Measuring Costs and Outcomes of Tele-Intervention When Serving Families of Children who are Deaf/Hard-of-Hearing

Abstract

Background:Optimal outcomes for children who are deaf/hard-of-hearing (DHH) depend on access to high quality, specialized early intervention services. Tele-intervention (TI), the delivery of early intervention services via telehealth technology, has the potential to meet this need in a cost-effective manner.Method:Twenty-seven families of infants and toddlers with varying degrees of hearing loss participated in a randomized study, receiving their services primarily through TI or via traditional in-person home visits. Pre- and post-test measures of child outcomes, family and provider satisfaction, and costs were collected.Results:The TI group scored statistically significantly higher on the expressive language measure than the in-person group (p =.03). A measure of home visit quality revealed that the TI group scored statistically significantly better on the Parent Engagement subscale of the Home Visit Rating Scales-Adapted & Extended (HOVRS-A+; Roggman et al., 2012). Cost savings associated with providing services via TI increased as the intensity of service delivery increased. Although most providers and families were positive about TI, there was great variability in their perceptions.Conclusions:Tele-intervention is a promising cost-effective method for delivering high quality early intervention services to families of children who are DHH.

Home Visit Quality Variations in Two Early Head Start Programs in Relation to Parenting and Child Vocabulary Outcomes

“…We used home‐visiting quality ratings to observe home‐visiting quality in EHS, but these quality ratings have been used for other home‐visiting programs using a similar approach (e.g., Boyce et al., ), and a version of the measure also has been used to measure home‐visiting quality in early intervention in both face‐to‐face and tele‐intervention home visits (Blaiser, Behl, Callow‐Heusser, & White, ). The practices measured by our home‐visiting practices ratings could be enhanced with training or coaching, just as similar practices have been increased with training in other studies.…”

Tele-Audiological Surveillance of Middle Ear Status among Individuals with Cleft Lip and/or Palate in Rural South India

“…However, there is limited literature to clarify the comparison of costs between telemodels and in-person models for service delivery. A study including children with hearing loss who underwent teleintervention in Utah, USA, reported costsavings between USD 56,280 and USD 6,970 compared with the in-person intervention over a 24-month period (Blaiser et al, 2013). Ramkumar et al (2018), reported the cost outcomes of community-based hearing screening programs integrated with remote diagnostic ABR via tele-audiology.…”

Feasibility of Orientation and Mobility Services for Young Children with Vision Impairment using Teleintervention

“…In the teleintervention model of practice, EI providers are required to improve their communication and modelling skills so parents become fully engaged and confi dent in the recommended O&M strategies. Research from various teleintervention models demonstrated an increased use of the family-centered coaching model of intervention (Blaiser, Behl, Callow-Heusser, & White, 2013;Heimerl & Rasch, 2009;Kelso et al, 2009;Olson et al, 2012). In a randomised controlled trial that compared EI teleintervention services to EI in-person services parent engagement was statistically more signifi cant (p < .05) for families receiving EI teleintervention (Blaiser et al, 2013).…”

“…Research from various teleintervention models demonstrated an increased use of the family-centered coaching model of intervention (Blaiser, Behl, Callow-Heusser, & White, 2013;Heimerl & Rasch, 2009;Kelso et al, 2009;Olson et al, 2012). In a randomised controlled trial that compared EI teleintervention services to EI in-person services parent engagement was statistically more signifi cant (p < .05) for families receiving EI teleintervention (Blaiser et al, 2013). The necessity of using coaching strategies with parents through an EI teleintervention model suggests an opportunity to promote family-centred best practices to increase parent engagement and positive child outcomes.…”