51
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Bhat A. Analysis of the SPARK study COVID-19 parent survey: Early impact of the pandemic on access to services, child/parent mental health, and benefits of online services. Autism Res 2021; 14:2454-2470. [PMID: 34591364 PMCID: PMC8578426 DOI: 10.1002/aur.2618] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 08/19/2021] [Accepted: 09/08/2021] [Indexed: 11/21/2022]
Abstract
Children with ASD receive a multitude of educational, medical, and therapeutic services. At the onset of the COVID‐19 pandemic, all of these services came to a complete halt following strict lockdowns. Many services have resumed in a hybrid format using face to face and virtual modes of delivery. This study describes findings from the COVID‐19 impact survey administered at the onset of the pandemic in a subgroup of families from the SPARK cohort (N = 6393), one of the largest ASD cohorts in the US. The differential early impact of COVID‐19 on various subgroups of children with ASD and their families was examined. Caregivers of children and adolescents with ASD between 19 months and 18 years completed an online survey inquiring about the impact of COVID‐19 pandemic on access to services, parent concerns about the same, impact on child's ASD‐related behaviors, child, and parent mental health, and the benefits/potential benefits of online/future online services. Analysis revealed that certain demographic (age, income/SES) and child‐related factors (repetitive behaviors, language, functional, cognitive, and motor impairments, and child's understanding), as well as parent's past mental health were associated with/predicted greater service disruptions, greater ASD‐related behaviors, and greater negative impact on parent mental health. In conclusion, younger children, children from low‐income families, and children with greater impairment severity (more severe repetitive behaviors, language, cognitive, function, language, and motor impairments) were more negatively impacted by the pandemic through service disruptions, increased ASD‐related behaviors, parent health/family impact, and found online interactions to be less beneficial.
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Affiliation(s)
- Anjana Bhat
- Department of Physical Therapy, University of Delaware, Newark, Delaware, USA.,Biomechanics & Movement Science Program, University of Delaware, Newark, Delaware, USA.,Department of Psychological & Brain Sciences, University of Delaware, Newark, Delaware, USA
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52
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Campbell DR, Goldstein H. Genesis of a New Generation of Telepractitioners: The COVID-19 Pandemic and Pediatric Speech-Language Pathology Services. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:2143-2154. [PMID: 34411487 DOI: 10.1044/2021_ajslp-21-00013] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Purpose In March 2020, the COVID-19 pandemic caused a worldwide shift from in-person care to synchronous videoconferencing or telehealth. Many barriers to remote service delivery were eliminated, effectively creating a new generation of telepractitioners. This study chronicles changes in speech-language pathology clinicians' use and perceptions of telehealth with pediatric populations. Method The Telehealth Services: Pediatric Provider Survey was created in multiple steps and then distributed broadly through social media and professional community sites. Respondents were speech-language pathologists and speech-language pathology assistants in a variety of employment settings from across the country and abroad who were serving primarily pediatric clients (n = 269). Survey questions sought to capture changes in speech-language pathology clinicians' experiences with and perceptions of telehealth before, during, and predictions after the COVID-19 pandemic. Analyses identified factors that influenced the use of telehealth services before and after March 2020 (COVID-19). Results Survey results documented the dramatic increase in telehealth use from before March 2020 to October 2020. The reasons pediatric speech-language pathology clinicians used telehealth during the pandemic were mostly a result of employer mandates or lowering infection risk for both client and clinician; however, over time, pediatric speech-language pathology clinicians increased their telehealth proficiency and discovered the benefits of telehealth. Conclusion The adoption of telehealth and the rapid improvement in proficiency is a testament to the resiliency of providers and has long-term effects on the use of telehealth into the future. Supplemental Material https://doi.org/10.23641/asha.15183690.
