Telehealth Therapy Enables a Stream of PCDA Services

Photo courtesy PCDA | Professional Child Development Associates therapist Alaina Hogue prepares for a music therapy telehealth session from her home. Like most PCDA therapists she has transformed her in-person therapy methods to a virtual format, ensuring the safety of medically at-risk clients and their families during the pandemic.

Amid the pandemic-generated tumult being confronted by many local nonprofit organizations, there are a few silver linings to be found here and there.
For Professional Child Development Associates, which focuses on family and child health services, the upside of social distancing protocols aimed at combating the spread of COVID-19 has been found in a radical leap to telehealth therapy.
Now, PCDA’s small army of therapists can be found streaming into a family’s kitchen or living room, engaging young children with music, puppets or soothing stories, and lending support to mothers and fathers as well as extended family members who might be isolating with them.
“We never would have taken this telehealth leap as quickly as we did if it hadn’t been for this health crisis,” said PCDA Executive Director Christopher Perri. “But now we’re discovering newer methodologies and some of the great advantages — we’re hoping telehealth will be an option on the menu going forward in offering services to more hard-to-reach clients. There is the feeling that we are better positioned to be helping the state serve more of the people who typically can’t be reached.”
PCDA was founded about 23 years ago as a child development nonprofit serving individuals from birth to age 21, and their families, when there is any concern regarding development or behavior, including the diagnosis of a child’s autism, intellectual disabilities, epilepsy, cerebral palsy, learning disabilities, premature birth, genetic syndromes and other concerns. The nonprofit’s specialists hail from the diverse fields of social work, psychology, pathology and therapies; provide evaluation, consultation and intervention services; and work as a multidisciplinary team to try to effect positive outcomes for children with special needs.
Therapists there often develop close and lasting relationships with children and their families, so when social distancing measures were implemented, PCDA began sounding an alarm: It knew the children and families struggling with special needs would suddenly be left on their own. Some of the clients’ great progress was also in danger of being lost in the absence of in-person therapies.
“We spent an enormous amount of time thinking about it, discussing it and entertaining options to in-person therapy, including outdoor social distancing therapy,” said Perri, who was about 10 weeks into his new position at PCDA when the pandemic hit.
But there were several obstacles to therapy alternatives, Perri noted: Many of PCDA’s clients are considered to be medically fragile or have underlying health conditions that would put them at an increased risk if they contracted the virus. And a good number live with extended family who help with the care of the child, meaning that even if the client is not considered to be at higher risk, one of their family members might be.
Furthermore, many of the young clients with autism or Down syndrome would not be able to support wearing a mask, while others might be afraid of the therapists who did wear a mask.
It started turning into a no-win situation, Perri recalled.

Photo courtesy PCDA
Professional Child Development Associates therapist Juliana Ross has been able to provide music therapy and social skills services to young clients and their families via telehealth, using Zoom, during the pandemic.

“It became clear that the risks to in-person therapy for our population far outweighed the advantages, and those risks haven’t gotten any better with time, nor do we see them improving in the near future,” Perri said solemnly.
Back to that silver lining, though: Once funding resources and insurance began to allow PCDA to provide telehealth, the nonprofit was at the ready.
“With our clinical philosophy of creating relationships and emphasizing family involvement in therapies, parent coaching, sibling support … our entire model sets us up for being streamed into their living room,” he added. “We were well-poised to become a part of that family dynamic.”
Certified as a nonpublic agency to serve children in public schools and programs through regional centers, PCDA is located in Pasadena but reaches clients throughout the Greater Los Angeles area, including the San Gabriel Valley, Downey, La Mirada and Whittier.
The staff of 75-80 therapists has also been learning new methodologies in its virtual sessions, and enjoying the experience despite the challenges, said Carol Fodera, an occupational therapist on PCDA’s Interdisciplinary Feeding Team, a widely lauded program that helps children with eating and swallowing issues.
Typically, families might bring their child into one of PCDA’s offices for therapy, but now Feeding Team specialists stream themselves into the clients’ kitchens.
“My main goal is to be supportive, not just of the child but to the whole family, asking the parents what their concerns are, how we can help,” said Fodera, who might spend part of the session encouraging her client to eat, positioning the camera on her mouth to show specific motor techniques. “The mode and the medium have changed, but at the heart of it, we are still connecting, still helping the children develop and partnering with the parents to collaborate on how to do that.”
Other forms of PCDA teletherapies present unique challenges.
For Juliana Ross, head of the agency’s creative arts programs, offering musical therapy via virtual sessions still allows for a personal connection of making live music together, although some of the children don’t have access to all the instruments at PCDA’s music room.
But they can access musical books together and find instruments they can play by touching keys on the screen.
“We engage the child through music, but we try to follow the child’s lead. Often it is a kind of non-verbal musical conversation … it is fun for them, it’s non-threatening, but it’s still therapy,” Ross said. “We are modeling and coaching for the parents and how they can do it at home on their own. No one was prepared to pivot to the online format as quickly as we needed to, so it was a very fast learning situation. Now, as we enter a newer phase, we focus on how to keep our clients motivated, we’re rallying together and having many discussions and we’re getting super creative.”
While Perri recognized that telehealth, in some ways, still can’t replace the impact of in-person therapy, the executive director does hope to always incorporate virtual therapy as an option for families that can’t travel or to provide supportive sessions in between regular ones.
He’s also proud that PCDA has kept both its clients and staff safe and healthy amid the ongoing pandemic.
“We’ve kept our staff employed, our clients with services and support, and we’ve had zero coronavirus cases among both,” he said. “We’ll be there with the parent or [the caretaker], supporting them and equipping them with the best tools and strategies to improve outcomes for the children.”