Telehealth and autism: A systematic search and review of the literature

Sutherland, Rebecca; Trembath, David; Roberts, Jacqueline

doi:10.1080/17549507.2018.1465123

Cited by 176 publications

(138 citation statements)

References 51 publications

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“…This study addresses the concerns raised by Sutherland et al . () regarding the lack of direct telehealth service provision to children with autism and is among the first to undertake formal assessments with children with autism in which the child and clinician interact directly via telehealth.…”

Section: Discussionmentioning

confidence: 99%

“…While telehealth has been used to provide training to parents and teachers of children with autism, there has been very limited research published regarding the involvement of children themselves with telehealth services. This study addresses the concerns raised by Sutherland et al (2018) regarding the lack of direct telehealth service provision to children with autism and is among the first to undertake formal assessments with children with autism in which the child and clinician interact directly via telehealth.…”

Section: Discussionmentioning

confidence: 99%

“…In a recent systematic search and review of the literature (Sutherland et al . ) only one speech pathology‐based study was identified (Boisvert et al . ), involving a single participant undergoing language intervention.…”

Section: Introductionmentioning

confidence: 99%

“…While early intervention, diagnostic and behaviour support services for people with autism have been provided via telehealth, few studies have focused on SLP services for children with autism directly, particularly those of school age. In a recent systematic search and review of the literature (Sutherland et al 2018) only one speech pathology-based study was identified (Boisvert et al 2012), involving a single participant undergoing language intervention. Further, the majority of studies concerning autism and telehealth involved training parents or teachers to facilitate assessments or intervention, rather than the use of telehealth to interact directly with the child on the autism spectrum.…”

Section: Introductionmentioning

confidence: 99%

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Telehealth and autism: Are telehealth language assessments reliable and feasible for children with autism?

Sutherland

Trembath

Redoblado-Hodge

et al. 2018

Intl J Lang & Comm Disor

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Background Access to timely and appropriate speech–language pathology (SLP) services is a significant challenge for many families. Telehealth has been used successfully to treat a range of communication disorders in children and adults. Research examining the use of telehealth for children with autism has focused largely on diagnosis, parent‐implemented interventions, and behavioural interventions involving interactions between clinicians and parents. There is, however, very limited research into the use of telehealth directly to assess or intervene with children with autism. This paper reports the outcomes of a study of telehealth language assessments with primary school‐aged children with autism. Aims To evaluate the reliability and feasibility of telehealth language assessments for school‐aged children with autism. Methods & Procedures The language skills of 13 children with autism aged 9–12 who attended mainstream schools or support classes were assessed using the Clinical Evaluation of Language Fundamentals—4th Edition. An SLP delivered and scored four subtests of the assessment via telehealth from a remote location. A second SLP at the same location as the child co‐scored the online subtests to provide a measure of reliability and delivered the remaining subtests. The local SLP completed checklists in both conditions to provide observations regarding behaviour. Parent feedback was elicited via survey. Outcomes & Results There was strong interrater reliability between the telehealth and face‐to‐face conditions (correlation coefficients ranged from r = 0.919 to 0.990 across the subtests and Core Language Score) and good agreement between clinicians on all measures. Analysis using the Wilcoxon Signed Rank test indicated no significant differences in children's behaviour between the telehealth and face‐to‐face conditions, although variation between individuals was observed. Parents provided generally positive feedback about the use of telehealth for the assessments. Conclusions & Implications The findings of this study provide preliminary support the use of telehealth assessments of school‐aged children with autism. Comparison of telehealth and face‐to‐face assessment scores showed high agreement and correlation, and while the children showed individual differences in their behaviour during the telehealth sessions, there was no clear difference between the conditions at the group level. The findings suggest that telehealth may present a reliable and feasible approach to the assessment of language for children with autism in some circumstances as a primary or adjunct service model, while acknowledging that individual differences among these children may be important to consider when planning both assessment and intervention via telehealth.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Telehealth and autism: Are telehealth language assessments reliable and feasible for children with autism?

