Karlyn Goodman, OT, has been an occupational therapist for more than 17 years. She grew up in a small town south of Boston and then moved to Seneca Falls, NY, when she was 10. She graduated from Boston University with her BS in Occupational Therapy (2004) and gained her certification from NBCOT (she was grandfathered in before OTs had to have a masters degree). Today, Karlyn lives in the greater Boston area with her husband and 5-year-old son who is in kindergarten and doing remote learning this year. She especially enjoys being a mom. Karlyn and her son like to do paint nights together.
What inspired you to become an OT?
I have actually wanted to be an OT since I was eleven-years-old. My cousin is an OT and we really only saw her at Thanksgiving. She used to bring all of her homework and the fun projects that she was making with her. I had always wanted to do something in medicine but I was very shy and terrified of blood. I’m named after my grandfather. He’s had a lot of influence on my life. He was a doctor so I’ve always wanted to be a doctor or something in the medical field. Occupational therapy fit. My cousin doesn’t practice as an OT anymore. She works in mental health. It’s fun when we get together because she was my inspiration.
What made you want to be a teletherapist with PL?
I worked for a company for 13+ years that provides clinicians to schools and day habilitation programs for adults ages 22 and up with significant intellectual disabilities. The “day hab” programs are therapeutic-based programs. I was working all over eastern Massachusetts. When I started with PL, I was spending up to three hours a day in my car just driving to and from work and then racing to get my son from school. It was very challenging, and I was ready to slow down and be closer to home. If there was a problem with my son, I wanted to be nearby so I could go get him from preschool.
As COVID-19 hit, I was able to increase my hours with PresenceLearning when I was laid off from my other job. So now I work exclusively as a PresenceLearning provider. I hope someday to see my clients again at my day hab programs. They had been my clients for more than 13 years. I’m very attached to certain ones, so it’s been a shift. I miss them, but I do get some reports on how they’re doing.
How did you connect with PL?
One of my good friends worked for PL. She was my college roommate. On multiple occasions she had encouraged me to put in my resumé. Finally I was ready so I contacted her and she helped me apply. The process when I was becoming a provider was very thorough in terms of how to use the platform, etc. My friend, along with my other colleagues at PL, helped me to develop a repertoire of activities to utilize for sessions and supported me in learning how to better manage my virtual sessions.
What do you enjoy about being a provider with PL?
I have enjoyed working with all of the families and students in my care. I’ve even had some better outcomes than I have had within schools because, for the most part, parents or other caregivers are engaged and able to listen and hear what I have to say when I am working with their child. It’s a big improvement over seeing them just once a year in an IEP meeting, or maybe calling them here and there to let them know about something new. Working directly with them as I do now, they’re able to help their child carry over new skills and knowledge throughout the day. In addition, instead of educating multiple teachers, there’s a definite point person. It’s been nice to have that and to build that connection.
It’s also been amazing because I’ve met some wonderful families and I’ve formed some great relationships. When you are in someone’s house, even if it’s only a half an hour a week, you’re still in their house. You know what’s going on. I see my students’ siblings. It’s really nice to see the whole dynamic. It answers a lot of questions.
Before the pandemic, I had a couple of kids in Maine who were at brick-and-mortar schools. But I did a lot of work with virtual schools in California and Massachusetts—they were the virtual homeschool charter schools. So for the most part, I was already living this kind of life when the pandemic started.
Now, in Massachusetts, the state increased the size of the charter school, and gave preference to students on IEPs so that they could be part of that virtual school system. In the state of Massachusetts, students are eligible for remote learning for the entire year. They can opt into it. I know some districts were not as prepared as others. It’s an interesting mix, because now I have some students who are transitioning from brick-and-mortar school to the virtual school. That’s been a unique transition because parents are very overwhelmed right now because they are not used to managing their child’s schedule like that.
Could you walk us through your daily routine? A “day in the life of a PL therapist” if you will?
I get up early so that I can do an online class at my gym (kettlebell, weight lifting, etc) or I go running. Then I usually have an email from my son’s school about what materials need to be printed for the day so I print all of those and get his area set up for him. Next, I get breakfast set up for him and sometimes for me. I usually try to have a stash of beverages and snacks at my little standing desk in case I don’t get a break. I start my day and then take 30 seconds to make sure my son is logged into school. And then I log into my next student and I just keep going. I try to minimize the interruptions, but they do happen. Most of the families have been very supportive if and when there is an interruption. I do have a standing desk so you can’t see him. On some days I only have 15 or 30 minutes during his lunch break to get him lunch and prepare him for the afternoon. I prepare all his snacks at night so they’re all in bell jars in the refrigerator so when they tell him it’s snack time, he goes and gets his own snacks. As an OT, I try to encourage independence. Then I treat until afternoon and then I “fly” to his activity, whether it’s on Zoom or we need to drive somewhere. Today I end a session at 4 and log him in to a karate Zoom session at 4. He has art class, karate, and swimming during the week so we juggle that. I make dinner. We might do some work that he didn’t complete during the day. We have systems in place where he is able to earn some fun things at home if he completes all of his school work before I finish my work. We eat dinner. We try to read some books. He goes to sleep. Sometimes I’ll do more work or cleaning or I might just sit and watch some TV to decompress.