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Affiliation(s)
- Deborah R Campbell
- Department of Communication Sciences & Disorders, University of South Florida, Tampa
| | - Howard Goldstein
- Department of Communication Sciences & Disorders, University of South Florida, Tampa
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53
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Jesus TS, Kamalakannan S, Bhattacharjya S, Bogdanova Y, Arango-Lasprilla JC, Bentley J, Landry MD, Papadimitriou C. PREparedness, REsponse and SySTemic transformation (PRE-RE-SyST): a model for disability-inclusive pandemic responses and systemic disparities reduction derived from a scoping review and thematic analysis. Int J Equity Health 2021; 20:204. [PMID: 34521433 PMCID: PMC8438560 DOI: 10.1186/s12939-021-01526-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 08/04/2021] [Indexed: 12/24/2022] Open
Abstract
Background People with disabilities (PwD) have been facing multiple health, social, and economic disparities during the COVID-19 pandemic, stemming from structural disparities experienced for long time. This paper aims to present the PREparedness, RESponse and SySTemic transformation (PRE-RE-SyST): a model for a disability-inclusive pandemic responses and systematic disparities reduction. Methods Scoping review with a thematic analysis was conducted on the literature published up to mid-September 2020, equating to the initial stages of the COVID-19 pandemic. Seven scientific databases and three preprint databases were searched to identify empirical or perspective papers addressing health and socio-economic disparities experienced by PwD as well as reporting actions to address them. Snowballing searches and experts’ consultation were also conducted. Two independent reviewers made eligibility decisions and performed data extractions on any action or recommended action to address disparities. A thematic analysis was then used for the model construction, informed by a systems-thinking approach (i.e., the Iceberg Model). Results From 1027 unique references, 84 were included in the final analysis. The PRE-RE-SyST model articulates a four-level strategic action to: 1) Respond to prevent or reduce disability disparities during a pandemic crisis; 2) Prepare ahead for pandemic and other crises responses; 3) Design systems and policies for a structural disability-inclusiveness; and 4) Transform society’s cultural assumptions about disability. ‘Simple rules’ and literature-based examples on how these strategies can be deployed are provided. Conclusion The PRE-RE-SyST model articulates main strategies, ‘simple rules’ and possible means whereby public health authorities, policy-makers, and other stakeholders can address disability disparities in pandemic crises, and beyond. Beyond immediate pandemic responses, disability-inclusiveness is needed to develop everyday equity-oriented policies and practices that can transform societies towards greater resiliency, as a whole, to pandemic and other health and social emergencies. Supplementary Information The online version contains supplementary material available at 10.1186/s12939-021-01526-y.
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Affiliation(s)
- Tiago S Jesus
- Global Health and Tropical Medicine (GHTM) & WHO Collaborating Centre for Health Workforce Policy and Planning, Institute of Hygiene and Tropical Medicine - NOVA University of Lisbon, Lisbon, Portugal.,Department of Occupational Therapy, College of Health & Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, USA
| | - Sureshkumar Kamalakannan
- Public Health Foundation of India (PHFI), South Asia Centre for Disability Inclusive Development and Research (SACDIR), Indian Institute of Public Health - Hyderabad (IIPH-H), Hyderabad, India.
| | - Sutanuka Bhattacharjya
- Department of Occupational Therapy, Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, USA
| | - Yelena Bogdanova
- Physical Medicine & Rehabilitation Service, VA Boston Healthcare System, Boston, MA, USA.,Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Juan Carlos Arango-Lasprilla
- IKERBASQUE. Basque Foundation for Science, Bilbao, Spain.,Biocruces Bizkaia Health Research Institute, Barakaldo, Spain.,Department of Cell Biology and Histology, University of the Basque Country UPV/EHU, Leioa, Spain
| | - Jacob Bentley
- Department of Clinical Psychology Seattle Pacific University, Seattle WA, USA.,Department of Physical Medicine & Rehabilitation, Johns Hopkins School of Medicine, Baltimore, USA
| | - Michel D Landry
- Duke Global Health Institute (DGHI), School of Medicine, Duke University, Durham, NC, USA.,Duke-Margolis Center for Health Policy, Duke University, Durham, NC, USA
| | - Christina Papadimitriou
- School of Health Sciences, Departments of Interdisciplinary Health Sciences, and Sociology, Oakland University, Rochester, MI, USA
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54
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Hackenberg B, Büttner M, Große L, Martin E, Cordier D, Matthias C, Läßig AK. [Impact of the COVID-19 pandemic on speech therapy for children with Speech and Language Disorders]. Laryngorhinootologie 2021. [PMID: 34507370 DOI: 10.1055/a-1613-5747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE In December 2019, the COVID-19 pandemic began to spread around the world and caused massive restrictions in our daily life. Many educational facilities and practices delivering speech therapy were temporally closed (so-called lockdown). Children with a speech and language disorder were forced to pause their therapy. The aim of this study was to describe if and how speech therapy was delivered during lockdown and what psychological burden was associated to affected parents. MATERIAL AND METHODS Parents of children with a speech and language disorder were asked about their child´s therapy during lockdown and about their fears and worries associated with it. RESULTS For 17 patients speech therapy was paused during lockdown while 20 patients could continue their therapy. Children speaking a language other than German had a higher risk for having their therapy paused during lockdown (Odds ratio = 5.11, with 95 % confidence interval = 1.09-32.54). Parents whose children did not receive speech therapy during lockdown were more worried about their child's development. CONCLUSIONS There is no common concept on how speech therapy can be delivered safely during lockdown. Possible barriers to healthcare might be more pronounced during the pandemic and parents experience a high psychosocial burden.
