Early Intervention for Children with Developmental Disabilities and their Families via Telehealth: A Systematic Review (Preprint)

Abstract

BACKGROUND Early intervention during the first 3 years of life is crucial for children with developmental disabilities to optimize developmental outcomes. However, access to such services is often limited by geographical distance and resource constraints. Telehealth can be part of a solution for overcoming these barriers, enabling the delivery of early intervention services. However, a comprehensive understanding of the efficacy and implementation of telehealth in early interventions remains elusive, in particular for children aged 0–3 years. OBJECTIVE This systematic review synthesized existing research on the effectiveness and implementation of telehealth interventions in infants and toddlers (0–3 years old) who are at risk of or diagnosed with developmental disabilities. The primary objective of the study was to evaluate the ways that telehealth compares to conventional in-person interventions in improving developmental outcomes for children and supporting family well-being. METHODS Guided by the methodologies used by the Joanna Briggs Institute, a systematic search was conducted of four electronic databases (PubMed, Embase, CINAHL, and Web of Science), focusing on studies published between 2010 and 2024. The inclusion criteria were studies involving telehealth interventions for children aged 0–3 years who were at high risk or had developmental disabilities, which involved active interactions between the providers and the families. Study quality was assessed using the Mixed Methods Appraisal Tool, and a narrative synthesis was used to analyze the data. RESULTS In all, 18 studies were selected. The majority of interventions used synchronous videoconferencing for caregiver training and coaching to enhance the communication, physical, adaptive behavior, and social and communication development of children with developmental challenges. Improvements were identified in child developmental outcomes and caregiver implementation, with telehealth proving equally effective as or more effective than traditional in-person methods. However, the studies often focused on specific conditions, and little research was found on cognitive development. CONCLUSIONS Telehealth is a viable and effective alternative to traditional in-person early interventions for young children who have developmental disabilities and their families. It provides enhanced accessibility, in particular for underserved populations, and it promotes family-centered care. Challenges exist, including those of technological literacy, and the lack of research on cognitive outcomes must be addressed. Future work should explore more comprehensive interventions, including multidisciplinary approaches and expanded family outcomes, to solidify the role that telehealth plays in early intervention. CLINICALTRIAL The study protocol is registered under the International Prospective Register of Systematic Reviews PROSPERO (CRD42023452565).