Sutherland

Trembath

Redoblado-Hodge

et al. 2018

Intl J Lang & Comm Disor

Self Cite

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“…The provision of technology-based, or telehealth, training and therapy services for individuals with ASD and their families is not new, and its effectiveness has received some support by research [Antezana et al, 2017;Sutherland et al, 2018]. Another form of distant intervention is available through research supported technology-aided intervention programs, supporting skill acquisition in various areas of functioning [Steinbrenner et al, 2020].…”

Section: Perspectives From the European Regionmentioning

confidence: 99%

COVID‐19 and Autism Research: Perspectives from Around the Globe

Amaral

Vries

2020

Autism Research

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Estimated Therapy Costs and Downstream Cost Consequences of iBASIS–Video Interaction to Promote Positive Parenting Intervention vs Usual Care Among Children Displaying Early Behavioral Signs of Autism in Australia

et al. 2023

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ImportanceThe growing global prevalence of autism spectrum disorder (ASD) is associated with increasing costs for support services. Ascertaining the effects of a successful preemptive intervention for infants showing early behavioral signs of autism on human services budgets is highly policy relevant.ObjectiveTo estimate the net cost impact of the iBASIS–Video Interaction to Promote Positive Parenting (iBASIS-VIPP) intervention on the Australian government.Design, Setting, and ParticipantsInfants (aged 12 months) showing early behavioral indicators of autism were recruited through community settings into the multicenter Australian iBASIS-VIPP randomized clinical trial (RCT), a 5- to 6-month preemptive parent-mediated intervention, between June 9, 2016, and March 30, 2018, and were followed up for 18 months to age 3 years. This economic evaluation, including cost analysis (intervention and cost consequences) and cost-effectiveness analyses of iBASIS-VIPP compared with usual care (treatment as usual [TAU]), modeled outcomes observed at age 3 through to 12 years (13th birthday) and was conducted from April 1, 2021, to January 30, 2023. Data analysis was conducted from July 1, 2021, to January 29, 2023.ExposuresiBASIS-VIPP intervention.Main Outcomes and MeasuresTo project the diagnostic trajectory and associated disability support costs drawing on the Australian National Disability Insurance Scheme (NDIS), the main outcome was the differential treatment cost of iBASIS-VIPP plus TAU vs TAU and disability-related government costs modeled to age 12 years, using a clinical diagnosis of ASD and developmental delay (with autism traits) at 3 years. Costs were calculated in Australian dollars and converted to US dollars. Economic performance was measured through the following: (1) differential net present value (NPV) cost (iBASIS-VIPP less TAU), (2) investment return (dollars saved for each dollar invested, taking a third-party payer perspective), (3) break-even age when treatment cost was offset by downstream cost savings, and (4) cost-effectiveness in terms of the differential treatment cost per differential ASD diagnosis at age 3 years. Alternate values of key parameters were modeled in 1-way and probabilistic sensitivity analysis, the latter identifying the likelihood of an NPV cost savings.ResultsOf the 103 infants enrolled in the iBASIS-VIPP RCT, 70 (68.0%) were boys. Follow-up data at age 3 years were available for 89 children who received TAU (44 [49.4%]) or iBASIS-VIPP (45 [50.6%]) and were included in this analysis. The estimated mean differential treatment cost was A $5131 (US $3607) per child for iBASIS-VIPP less TAU. The best estimate of NPV cost savings was A $10 695 (US $7519) per child (discounted at 3% per annum). For each dollar invested in treatment, a savings of A $3.08 (US $3.08) was estimated; the break-even cost occurred at age 5.3 years (approximately 4 years after intervention delivery). The mean differential treatment cost per lower incident case of ASD was A $37 181 (US $26 138). We estimated that there was an 88.9% chance that iBASIS-VIPP would deliver a cost savings for the NDIS, the dominant third-party payer.Conclusions and RelevanceThe results of this study suggest that iBASIS-VIPP represents a likely good-value societal investment for supporting neurodivergent children. The estimated net cost savings were considered conservative, as they covered only third-party payer costs incurred by the NDIS and outcomes were modeled to just age 12 years. These findings further suggest that preemptive interventions may be a feasible, effective, and efficient new clinical pathway for ASD, reducing disability and the costs of support services. Long-term follow-up of children receiving preemptive intervention is needed to confirm the modeled results.

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Telehealth and autism: A systematic search and review of the literature

Abstract: The findings suggest there may be a range of benefits in using telehealth with individuals with ASD, their families, and teachers. Further research, however, is required particularly regarding the use of telehealth directly with children with ASD for assessment and intervention.

Cited by 176 publications

References 51 publications

Telehealth and autism: Are telehealth language assessments reliable and feasible for children with autism?

Telehealth and autism: Are telehealth language assessments reliable and feasible for children with autism?

COVID‐19 and Autism Research: Perspectives from Around the Globe

Estimated Therapy Costs and Downstream Cost Consequences of iBASIS–Video Interaction to Promote Positive Parenting Intervention vs Usual Care Among Children Displaying Early Behavioral Signs of Autism in Australia

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