Bridging the Gap | Accessible Telehealth Therapy

Caleb (name changed for privacy) is an imaginative and energetic six-year-old boy who loves outer space and drawing comic books. Caleb lives with his family in a regional town, located hours away from specialized pediatric clinics.

While Caleb is highly creative, he was struggling significantly with emotional regulation and following directions. When asked to transition from a preferred activity (like drawing) to a non-preferred task (like getting ready for school or sitting down for dinner), Caleb would engage in severe behavioural issues. He would frequently yell, throw verbal insults, and occasionally hide under his bed, refusing to come out for hours. His parents were overwhelmed, but because of their geographic location, local waitlists for specialized pediatric therapists were over a year long. Desperate for immediate, professional help, the family reached out to the multidisciplinary team at daar to explore the possibilities of Telehealth therapy.

The Challenge

Without access to specialized local support, Caleb’s challenges were compounding, leading to severe disruptions in his daily life:

• At Home: The family dynamic was strained. Simple, everyday routines like getting dressed or sitting at the table ended in explosive arguments. Because of his receptive language delay, long verbal instructions like "Go to your room, put on your shoes, and grab your backpack" sounded like a confusing jumble of words. When overwhelmed, Caleb’s "fight or flight" response triggered, resulting in massive behavioral meltdowns.
• At School: His local rural school was dedicated but under-resourced. Caleb’s teacher noted that he was constantly off-task and disruptive when the class transitioned between subjects. Without a specialized intervention plan, Caleb was frequently sent to the principal's office, leading to a negative association with school and a concerning drop in his academic engagement.

Caleb and his family desperately needed robust intervention, but traveling three hours each way for weekly clinical appointments was geographically and financially impossible.

daar Therapy Approach

The clinicians at daar are pioneers in delivering high-quality, accessible care through Telehealth. We designed a comprehensive, virtual intervention plan that brought our specialized allied health team directly into Caleb's living room and his local school via video conferencing.

Our Telehealth-delivered strategy included:

• Virtual Functional Behaviour Assessment (FBA): Using secure video calls, our behaviour practitioners observed Caleb in his natural home environment. We also virtually interviewed his parents and teachers. This allowed us to build a robust positive behaviour support plan tailored specifically to the realities of his home and rural classroom.
• Telehealth Speech Therapy: To address his receptive language delays, a daar speech pathologist conducted weekly, interactive virtual sessions with Caleb. Through screen-sharing engaging, space-themed games, we integrated speech therapy that focused on auditory processing, teaching him how to break down and understand multi-step directions.
• Parent Coaching in the Natural Environment: Telehealth is uniquely powerful because it coaches parents in real-time. During our video sessions, we utilized evidence-based behaviour therapy for children, guiding Caleb’s parents dynamically on how to implement visual schedules and break verbal instructions into single, manageable steps (e.g., just saying "Shoes on," accompanied by a visual cue).
• Virtual Socialised Behaviour Therapy for Educators: Distance did not stop us from supporting his school. Through virtual meetings, we delivered socialised behaviour therapy coaching to Caleb’s regional teacher. We provided the school with digital visual aids and trained the staff on how to proactively praise Caleb for following single-step directions, ensuring total consistency between his home and school environments.

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Results & Progress

The Telehealth model proved to be incredibly effective. By receiving coaching directly in their living room, Caleb’s parents could immediately apply the strategies exactly where the challenging behaviours were occurring.

Within four months of consistent virtual intervention, Caleb's home transformed. The yelling matches stopped because his parents learned to communicate using the visual supports and chunked instructions provided by his speech pathologist. At school, regular virtual check-ins with his teacher ensured the positive behaviour support plan was actively working. Caleb began following classroom instructions and learned to transition smoothly between subjects without disrupting his peers.

83%

Reduction in intense avoidance behaviour at home. 

75%

Massive improvement via integrated Telehealth speech therapy. 

100%

Elimination of travel barriers, allowing consistent therapy.