Why Online Therapy May Delay Your Child’s Progress

Online therapy has grown quickly over the past few years. After the pandemic, many families turned to it out of necessity—and for some, it seemed like a convenient solution. You don’t have to travel. You can attend sessions from home. It saves time and sometimes even money. But for children with disabilities—children who struggle with communication, learning, behavior, or motor skills—online therapy often doesn't meet their needs. In fact, it can hold them back.

If your child is receiving speech therapy, occupational therapy, behavior therapy, or special education sessions, you may have wondered: Is online therapy really helping? The hard truth is, most of the time, it’s not. Children with disabilities need more than a screen and a scheduled Zoom call. They need hands-on support, connection, and an environment where they can actively engage, move, and interact. This article will walk you through the reasons online therapy often fails for these children—and why face-to-face therapy makes all the difference.

What Online Therapy Claims to Offer

Online therapy sounds good on paper. The idea is simple: deliver services over video calls. That way, children anywhere—even in rural areas—can access therapy. It can be easier for parents who work or have multiple children. Therapists can send worksheets, videos, or digital tools. And some families find it more affordable.

But here's the catch: these benefits mostly serve the adults. They make things easier for the system, not necessarily better for the child. Just because something is easier doesn’t mean it works.

Why Online Therapy Falls Short for Children with Disabilities

Children with disabilities don’t just need therapy—they need the right kind of therapy. Online sessions may be helpful in very specific situations, but most of the time, they leave major gaps. These gaps become bigger when a child has sensory needs, communication delays, behavior challenges, or difficulty following instructions. Let’s break down where online therapy fails.

1. No Hands-On Interaction

Therapies like OT and speech are built around movement, touch, and real-world interaction. A child learning to hold a pencil properly, build hand strength, or form sounds with their mouth needs physical modeling. A therapist needs to show, guide, and gently correct. Through a screen, this is impossible. Children miss out on tactile learning, which is how many of them process and remember information.

2. Attention Issues and Poor Engagement

Most children with disabilities struggle to focus even in a quiet room. Now imagine asking them to sit in front of a screen and listen for 30 minutes. Many wander off, mute the screen, or ignore what’s happening. Some throw tantrums or become overstimulated. The therapist can’t redirect them or pull them back in. In the end, much of the session is wasted.

3. Therapy Turns into Parent Homework

During online sessions, the therapist often instructs the parent to do the activity: “Can you move his hand this way? Can you prompt him to look at the screen?” This turns parents into therapists. But most parents aren’t trained in these strategies. They’re also juggling work, other kids, or household responsibilities. They try their best, but inconsistent techniques lead to poor results.

4. Limited Behavior Support

Let’s say a child starts crying, running away, or refusing to cooperate. Online, the therapist can’t intervene. They can’t use calm body language, proximity, or reinforcement techniques. The session either stalls—or ends early. In-person, therapists know how to respond quickly and adjust their methods to keep the child engaged without letting behaviors escalate.

5. Missed Cues and Misunderstood Progress

A good therapist notices the small things: how your child reacts to new tasks, their posture, eye contact, and frustration levels. On camera, these cues are often lost. Some children mask their struggles by smiling or staying quiet. Others shut down and don’t participate at all. When therapists can’t see the full picture, they might assume the child is doing better—or worse—than they really are.

6. Tech Problems Interrupt Learning

It sounds basic, but it matters: poor internet, sound delays, blurry video, and log-in problems break the flow of therapy. You may spend 10 minutes fixing a camera or repeating yourself, and by the time it’s sorted out, your child has mentally checked out. For a child with limited attention or communication difficulties, these disruptions can ruin the session.

Why Face-to-Face Therapy Works Better

Now let’s look at what happens in an in-person session. A child walks into a space that’s designed for learning and growth. They’re greeted by someone who knows how to connect with them, who’s trained to notice every small change in their behavior or mood. There are tools, games, toys, and structured routines built specifically for children with disabilities.