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Affiliation(s)
- Berit Hackenberg
- Otorhinolaryngolgy, Head and Neck Surgery, Johannes-Gutenberg-Universität Mainz, Hals-Nasen-Ohrenklinik und Poliklinik, Mainz, Germany
| | | | - Lisa Große
- Otorhinolaryngolgy, Head and Neck Surgery, Johannes-Gutenberg-Universität Mainz, Hals-Nasen-Ohrenklinik und Poliklinik, Mainz, Germany
| | - Evgenia Martin
- Schwerpunkt Kommunikationsstörungen der Hals-Nasen-Ohren-Klinik und Poliklinik - Plastische Operationen, Unimedizin Mainz, Germany
| | - Dahlia Cordier
- Schwerpunkt Kommunikationsstörungen der Hals-Nasen-Ohren-Klinik und Poliklinik - Plastische Operationen, Unimedizin Mainz, Germany
| | - Christoph Matthias
- Otorhinolaryngolgy, Head and Neck Surgery, Johannes-Gutenberg-Universität Mainz, Hals-Nasen-Ohrenklinik und Poliklinik, Mainz, Germany
| | - Anne Katrin Läßig
- Schwerpunkt Kommunikationsstörungen der Hals-Nasen-Ohren-Klinik und Poliklinik - Plastische Operationen, Unimedizin Mainz, Germany
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55
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Srinivasan SM, Su WC, Cleffi C, Bhat AN. From Social Distancing to Social Connections: Insights From the Delivery of a Clinician-Caregiver Co-mediated Telehealth-Based Intervention in Young Children With Autism Spectrum Disorder. Front Psychiatry 2021; 12:700247. [PMID: 34276452 PMCID: PMC8280343 DOI: 10.3389/fpsyt.2021.700247] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 06/07/2021] [Indexed: 12/11/2022] Open
Affiliation(s)
- Sudha M. Srinivasan
- Physical Therapy Program, Department of Kinesiology, University of Connecticut, Mansfield, CT, United States
| | - Wan-Chun Su
- Department of Physical Therapy, University of Delaware, Newark, DE, United States
- Biomechanics and Movement Science Program, University of Delaware, Newark, DE, United States
| | - Corina Cleffi
- Department of Physical Therapy, University of Delaware, Newark, DE, United States
- Biomechanics and Movement Science Program, University of Delaware, Newark, DE, United States
| | - Anjana N. Bhat
- Department of Physical Therapy, University of Delaware, Newark, DE, United States
- Biomechanics and Movement Science Program, University of Delaware, Newark, DE, United States
- Department of Psychological and Brain Science, University of Delaware, Newark, DE, United States
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56
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Claridge R, Kroll N. Aural Rehabilitation via Telepractice During COVID-19: A Global Perspective on Evolving Early Intervention Practices. Int J Telerehabil 2021; 13:e6362. [PMID: 34345339 PMCID: PMC8287731 DOI: 10.5195/ijt.2021.6362] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Pre-pandemic, telepractice was not globally implemented despite its effectiveness. Clinicians reported challenges related to technology, confidence, and inadequate resources. OBJECTIVES To document global telepractice, identify current obstacles and measure the impact of a possible solution. The timing of this research facilitated tracking telepractice changes during the pandemic. METHODS Two surveys measured practitioners' experience and attitude towards telepractice. Survey 1 was completed in February-March 2020. Participants then received two specialized lesson kits to trial if desired. Survey 2 was a follow-up after 4-6 weeks. RESULTS Between surveys, the proportion of participants providing telepractice increased from 47.6% to 91.7%. The lesson kits were trialled by 74.3%. Their use had a positive impact on three of the top five factors affecting the delivery of telepractice: parent coaching, clinician experience and accessing resources. Conclusion: Telepractice was rapidly adopted globally during the pandemic. The specialized resources were helpful in overcoming some of the barriers to delivery.