What age range/student population are you currently serving? Please include demographic information.
I am working with GCVS, a virtual charter school in MA that provides services to students K-12. My caseload is currently students ages 5-19.
How do you explain doing occupational therapy using teletherapy to people who can’t imagine how it could be successful?
It really goes back to the family piece—whatever the team is—and being able to educate that entire unit on how to help that particular child. Whatever adult is sitting with the child, they have to be your hands. I usually try to start small and do things that will help them to see results. I would do this anyway. I try to do things that will make small changes but give the greatest result. For example, if I can convince them to use broken or small crayons for a preschooler, kindergartner, or lower elementary student who is having trouble writing and show that they’re able to use that pincer grasp and have a better grasp on a writing implement, then once I get that buy-in from them, usually I can get them to do other things.
The kids do so much better. It’s unique. You’re in their home and you have to be respectful of that. You are also able to use all of their toys, materials, and preferred items that they have at home. The home environment provides the student with the opportunity to share their interests and for the family to assist in expanding on their interests. I am able to use all of these preferences to develop more effective treatment sessions. I have had students write letters to Tim Burton and Matthew Broderick, use their favorite toys, use STEM/STEAM subscription boxes, and/or incorporate their pets (dogs, cats, birds, snakes, etc) to help with their sensory regulation. If they’re a kid at a brick-and-mortar school, I would not have been able to use these modalities, and it is more difficult to provide parents with opportunities to carry over the skills gained during sessions with the materials they have at home.
It’s a relationship that you wouldn’t ordinarily have with either the school personnel or the family because in most circumstances that I’ve been in, OT is very solitary. Typically, you’re bringing them to a room and doing your session with them, then you come back and you tell the teacher this is what they should do, and then you move on to the next kid. It’s a little different when you have that person that’s sitting with them or at least is in earshot of the room to say, “Look at what they did! They were successful.” Then when you get super excited about it, the kid gets super excited, the family is super excited, and it mushrooms because they carry it over all week long. It feeds on that enthusiasm. And it’s not always that big but at least they can see it.
I know that the majority of the regular population has no idea what an OT is and no idea what an OT does in the school so by being up front and in their face, it demonstrates what we’re here to do and what skill set we have to offer, so it’s that education piece without being educational.
How has this transition since the start of the COVID-19 crisis been for you and for your students and their families? It would be good to know what some of the challenges have been and how you’ve worked through those challenges, when applicable.
I have been with PL for almost three years and a lot of my students attend virtual or home school charters. I have seen an increase in students attending these schools since March and those have been students who have transitioned from brick-and-mortar to teletherapy. I think their families were apprehensive initially, but once we get started, they really enjoy it. I usually try to keep my sessions fun while working, but since March, I have really tried to be even more creative. I have found that a lot of my students just want to feel “normal” even if for 30 minutes. We use jokes and silly stories, Mad Libs, etc. to engage in writing and fine motor activities. I have learned that a student who is relaxed and happy is more likely to engage in tasks. Typically in a school, OT can be very isolated and it can be hard to encourage carryover of skills even when providing inclusive services. When you are working directly with the student at home, there is a lot more time for teaching and training. I have seen a significant increase in the amount of carryover and skill building during this time.
How have you been helping parents and caregivers who are now acting as the primary support person with their child?
I use a lot of therapeutic “use of self” with kids and families—in other words, I talk a lot about myself. I will use myself as an example, usually with parents. And often on cue, my son will do something in the background, and they’ll ask, “Oh, is that your son?” This usually breaks the ice a little when they realize I am in a similar position trying to make things work just like they are. Just having the conversation that I, too, am in the same position makes everyone take a deep breath. From March to June, if I could make my kids laugh, then I really had met my goal for the day. If they were smiling, laughing, and appeared to have a good time, the goals matter, but they’re much more attainable when they’re in that space. I was just trying to work on people’s mental health at that time.
I have a kindergartner who is participating in remote learning this year (and was doing virtual preschool in the Spring). I try to break down what is needed into small pieces for the families/learning coaches. Once they are successful, we add a bit more. I try not to overwhelm them and if the learning coach does appear overwhelmed, I take a few moments with them to determine why that is and how I can help them. Sometimes just having a brief discussion solves the problem.
What tips do you have for other providers getting started with telepractice?
My biggest tip is to remember that they are at home, which is typically a safe space for the student. Making it fun and incorporating their favorite toys and games brings you into their world and their space. It is important to remember to have fun! I think in this digital age sometimes we think that the more complicated and digital our therapeutic tools are, then we will be more successful. I think the opposite is true. Keep it simple—movement, drawing, writing, typing, etc.
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