BLOG: Keeping Kids Engaged in Online Therapy/Coaching and Other Remote Sessions

Dr. Carey Heller; Licensed Psychologist in Bethesda, Maryland specializing in ADHD/Executive Functioning

As a psychologist who specializes in ADHD/executive function issues (i.e., time management, organizational, task initiation trouble), helping children and teens stay focused and engaged during sessions is not something that is new to me. Many of the kids I work with like to be active and have trouble sitting still.

With the COVID-19 pandemic and the transition to telehealth video appointments for therapy, coaching, tutoring, speech-language therapy, and lots of other services as well, it has created the potential for increased difficulties for children and teens to stay engaged during appointments and prolonged time in front of the computer (i.e., remote learning).

Interestingly, many of the same tools that I use in person with clients to stay focused and engaged can be incorporated into video appointments. In addition, adding new strategies has been helpful and necessary at times as well. Therefore, to assist you in helping your children, teens, clients, or students stay engaged with video sessions, here are some suggestions.

• Harness fidgeting to improve focus: For individuals who have trouble sitting still, by harnessing the movement in a controlled manner, it reduces the excessive movement, tricks the mind into thinking you are more interested in something than you are, and in turn improves focus.
  • Feet: use a desk bike, elliptical, kick bands, foot pedals, or something else under the feet to harness feet/leg fidgeting.
  • Core: Use a yoga ball (with a desk chair meant to hold the ball in place if needed or a stand for the ball) or wiggly seat cushion, which often resembles the top part of a yoga ball and provides for extra movement. Obviously if the child or teen cannot keep the ball still enough, it is important that it is secured in place.
  • Hands: Use fidgets such as a fidget cube, tangler, or another similar item. One can order a variety pack of fidgets online for under twenty dollars.
• Take frequent breaks at set times and use a timer if needed. Besides trouble sitting for long periods of time, it is not good for one’s body to sit for too long. In addition, it is not great for the eyes to stare at a screen without breaks.
  1. Use a timer to set breaks at appropriate intervals.
  2. During break times, have the child or teen engage in some movement if feasible such as jumping jacks, situps, or use a video such as one from Go Noodle to have them follow along with.
• Engage the child or teen in activities during sessions that require them to give both verbal and written responses.
  1. For example, have them complete tasks where they use a Google Doc shared with you and have to write in certain things themselves as relevant to what is being focused on.
     1. In therapy/coaching, you could have the child or teen write down relevant tools as you go.
     2. The therapist/coach/tutor could also write down items too, which would also help keep the child or teen engaged by seeing and hearing things.
     3. Active activities also limit the likelihood that the child or teen is doing something else on the computer during the appointment.
     4. Using screen share features when doing activities together further limits the ability of a child or teen to do other activities during appointments.

• For younger children or teens, if you normally would play games with them during appointments, figure out how to translate existing games or develop new ones that can be played remotely.
  1. For instance, if you often use card games, have the child bring their own deck of cards to the video appointment and play a game of War or another one where having two full decks would not greatly impede the ability to play the game accurately.
  2. Word association games can be useful for keeping kids engaged and also beneficial therapeutically.
  3. Having children or teens draw for a few minutes about a particular topic and then discuss the drawing is another possible approach.
• Consider letting your child or teen have a pet present during the appointment.
  1. Numerous studies have shown that for many people, the presence of a pet such as a dog or cat can help them to feel more relaxed and open up. If the child or teen has a pet, you may find that having them hold the pet or have the pet nearby could be helpful, provided that it does not become a distraction.
  2. In other instances, if you have a pet of your own, and it is appropriate or useful, you may find it beneficial when needed to incorporate your own pet into the appointment.

I hope that these tools are helpful to you in your transition to working with children and teens remotely.

Copyright 2020 Carey Heller, Psy.D.

*Disclaimer: The previous information is intended as general guidance based on my professional opinion, does not constitute an established professional relationship,  and should not replace the recommendations of a psychologist or other licensed professional with whom you initiate or maintain a professional relationship*

About Carey Heller, Psy.D.

Dr. Carey Heller is the author of the blog Practical Parenting Strategies. He is a licensed psychologist with The Heller Psychology Group LLC in Bethesda, Maryland. Dr. Heller specializes in the evaluation and treatment of Attention-Deficit/Hyperactivity Disorder (ADHD), executive function challenges, learning disabilities, and co-occurring issues such as anxiety. With treatment, he often blends traditional psychotherapy with practical coaching to help individuals improve time management, organizational, and related study skills as relevant.

View all posts by Carey Heller, Psy.D.