Telehealth delivery of cognitive-behavioral intervention to youth with autism spectrum disorder and anxiety: A pilot study

Abstract

Youth with autism spectrum disorders frequently experience significant symptoms of anxiety. Empirically supported psychosocial interventions exist, yet access is limited, especially for families in rural areas. Telehealth (i.e. videoconferencing) has potential to reduce barriers to access to care; however, little is known about the feasibility or efficacy of directly intervening with youth with autism spectrum disorders through this modality. This study details the pilot testing of a telehealth version of an empirically supported intervention targeting anxiety in youth with autism spectrum disorders. The primary focus of this study is on feasibility, with evaluation of outcomes as a starting point for future randomized trials. In all, 33 families of youth with autism spectrum disorders and significant anxiety symptoms participated in this study (Telehealth Facing Your Fears (FYF) Intervention: n = 17; Wait-list control: n = 16). Youth of all functioning levels were included. Acceptability was strong; however, the usability of the technology was problematic for some families and impeded some sessions significantly. Fidelity of the telehealth version to the critical elements of the original, in vivo version was excellent. More work is needed to improve delivery of exposure practices and parent coaching. Preliminary efficacy analyses are promising, with improvements observed in youth anxiety over time (relative to a comparison group waiting for live intervention) and parent sense of competence (within group). Clearly, stronger designs are necessary to evaluate efficacy sufficiently; however, this study does provide support for further investigation of clinic-to-home videoconferencing as a direct intervention tool for youth with autism spectrum disorders and their parents.

Collateral Effects of Youth Disruptive Behavior Disorders on Mothers’ Psychological Distress: Adolescents with Autism Spectrum Disorder, Intellectual Disability, or Typical Development

“…One promising intervention that reduces the transportation and waiting burden on parents, especially in rural areas, is Facing your Fears. This "telehealth" program delivers cognitive behavior therapy for anxiety disorders to small groups of youth with ASD and their parents, through clinic-to-home videoconferencing (Hepburn et al 2016).…”

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

“…), with positive outcomes reported for communication and other skills, including behaviour and imitation, as well as to support older children with autism and co‐occurring anxiety (Hepburn et al . ) and to provide functional behavioural assessment and functional communication training for children with behaviour support needs (Lindgren et al . , Suess et al .…”

“…Telehealth has been found to be a viable method of service provision for families of children with autism who are unable to access local services, particularly in the preschool population. It has been used to provide parent training in early intervention (e.g., Ingersoll and Berger 2015, Meadan et al 2016, Wainer and Ingersoll 2015, Simacek et al 2017, with positive outcomes reported for communication and other skills, including behaviour and imitation, as well as to support older children with autism and co-occurring anxiety (Hepburn et al 2015) and to provide functional behavioural assessment and functional communication training for children with behaviour support needs (Lindgren et al 2016, Suess et al 2014) via parent training. Diagnostic assessments for autism have been completed via telehealth with adults (Schutte et al 2015).…”

Hospital psychosocial interventions for patients with brain functional impairment: A retrospective cohort study

“…Although telehealth approaches demonstrated feasibility to delivery psychosocial interventions in access-limited environment (Hepburn et al 2016), robust evaluation of population-based effectiveness was lacking and the usability of such new technology was somewhat problematic during implementation. In the absence of effective countermeasures to eliminate practical barriers, increasing universal access to psychosocial services in patients with brain function impairment remains a challenge In this study, use of psychosocial interventions increased in association with receiving intensive care or having comorbid mental illnesses.…”