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Misericordia Occupational Therapy Telehealth Handwriting Clinic Helps Children Overcome Pandemic Learning Deficiencies
Students and faculty members who participated in the AOTA 2022 national conference

The Covid 19 pandemic clearly impacted the way students learn, particularly the youngest students. Learning online presented many challenges, including lack of technology and internet access at home. Parents were left to juggle supporting their children in a variety of grade levels while also performing their own job duties while working from home.

Children of the pandemic are behind in many facets of their education, including the basic skills of handwriting. Without direct contact from teachers in a classroom setting, many young children ages four to six have been without instruction on proper handwriting techniques. Several parents in the Wyoming Valley were concerned they were seeing a delay in their children's handwriting; not because they had some type of a disorder, but simply because they didn’t have the instruction and opportunity to learn the technique in the in-person classroom environment.

To help these children overcome this lack of direct classroom instruction, the Misericordia University Occupational Therapy program developed an online handwriting clinic, held during the summer of 2020 to help students catch up before the new school year began.

"We know that children need to be in the classroom to learn, especially handwriting. It doesn't come intuitively. There were so many missed opportunities for young children to learn handwriting techniques because of the pandemic," said Lori Charney, OTD, OTR/L, assistant professor and Occupational Therapy department chairperson.

Ten children participated in the university's three-week long virtual handwriting clinic. Eight occupational therapy students along with Dr. Charney and Orley Templeton, OTD, OTR/L, assistant professor of Occupational Therapy, worked with the children during individual telehealth sessions. "We did an assessment of their handwriting and their visual perception at the beginning and then we engaged them in the telehealth occupational therapy sessions. The children would come on and we would do interventions through telehealth for fine motor coordination and visual perception. It was a lot of handwriting practice with them in an online scenario," explained Dr. Charney.

There were numerous challenges for this type of telehealth clinic. The children needed to see the instructor's hands and how they were holding a pencil while writing, so several cameras were used to replace the in-person instruction. "I can't put my hands on the child's hands to show them how to hold the pencil correctly. I can't sit next to them and model for them how to hold the pencil," said Dr. Charney. "We learned many things with Zoom. It helped us as practitioners realize a program like this can be done in an online format."

Dr. Charney and her team retrospectively collected and analyzed data on the handwriting skills of the children who participated in the program. Their research presentation based on this data, "Implementation of a Handwriting Camp Via a Telehealth Delivery Service Model," was presented at the American Occupational Therapy Association's national conference held recently in San Antonio, Texas.

"We hated the pandemic, but it did teach us some things. It taught us we can do this type of intervention in a telehealth setting," said Dr. Charney. The group decided to conduct the retrospective research project by obtaining approval from Misericordia University’s Institutional Review Board, an organization established to protect the rights and welfare of people who participate in research studies.

"Having students engaged in fieldwork and doing professional research alongside that turned out very well. There were great improvements in the children’s handwriting. The parents were ecstatic about it and our students learned so much," she said.

Megan Oldak, a fifth-year senior Occupational Therapy major, was one of the students who participated in the program. "It was a fantastic experience. Dr. Charney and Dr. Templeton were very quick to come up with this format. They communicated with us very clearly to understand the expectations. Our first exposure to telehealth has given us a step up now that it's more widely accepted as a treatment model," said Oldak. "In the telehealth model, the children might be in their living room or kitchen. Learning how to adapt to that and working with the parents and educating them to become our hands at certain points and guiding them was important. Typically, we wouldn't have that much interaction with the parents until the last session where we give them a home education plan."

As the sessions continued, Oldak noted, both the occupational therapy students and the children seemed to forget they didn’t have the usual hands-on experience. "We had the luxury of being able to send them materials during the week. We knew they had the same resources that we were planning to use for that session. It was a great experience I wouldn't have changed for anything," she said.

Both Dr. Charney and Oldak see this telehealth program as a positive delivery model for the future, giving access to therapy programs to people living in rural areas, those who have a lack of transportation to get to a clinic, or those who are immunocompromised and cannot leave their homes.

"There's no longer a barrier to get people the services they need. I wish it came about a different way than because of a worldwide pandemic, but ultimately if we can find any positives, telehealth becoming more common is one of those things," said Oldak.

Photo Caption: Pictured left to right: students and faculty members who participated in the AOTA 2022 national conference: Samantha Sweizer, OTS, Megan Oldak, OTS, Jessica Knisely, OTS, Peyton Breinich, OTS, Brigid Dolan, OTS, Dr. Lori Charney and Dr. Orley Templeton