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57
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Jesus TS, Bhattacharjya S, Papadimitriou C, Bogdanova Y, Bentley J, Arango-Lasprilla JC, Kamalakannan S. Lockdown-Related Disparities Experienced by People with Disabilities during the First Wave of the COVID-19 Pandemic: Scoping Review with Thematic Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6178. [PMID: 34200979 PMCID: PMC8228347 DOI: 10.3390/ijerph18126178] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/16/2021] [Accepted: 04/17/2021] [Indexed: 02/08/2023]
Abstract
People with disabilities may be disproportionally affected by the COVID-19 pandemic. We synthesize the literature on broader health and social impacts on people with disabilities arising from lockdown-related measures. METHODS Scoping review with thematic analysis. Up to mid-September 2020, seven scientific databases and three pre-print servers were searched to identify empirical or perspective papers addressing lockdown-related disparities experienced by people with disabilities. Snowballing searches and experts' consultation also occurred. Two independent reviewers took eligibility decisions and performed data extractions. RESULTS Out of 1026 unique references, 85 addressed lockdown-related disparities experienced by people with disabilities. Ten primary and two central themes were identified: (1) Disrupted access to healthcare (other than for COVID-19); (2) Reduced physical activity leading to health and functional decline; (3) From physical distance and inactivity to social isolation and loneliness; (4) Disruption of personal assistance and community support networks; (5) Children with disabilities disproportionally affected by school closures; (6) Psychological consequences of disrupted routines, activities, and support; (7) Family and informal caregiver burden and stress; (8) Risks of maltreatment, violence, and self-harm; (9) Reduced employment and/or income exacerbating disparities; and (10) Digital divide in access to health, education, and support services. Lack of disability-inclusive response and emergency preparedness and structural, pre-pandemic disparities were the central themes. CONCLUSIONS Lockdown-related measures to contain the COVID-19 pandemic can disproportionally affect people with disabilities with broader impact on their health and social grounds. Lack of disability-inclusive response and emergency preparedness and pre-pandemic disparities created structural disadvantages, exacerbated during the pandemic. Both structural disparities and their pandemic ramifications require the development and implementation of disability-inclusive public health and policy measures.
