. With the handwriting kids, you could communicate via holding it up and you have to read it. And, you know, you could play. The kids really, really love 20 questions, like for guessing animals. So, like, I'm thinking of an animal and then. Or they're thinking of an animal and I always have the parent know what it is. So I know they're answering the question right. But it's like, does it have four legs? Does it swim? Does it, you know, yes, no, yes, no, yes, no. So they could be writing the answers to do it that way. That's a fun game. You can do. Work on a lot of different skills with that one. I haven't actually done this, but when I was brainstorming for this, I thought of this fun idea, like with the teens, I think For a lot of them, it would kind of crack them up to see a picture of you at their age. Because kids, you know, they really like connecting with you personally. And I think that would kind of crack them up. Or oh, we already talked about music. So those are the main things. Trying to think if there's any examples I didn't give you. I mean, if you were on the other one, I talked about working with this kiddo in the back of a car. I mean, you can do. You can. We had to like figure out like they're on vacation and they didn't have WI fi where they were. So they would drive to a. They're so dedicated. They drove to the, like a store or something. And so our session was in the back of the car. I'm like, what are we gonna do sitting in the back of a car during telehealth with a phone? But we ended up doing all kinds of things, like, and he's non verbal too. So we were doing like, we start. One thing that we discovered was we played 20 questions with mom would hold up two hands, like, do you want to ask her does it have four legs or does it swim? And then he would touch the hand, like which question he wanted to ask me. And we actually started to get more communication out of him than we've ever gotten. And it started with the telehealth because he started also answering like the yes and the no questions, which was pretty cool. So there's always a way. I mean, that was a challenging one. Like, how do I engage him when we're just sitting in the back of the car? But we figured it out. So how are we doing on questions? We'll get to the questions in a minute. But are there a lot, Morgan?

There's only about three right now.

Okay, so I am going to show you. We're doing pretty good on our time. I'm going to show you a few live examples and oh, I was going to tell you about the tool. Okay. So I call this my Spice it Up list. So. And I will email you a template. But basically, is that backwards for you guys? Basically you take those seven areas and you just make a column and then a place to jot, like organize your notes and be like, well, here's a few things I'm going to do to be more connected. Here's a few things I can try to be more meaningful. Just so that you, like when you're like sitting there going, this kid's not engaging. You have something to look at. So it's Just a way to organize your notes. So I will send that to you and let me pull up the screen to share. Share screen. Share screen. So I just want to show you some actual sessions. So what we're looking at here is if you're not already in it, this is my membership site. The Level up pedsot up is one of my favorite movies. So I kind of did a little play on that. And I have a lot of different things in here. I have 36 actual little these. I've posted all of these in the, in the Facebook group, but they're organized here. The telehealth activities, the parent empowerment program is parent education the World challenge. These are 40 days. The first 40 days of COVID I went on at 2 o' clock every day and did some self regulation activities with the kids. So there's a lot. And these all translate into telehealth really well. This is a whole handwriting program that I have. All of it translates into telehealth really well. Some stuff on how I do documentation. All the master class replays go in here. And then there's bonus resources like my, my reflex testing tool that I made, my cheat sheet, all that kind of stuff for development. But here's what I want to show you. So. So these are divided by category. So let's see. Let's show Anthony doing his dance party here. Oh, there's Haley. So this was the surprise visitor 1. Woody had to come back and dance with us. So with him we, we usually ended with a dance party. Let's see. Animal walks have been really fun. What kind of sound does a wallaby make? So this is dad. He was coming up with things like wallaby. He's being a wall. So she's being a wallaby. Those are little wallaby sounds. Armadillos. Oh yeah, let's see you crawl again, Armadillo. Dad had all kinds of fun ones. Protect yourself. Can you hear that? He's like, I'm a coyote, you're an armadillo. Curl up and protect yourself. Here's just an example of using furniture. So we're just doing like a superman on a chair. That's it. That's it. Now throw it in. Good job. Anyway, there's like 36 of these in here. All different ones. This is one of my favorites. Vestibular has been like probably the hardest one to do. So came up with spinning in a chair here. Anyway, you get the idea. There's a bunch of stuff in here. Oh, here's the, here's the little thumb Puppets. Okay. And share. Stop. Share. Alrighty, let me see where we're at here. So, so just to recap. Number one was connect, be present. Number two is making it meaningful. Number three was shared control, taking turns with the activities. Number four was just right challenge. And number five was have it be interesting, entertaining. Then six is making it fun and silly. And seven, variety unexpected. So you can just take those seven and then put some things from your notes in there and make it, I call it like your spice it up list. So when you're feeling a little stuck, you have something to spice it up. So if you found this helpful and you want to put a comment in, I'd appreciate it. It's really helpful for me to know if doing these is helpful to you gu the information I'm providing. You know, if you liked it, just let me know. Go ahead and type it in the comments. That'd be. I appreciate that quite a bit. And like I said, the replay of this will be uploaded into the level up peds ot and if you're not in that, you're wondering how to get into it. I can, I can, I'll post the link in the group. If you go to our website, ohanaot.com Morgan can put that in there and you go to the store and you just scroll. There's a bunch of products like sensory products. You just scroll to the bottom. I stuck it down there so that it's easy to find. So it's in our store on our website and I will be provided this. Are you trying to tell me something, Morgan? No. Okay, I will be provided all the planets aligned technology works. It worked last time. I will upload, I will send this replay to you guys all via email. If you don't get it, just let me know and then that's it. So questions and answers. Oh, the words to the song. Yeah, I can send that to you guys. It's also I was actually thinking I should probably just put it in the telehealth, embarrass myself and sing it and put it in the telehealth. But it's also in that handwriting course that I made. But I can just, I know I have the words in there so I can get that document and send it in the email for you guys. So what questions did did they have, Morgan?