Here’s why face-to-face therapy works—and why it gives better outcomes over time:

1. It’s Multisensory and Real-Time

Therapists can guide your child’s hand, help them form sounds with their mouth, or physically demonstrate a skill. Children can touch, move, climb, play, and interact in a way that supports brain development. This is especially critical for children with sensory or motor delays.

2. Behavior Can Be Managed on the Spot

In a clinic or classroom, therapists have the tools to redirect, calm, or re-engage a child. If a child refuses an activity, the therapist can quickly adapt. If a meltdown starts, they can use strategies to bring the child back into focus. This creates more learning time and less frustration.

3. The Therapist-Child Bond Is Stronger

Children respond better when they trust and feel connected to the person working with them. Eye contact, facial expressions, body language—all of these build trust. This bond makes children more likely to participate and try harder, even when things are difficult.

4. Therapy Feels Like Play

Good therapists know how to turn work into fun. They use toys, games, songs, and interactive tasks that match the child’s interests and learning style. It doesn’t feel like a lesson—it feels like a game. This makes children want to come back and engage.

5. Parents Learn by Watching

When therapy happens face-to-face, parents can sit in, observe, and ask questions. They see the techniques in action. They learn how to support their child at home. It’s easier to carry over progress into daily life when you’ve seen what works and why.

6. Progress Is More Accurate and Measurable

In-person sessions allow therapists to see exactly what your child can and can’t do. They can try different strategies on the spot and adjust their approach. This leads to more accurate assessments and realistic goals.

Real-Life Examples

Online therapy might seem like a practical solution, but for many children with disabilities, it doesn’t reflect what’s really going on. What looks like cooperation on screen can often hide the child’s true struggles—and delay real progress.

Take Salim, a 4-year-old boy diagnosed with autism. During online occupational therapy, Salim would scream, avoid the screen, and run off the moment the session started. His parents were frustrated and unsure if therapy was helping at all. When they switched to in-person sessions, Salim’s behavior was completely different. He became curious about the sensory gym, willingly followed the therapist’s routines, and began working on dressing skills with direct support. It wasn’t that Salim didn’t want to learn—he just needed the right environment to feel safe, engaged, and motivated.

Huda, a 3-year-old girl who doesn’t use words to speak, showed very little interaction during online speech therapy. Her mother worried that Huda might never develop speech. But once they began in-person sessions, the therapist used visual cues, gestures, and toys to get her attention. Within a few weeks, Huda started pointing to pictures, using communication cards, and even trying to vocalize simple needs. What seemed like a lack of ability online turned out to be a lack of connection.

Then there’s Nasser, a 6-year-old with ADHD. His online therapy sessions were quiet. He followed instructions, nodded along, and rarely objected. His therapist believed he was making steady progress. But when he attended a face-to-face session for the first time, it became clear that he struggled much more than anyone realized. He couldn’t sit still, constantly looked around the room, and avoided tasks by trying to change the subject. Seeing him in person helped the therapist adjust her goals, tools, and expectations—something that would’ve never happened if they relied on screen-based sessions alone.

These aren’t rare cases. They’re common stories that show just how much we miss when therapy is reduced to a screen. Children with developmental challenges need more than verbal instructions and a webcam. They need environments built for growth—and adults who can see, hear, and respond to the full range of their needs in real time.

Why These Children Deserve Better

Children with disabilities already face more barriers than their peers. They often struggle to be understood, to communicate, to learn, and to regulate their bodies and emotions. Therapy isn’t just a service—it’s a lifeline. But when that therapy is watered down, inconsistent, or inaccessible, these children suffer more delays, more frustration, and fewer chances to grow.

It’s not just about convenience. It’s about giving children the support they actually need—not what’s easiest for the system.

Online therapy may be better than nothing—but it’s rarely enough. Children with disabilities need interaction, structure, and human connection. They need therapists who can observe, adjust, and support them in real time. Face-to-face therapy brings all of that. It gives children the tools to grow—not just log in.

Ask yourself: Is my child truly making progress? Are they engaged, supported, and understood? If the answer is no, it may be time to step away from the screen—and step into a space where real change can happen.