Utilization of telemedicine to support caregivers of young children with ASD and their Part C service providers: a comparison of intervention outcomes across three models of service delivery

Abstract

Background Families of young children with autism spectrum disorder (ASD) frequently experience barriers to accessing evidence-based early intervention services. Telemedicine presents an opportunity to increase access to these services, particularly for families in rural and under-resourced areas. The present article describes a brief behavioral intervention and support model for families of young children with concerns for ASD. In the context of the COVID-19 pandemic, this service model shifted to telemedicine-only service delivery, resulting in an opportunity to analyze intervention outcomes from services delivered either via traditional in-person visits, telemedicine-only sessions, or a hybrid model including both in-person and telemedicine sessions. Methods Data are presented for 115 families with toddlers 16-33 months of age who participated in a six-session behavioral intervention and support service model either in-person, through telemedicine, or through a hybrid service model. This intervention was available for families referred for ASD evaluation through the state Part C early intervention program. Intervention feasibility, fidelity of implementation, child outcomes, and stakeholder satisfaction are compared across service delivery models. Results Caregivers, behavioral consultants, and Part C early intervention providers reported satisfaction with services, regardless of service delivery model. Caregivers and consultants also reported positive child outcomes. Statistically significant differences emerged for caregiver- and consultant-reported child outcomes in some domains, with stakeholders in the telemedicine-only group reporting slightly less improvement, compared to stakeholders in the in-person-only group. Caregivers and consultants in the telemedicine-only group also provided qualitative feedback on benefits and challenges related to telemedicine services. Conclusions Both caregivers and behavioral consultants reported positive outcomes following a brief behavioral intervention and support model targeted at families of young children with concern for ASD. Stakeholders reported improvement in child behavior and satisfaction with services across in-person, telemedicine-only, and hybrid models of service delivery. These results suggest that telemedicine presents a promising opportunity for increasing service access. Additional research is needed to continue optimizing the experience of telemedicine-based service delivery for both families and intervention providers.

Is tele-diagnosis of dental conditions reliable during COVID-19 pandemic? Agreement between tentative diagnosis via synchronous audioconferencing and definitive clinical diagnosis

“…We also observed very good agreement when the caller was the patient's father, or the patient himself, while agreement was less when other family members, friend, or caregiver mediated the call, although it was still good. This concurs with studies have similarly shown that during the current pandemic, parent-mediated teleassessment within the home environment was feasible for many medical conditions [ 49 , 50 ]. Hence, AD may be worthy in under-resourced and geographically isolated communities, where family members can contribute to remote patient evaluation [23] and improve the AD experience.…”

Expectations and Concerns about the Use of Telemedicine for Autism Spectrum Disorder: A Cross-Sectional Survey of Parents and Healthcare Professionals

“…Consistent with the available literature, approximately half of the parents and professionals in our study sample expressed concern about the child’s distraction induced by electronic devices and the home environment (e.g., sharing rooms with siblings, presence of young children or other family members, etc.) [ 39 , 56 , 57 , 58 ], which may reduce their willingness to participate in the diagnostic/therapeutic session. In light of these concerns, healthcare professionals should provide practical advice to families on the proper use of the devices and the optimal preparation of the home setting (limiting distractions at home, materials to be used during telematics sessions).…”

“…In the literature, many studies have examined the efficacy of remote approaches for ASD diagnosis and intervention [ 37 , 38 , 39 , 40 , 41 , 50 , 51 ], parental satisfaction [ 52 , 53 , 54 ], perceptions of telemedicine, and its potential benefits and limitations after using the service remotely [ 39 , 55 , 56 , 57 , 58 , 59 ]. Although some studies to date have examined healthcare professionals’ and parents’ views after experiencing remote services for ASD [ 39 , 53 , 54 , 55 , 58 , 59 ], few studies have explored the opinions about telemedicine that providers and users have before its use [ 56 , 60 ].…”

Role of Newly Introduced Teledentistry Service in the Management of Dental Emergencies During COVID-19 Pandemic in Qatar: A Cross-Sectional Analysis

“…During the current pandemic, TD changed to be directly between the dental professional and patient, hence probably necessitating the mediation of a family member, guardian, or caregiver in some instances. A point is that while teleassessment within the home environment is feasible for many medical conditions (e.g., children with autism 31 , 32 ), TD could represent additional challenges. From the provider side, training for dentists is required to enhance their ability to provide precise information to patients/caregivers to perform delicate tasks, for example, compression to stop bleeding or undertaking oral hygiene measures.…”