So the first question was from someone who works at a school with parents who speak like little English, don't have a lot of supplies and are kind of uninvolved and they're wondering how they can work with Disabled children when their parents are so uninvolved.

I think that's probably been the big heartache and hardest thing that I've seen people talk about in the group. And when you think about it, like, for me, in my clinic, they chose to be there, they're bringing their child, they made the appointment. I've worked 17 years in schools. I know that a good chunk of the parents aren't like the parents that bring their kids to my clinic and that they, you know, I know what you're talking about. So I don't think there's a magic wand. I think you have to do the best that you can do. I think the more that you can do things, if there, if there's limited language, the more you can do things with pictures of some kind, examples, videos of what you want them to do, the better. I literally would take the videos of these video, 36 video clips that I have. I would literally, because I had some families that didn't speak English and so I would play the video and then like hold it up there, hold my phone up like that. And then they'd get it and they'd be, oh, that's what she wants me to get a chair and have them lay on the chair and then do that. So that was really helpful. And you can do that with the platform that I use for the, for the membership site is Kajabi, and you can actually load that up to your phone as an app. And so I've done that so I can get to my videos because, like, I can't even find my videos in the Facebook group because, you know, there's so much in there now. So that way I can get to the videos if I want to show them an example or if you look up something on YouTube and screen share it as an example that I think you're going to. It's probably going to help them the most. But, you know, if you literally have a parent that doesn't care, you know, the child's neglected and not, you know, maybe not like severely neglected, but they just, I don't know, there's not like a magic wand. I think it's going to be very hard. My friends that are teachers, I have a friend that's a seventh grade teacher and they only got one third of the kids doing the school online. Only one third, you know, and these aren't children with disabilities, these are just seventh grade kids. So I think all we can do is the best that we can do. And it's just going to be really hard Sometimes, hopefully that gives you some ideas. I think anytime there's a language barrier, if you can show it visually, that's. That's going to be your best route. Hopefully that was helpful. Hopefully that was helpful. Answer. I don't, I don't have a magic wand, but that's how I did it though. And you have to have a lot of patience because like one parent that didn't speak English very much English and I had to teach the Wilbarger depressure protocol through telehealth. It took us like the whole session. It was really hard, but we did it and she was able to provide him with it. But it just, I mean something that would take me just a few minutes in the clinic took a whole session but we stuck with it until she got it. So I did it on my monkey. I had a monkey and I was showing her. Yeah. Other family members. If there could be like a sibling or you know, just another person that can be there to help them, that would be good. What else? Morgan?

