COVID-19 Lessons From The Field: Toward A Pediatric Physical Therapy Telehealth Framework


  • Galia Daube Fishman Department of Physical Therapy, Movement & Rehabilitation Sciences, Northeastern University, Boston, Massachusetts, USA & University of Haifa, Mount Carmel, Haifa, Israel
  • Jeananne Elkins University of Haifa, Mount Carmel, Haifa, Israel



Early intervention, Pediatric physical therapy, Telehealth


Introduction: Telehealth is an established health service delivery method, yet little is known regarding pediatric physical therapy telehealth. We aimed to evaluate users’ experiences and create a framework for effective delivery. Methods: A pediatric physical therapists’ telehealth user survey was conducted. Results: Seventy-three respondents varied in years of experience and caseload. Most found telehealth easy to learn and use, and they believed the treatment they delivered was useful. Three main themes for successful treatments emerged and were organized into a framework for effective delivery: (1) caregivers’ involvement; (2) therapist telehealth ‘toolbox’ (sub-divided into: treatment management tools, and therapist-caregivers’ collaboration tools); and (3) telehealth client (child) characteristics. Conclusion: This study suggests a new framework for effective pediatric physical therapy telehealth delivery to support best practice, for use by administrators and therapists and recommends directions for further research.


Author Biography

Jeananne Elkins, University of Haifa, Mount Carmel, Haifa, Israel

Dr. Elkins while serving as an Advanced Fellow in Geriatrics at the Birmingham/Atlanta VA Geriatric Research Education and Clinical Care Center was a part of CG ASSIST where via tele-implementation caregiving dryads and the home environment were assessed for safety in transfers. After equipment was placed Dr. Elkins provided training and follow up assessments via telehealth. Dr. Elkins is a health services researcher focusing on caregivers and evidenced based practice in physical therapy. She continues to have a strong interest in telehealth. 


American Physical Therapy Association. (2019). Position on Telehealth.

American Physical Therapy Association. (2020). Telehealth state and federal regulations and legislation. Updated September 28, 2020. Accessed November 22, 2020. (2020, September 28). APTA.

Behl, D. D., Blaiser, K., Cook, G., Barrett, T., Callow-Heusser, C., Brooks, B. M., Dawson, P., Quigley, S., & White, K. R. (2017). A multisite study evaluating the benefits of early intervention via telepractice. Infants and Young Children, 30(2), 147–161.

Cady, R. G., Cady, R. G., Erickson, M., Erickson, M., Lunos, S., Lunos, S., Finkelstein, S. M., Finkelstein, S. M., Looman, W., Looman, W., Celebreeze, M., Celebreeze, M., Garwick, A., & Garwick, A. (2015). Meeting the needs of children with medical complexity using a telehealth advanced practice registered nurse care coordination model. Maternal and Child Health Journal, 19(7), 1497–1506.

Cason, J., Hartmann, K., Jacobs, K., & Richmond, T. (2018). Telehealth in occupational therapy. The American Journal of Occupational Therapy, 72(Supplement_2), 7212410059p1-7212410059p18.

Cole, B., Pickard, K., & Stredler-Brown, A. (2019). Report on the use of telehealth in early intervention in Colorado: Strengths and challenges with telehealth as a service delivery method. International Journal of Telerehabilitation, 11(1), 33–40.

Criss, M. J. (2013). School-based telerehabilitation in occupational therapy: Using telerehabilitation technologies to promote improvements in student performance. International Journal of Telerehabilitation, 5(1), 39–46.

Figueiredo, M. (2019). The use of telehealth in pediatric occupational therapy. Annals of Medicine (Helsinki), 51(sup1), 66–66.

Friedman, M., Woods, J., & Salisbury, C. (2012). Caregiver coaching strategies for early intervention providers: Moving toward operational definitions. Infants and Young Children, 25(1), 62–82.

Garcia, R., & Adelakun, O. (2019). A conceptual framework and pilot study for examining telemedicine satisfaction research. Journal of Medical Systems, 43(3), 51.

Hageman, J. (2020). The emergence of pediatric telehealth as a result of the COVID-19 pandemic. Pediatric Annals, 49, e283–e284.

Hall, J. B., Luechtefeld, J. T., & Woods, M. L. (2021). Adoption of telehealth by pediatric physical therapists during COVID-19: A survey study. Pediatric Physical Therapy, 33(4), 237–244.

Jason T Long, Christopher J Kovacs, Aurora J Hoobler, Erin E K Fritts, Brian E Cunningham, & Cailee M Caldwell. (2015). Integrating telehealth: Experiences in incorporating telehealth tools and principles into a pediatric therapeutic environment. OT Practice, 20(7), CE1-.

Lee, A. C. W., & Billings, M. (2016). Telehealth implementation in a skilled nursing facility: Case report for physical therapist practice in Washington. Physical Therapy, 96(2), 252–259.

Lee, A. C. W., & Harada, N. (2012). Telehealth as a means of health care delivery for physical therapist practice. Physical Therapy, 92(3), 463–468.

Meadan, H., & Daczewitz, M. E. (2015). Internet-based intervention training for parents of young children with disabilities: A promising service-delivery model. Early Child Development and Care, 185(1), 155–169.

Monlux, K. D., Pollard, J. S., Bujanda Rodriguez, A. Y., & Hall, S. S. (2019). Telehealth delivery of function-based behavioral treatment for problem behaviors exhibited by boys with Fragile X Syndrome. Journal of Autism and Developmental Disorders, 49(6), 2461–2475.

Reifenberg, G., Gabrosek, G., Tanner, K., Harpster, K., Proffitt, R., & Persch, A. (2017). Feasibility of pediatric game-based neurorehabilitation using telehealth technologies: A case report. The American Journal of Occupational Therapy, 71(3), 7103190040p1-7103190040p8.

Rush, D. D. (2019). The Early Childhood Coaching Handbook (Second Edition.). Paul H. Brookes Publishing Co.

Stredler-Brown, A. (2017). Examination of coaching behaviors used by providers when delivering early intervention via telehealth to families of children who are deaf or hard of hearing. Perspectives of the ASHA Special Interest Groups, 2(9), 25–42.

Tenforde, A. S., Borgstrom, H., Polich, G., Steere, H., Davis, I. S., Cotton, K., O’Donnell, M., & Silver, J. K. (2020). Outpatient physical, occupational, and speech therapy synchronous telemedicine: A survey study of patient satisfaction with virtual visits during the COVID-19 pandemic. American Journal of Physical Medicine & Rehabilitation, 99(11), 977–981.

Tsami, L., Lerman, D., & Toper‐Korkmaz, O. (2019). Effectiveness and acceptability of parent training via telehealth among families around the world. Journal of Applied Behavior Analysis, 52(4), 1113–1129.

U.S. Department of Health and Human Services. (2020, March 20). OCR Issues Guidance on Telehealth Remote Communications Following Its Notification of Enforcement Discretion. HHS.Gov.

Zylstra, S. E. (2013). Evidence for the use of telehealth in pediatric occupational therapy. Journal of Occupational Therapy, Schools & Early Intervention, 6(4), 326–355.




How to Cite

Daube Fishman, G., & Elkins, J. (2022). COVID-19 Lessons From The Field: Toward A Pediatric Physical Therapy Telehealth Framework . International Journal of Telerehabilitation, 14(1).



Clinical Practice - COVID 19