The next question was ways to go about doing telehealth for school in groups, like about four to five kids, like from preschool to high school.

I haven't done a group yet. That would be an interesting topic. We could get some brainstorming going on that in the group. Are they wondering about like what kind of activity to do or I guess I'm not sure exactly what the question is because you would have four or five kids up there and then you know, if you were doing, depending on what you're doing, you could, you would do a lot of the same things. You know, like if you're doing a song play or an activity assignment says or taking turns. I'm not sure the activity would be much different. Yeah.

So it looks like activities and collecting data, what they just sent.

Collecting data. It wouldn't really be any different than normally. Normally how you collect data through your observation skills and checklists and things like that. Oh, I like this comment. Yeah, a wonderful, wonderful window into the families reality helps target our sessions. Yeah, you know, it's been very interesting like even in, just in terms of space because we had one family that their living room was so little we were trying to do log rolls and he barely had any room to even do a log roll because the room was so little. So you know, it was really eye opening. Like when we're trying to think of things for them to do at home, like what's reasonable. Any other ones?

Yeah, well, you saw the one that people wanted the words to the handwriting Songs. Yep, that was mentioned a couple times.

Okay.

Yeah. Another question I was asked a couple times is how to track data when you see multiple kids.

Well, if anybody's used, if anybody has thoughts about that, type them in. I haven't done a lot of groups myself. My therapy's more one to one. But for me, I always make things as simple as possible, like little, I like check or grids and checklists and things like that just to make it super easy. And probably this would help you too, because what I do in a session is, I mean, I might have 14, 15, 18 goals for a kid for the 36 sessions that we'll do. And we'll meet them, meet all those goals. But when I'm in a session, I only focus in my mind on two things the whole session. It doesn't mean I won't do a whole bunch more stuff. But what I'm going to collect data on and what I'm going to like try to target my session on will only be two things. And I do that for at least four sessions in a row. And that I think as OTs, we tend to kind of delude ourselves because we want to work on too many things at one time and feel like we have to work on everything at one time. But I really have found I make the most progress the more focused I am. So for example, let's say I'm working on core extension and following three step directions and I might have those two goals for four sessions in a row that the entire session. That is what's in the back of my mind. How am I going to accomplish those two things? How am I going to take whatever we're doing and turn it into that? And I don't think about anything else in the back of my mind. I'm just thinking about two things and that's it. So if I was taking, so taking data, if you're trying to target less things, it's easier to take data on. It's easier to hold it in your head if you have to hold it in your head until you write it down. So I think being really intentional and really focused on your priorities makes it easier.

Another question was, which evals are you using on telehealth?

So for me, because how I do my evals, it really didn't change much. I've given thousands of Bruinics and Peabody's and VMIs and all that stuff and a whole bunch of sipped tests and all that. And being in private practice, my time to do those things is really not reimbursed. And so I've really streamlined my process to what gives me the most meaningful information to get the most done in the shortest amount of time. And so I do the Ayers clinical observations. So they're, they're, they're normed. Like I know like how, how what's in the normal range. So I do that and I do. And if you can find the. There's a whole post on this and then telehealth activities under. If you, if you go into the. There's an evaluation tag that you can on popular tote popular posts. There's one on evaluation. So you'll find it all in there. People have looked it up and put, put in the different products that they've been using. But I really like that and I was able to do those through telehealth. And then I do the sensory processing measure and I do. I gather a lot of functional data from them. If I need, if I want to focus on like ADLs and IADLs, I'll do the real, which I only actually learned about that test like last year. It's the real. It's super easy. It's a lot easier than doing the. I don't know if you say PD or Pedi, that really extensive one for ADL's. The real is shorter, quicker to fill out and it gives you a real good idea of where they're at in their, in all the functional things. And it gives you a score if you need a number if you need it. And especially on the IADLs, there's some stuff in there I don't know how I'd score. So if you're needing, you know, if your insurance or whatever you're really needing a score, that's helpful and it's helpful to get functional goals from that. So I like to learning about that one. What else do I do? Yeah, so I do a lot of si like clinical observations, sensory and extensive history and yep, that's what I do. And my evals, I write, I have a real streamlined way in the level up peds ot there's a. I show you how I do my evals, how I write them up, what I include in them. So really for me, because how I was doing it, it's pretty much the same but I know not everybody can do it that way. But I know that there's a lot of information that's been posted and there's some. There's a lot of information from like the testing companies of how you can use their tests in telehealth, which ones can be used. There's been a lot of people contributing to that topic. So just look up the popular posts of tele. I'm melting. My words aren't coming out right. Popular posts, evaluations and you'll get lots of good, good info. Anything else?

There's just a question that says when you write your evals, do you write them from an educational model?

No, because I'm a private practice, so I'm a medical model. So it's all function based. It's all. Yeah, I'm not, I don't work for a school, so But I did for 17 years when I worked in the schools. So it, you know, depends on your setting.

There's also a question asking if you have like a must have list for parents when doing telehealth with supplies that they should have ready.

I keep it so simple. I know a lot of people do that. Like they'll have the parents fill out like a checklist of what they have in their house. I really rely on things that I think are in every house and I look and see in the space that they're in at the moment and see what's there and use what I see. I just keep it really, really simple and I don't want to make it hard for them. I don't want them to have to run around and get six things. So I keep it really simple. So that's, that's a lot of why I started posting. Because like the number one, that's what the other class is about that I did. The number one thing people were having challenges with was how do we do this with just what's in the home? We don't have our tools to do our job. And so that's been really fun having everybody brainstorm. I'm like, well, what are all the things you can do with a T shirt? What are all the things you can do with. You know, more and more I'm trying to think of things that are pretty much in every house and that way it's not hard. And if you're only asking them to get like two things, then it's not that much of a burden to do it in the beginning. But I'm not against being more organized and communicating with them ahead of time because I think that they would appreciate that if you were able to say, hey, can you have this, this and this ready? But I think, but like for example, working on the wiping, I didn't even know I was going to work on wiping that day. So it kind of came from connecting with the parent and finding out what has been the struggle. And. And it still fit with the goal area that I had, that I was able to target it to what was really the need that day. And most everybody has. Has toilet paper and a cookie sheet. And if she didn't have. If she didn't have shaving cream, I would have thought of something else, like how about some shampoo? Or, you know, I just try to stick with things that I. That are in the house for sure. Keep it really simple. Yeah. I admire you, Diane. Emailing the night before. I'm just not that organized. I don't know. It's not that I'm not that organized. I think it's more that. So many of the times what I think I'm going to do in a session isn't what I end up doing. So I think it's more that maybe that's why you were going crazy. Honestly, they can lead you in. I know a lot of people really, really like having everything, like, really organized and really planned because it makes them feel more prepared. But I think the more experience I've had over the years, if I just really, truly tune in and connect, I can really serve them better in that moment without having a huge agenda. And then I don't feel frustrated that I didn't get to this whole thing that I planned. So I know a lot of people can't operate that way, so it's okay. I admire you for being organized and prepared in the moment. Yeah. Yeah. You know, that's the thing. Like, okay, when you're really in this SI mode, your job is to. The child's half of it. Like, you're going with them and figuring. It's like that child directed, therapist guided. You're collaborating together, so you're. So it's a really different kind of approach, but that. That's more how I operate. Yeah. Any other thoughts? I think the thing is you got to just like, come a little less pressure on yourself. And like I said, I'm going to go back to the beginning now. Don't forget we're in a huge pandemic and you don't know what the parents are going through and what's going on. So the less pressure you put on them, the better. And to really make sure you find out that day, like, what's hard right now and really serve them, really help them with what's hard right now and help. And for that one parent was that she couldn't go see her husband who's it turns out he had like something like six strokes and that's why he fell and hit his head. And it's really bad. So that, you know, in that moment, it was really all about taking care of her. And I spent a lot of time that night making sure that people would wrap around her that make it so that she could go see him. And you just. I think we just have to not forget that things are not normal right now. And to be easy on yourself and to be easy on the parents and have fun and be silly and, you know, and it. And like I said, I just focus on one or two things in my head that I'm trying to get to. And I don't write goals. Like, I don't put myself in a box, literally in a box, like draw a square as a goal. I never write goals like that because what if they hate doing that? We all been there, they hate it. They don't want to work on drawing a square, then what do you do? So, I mean, if you, I mean, raise your hand if you've been there, you know, you wrote a goal that they hate working on and they won't do it. So don't write goals like that. I write goals like, well, okay, if it's a handwriting goal, I'll write a goal like that. They'll imitate, you know, vertical or curved or angled lines or shapes or letters or something. Like, I leave it wide open of what the skill is. What's the actual visual motor skill that I'm trying to get to. I don't put myself in a little box because then I'm stuck. Or I like goals. Like, if it's, you know, following directions, I wouldn't be so specific to say that they'll do X, Y and Z. I'll say that they'll follow a three step direction with, you know, after one verbal cue or whatever. You got to leave yourself some wiggle room to be creative. Prepare for multiple groups of four to five kids. Yeah. Well, I think we should do a post about group. Like what, what works well for groups for the kids. That's got to be challenging. But I would definitely do things that are visual. Keep it really visually interesting. Anything else about all the questions, Morgan?

Yeah, that's all the questions I caught on the side. So if anyone has one, you can type it in now.

Okay. Jade. I see a cute little one. Hi. I see you. So fun. Well, thanks for joining me tonight. I appreciate you guys taking your time. If you thought it was worth your time, let me know. And I'LL keep doing them. Thanks, Mary. You're welcome. Thank you. All right, anything else before we go? Thank you, Mary. Oh, you're welcome. Have a good night. Thank you. If you didn't watch it, watch the interview with Hadra in Pakistan. It was so fun. It was great.

I will. Thank you.

It was really inspiring. And she asked me to do it because only 5% of her families were doing telehealth. So she was hoping to, like, inspire them to have me help inspire them to do it. And she told me that after the interview that her phone's ringing off the hook. They all want to do it now.

Oh, that's great.

Isn't that so cool? It just made me so happy. And then she shared the heck out of that video, and it has like 8,000 views. I'm like, I'm really glad that I thought I did a decent job. Now it's, like, all over the place. But she was really fun. It was. I had a really good time. That was. She's a go getter. She's only like, three years out of school, but, yeah, that was really fun. So that's just on your website. It's on the group on the pediatric OT telehealth activities. I just posted it recently. It's the interview with Hadra, I think is how you say your name. Ajra. And she's in Pakistan. And she just messaged me on Facebook and said she's, you know, was wondering if I would talk to her parents to tell them about telehealth and what it's like, because I think they, you know, they're spiking later than we did, so they're just like. They just closed down their clinic and. But they weren't getting. They only were at, like, 5% of families that were willing to do it. And so we just had a really fun conversation and gave a lot of examples and what it's like. And, you know, if it goes crazy and they're hiding under the bed, then you just go under the bed with them. You know, it's like, don't worry. It's okay. You know, it's just kind of giving a lot of examples of what it's like so they could picture it in their mind. And. Yeah, so now she's getting a lot of parents doing it. So that made me so happy. It was super cool. But, yeah, it's a fun conversation. Okay, have a great night, everybody. Thank you. Bye. Thank you.