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Affiliation(s)
- Tiago S. Jesus
- Global Health and Tropical Medicine (GHTM) & WHO Collaborating Centre for Health Workforce Policy and Planning, Institute of Hygiene and Tropical Medicine, NOVA University of Lisbon, 1349-008 Lisbon, Portugal;
- Department of Occupational Therapy, College of Health & Rehabilitation Sciences: Sargent College, Boston University, Boston, MA 02215, USA
| | - Sutanuka Bhattacharjya
- Department of Occupational Therapy, Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, GA 30303, USA;
| | - Christina Papadimitriou
- Departments of Interdisciplinary Health Sciences, and Sociology, School of Health Sciences, Oakland University, Rochester, MI 48309-4452, USA;
| | - Yelena Bogdanova
- Physical Medicine & Rehabilitation Service, Veterans Affairs Boston Healthcare System, Boston, MA 02130, USA;
- Department of Psychiatry, School of Medicine, Boston University, Boston, MA 02130, USA
| | - Jacob Bentley
- Department of Clinical Psychology, Seattle Pacific University, Seattle, WA 98119, USA;
- Department of Physical Medicine & Rehabilitation, School of Medicine, John Hopkins University, Baltimore, MD 21205-2196, USA
| | - Juan Carlos Arango-Lasprilla
- IKERBASQUE, Basque Foundation for Science, 48009 Bilbao, Spain;
- Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain
- Department of Cell Biology and Histology, University of the Basque Country UPV/EHU, 48940 Leioa, Spain
| | - Sureshkumar Kamalakannan
- Public Health Foundation of India (PHFI), South Asia Centre for Disability Inclusive Development and Research (SACDIR), Indian Institute of Public Health, Hyderabad 500033, India
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58
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Kamalakannan S, Bhattacharjya S, Bogdanova Y, Papadimitriou C, Arango-Lasprilla JC, Bentley J, Jesus TS. Health Risks and Consequences of a COVID-19 Infection for People with Disabilities: Scoping Review and Descriptive Thematic Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4348. [PMID: 33923986 PMCID: PMC8074171 DOI: 10.3390/ijerph18084348] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/08/2021] [Accepted: 04/16/2021] [Indexed: 12/11/2022]
Abstract
This study aims to synthesize the literature on any disproportionate health risks or consequences of a COVID-19 infection for people with disabilities. Scoping review with a descriptive thematic analysis was carried out. Up to mid-September 2020, seven scientific databases and three preprint servers were searched to identify empirical or perspective papers. Snowballing searches and expert' consultations also took place. Two independent reviewers were used for the screenings and data extractions. Of 1027 references, 58 were included, 15 of which were empirical articles. The thematic analysis showed that: (1) People with disabilities living in residential or long-term care facilities were more likely to have greater infection rates; (2) Intersecting mediators of greater infection risks were multiple (e.g., lack of accessible information); (3) People with disabilities often face greater health problems when infected; and (4) Unethical disadvantages in the rationing of lifesaving and critical care can be experienced by people with disabilities. Conclusions: Beyond any health-related vulnerabilities (e.g., comorbidity rates), multiple yet modifiable environmental factors can provide disproportionate health risks and consequences of a COVID-19 infection for people with disabilities. Public health and policy measures must prevent or reduce modifiable environmental risks.
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Affiliation(s)
- Sureshkumar Kamalakannan
- Public Health Foundation of India (PHFI), South Asia Centre for Disability Inclusive Development and Research (SACDIR), Indian Institute of Public Health-Hyderabad (IIPH-H), Hyderabad 500 033, India;
| | - Sutanuka Bhattacharjya
- Department of Occupational Therapy, Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, GA 30303, USA;
| | - Yelena Bogdanova
- Physical Medicine & Rehabilitation Service, VA Boston Healthcare System, Boston, MA 02130, USA;
- Department of Psychiatry, Boston University School of Medicine, Boston, MA 02118, USA
| | - Christina Papadimitriou
- Departments of Interdisciplinary Health Sciences, School of Health Sciences, Oakland University, Rochester, MI 48309-4452, USA;
| | - Juan Carlos Arango-Lasprilla
- IKERBASQUE, Basque Foundation for Science, 48903 Bilbao, Spain;
- Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain
- Department of Cell Biology and Histology, University of the Basque Country UPV/EHU, 48903 Leioa, Spain
| | - Jacob Bentley
- Department of Clinical Psychology, Seattle Pacific University, Seattle, WA 98119, USA;
- Department of Physical Medicine & Rehabilitation, Johns Hopkins School of Medicine, Baltimore, MD 21205-2196, USA
| | - Tiago S. Jesus
- Global Health and Tropical Medicine (GHTM) & WHO Collaborating Centre for Health Workforce Policy and Planning, Institute of Hygiene and Tropical Medicine, NOVA University of Lisbon, 1349-008 Lisbon, Portugal
- Department of Occupational Therapy, College of Health & Rehabilitation Sciences: Sargent College, Boston University, MA 02215, USA
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Abstract
Telehealth in the broadest sense has been used by pediatric clinicians for over a century, as telephone triage has been and continues to be an essential part of pediatric practice. Utilizing more advanced technology including video communication, although available, was generally underutilized until the onset of the COVID-19 pandemic. Telehealth presents the opportunity to bridge many divides including geographical and logistical challenges. Many acute pediatric conditions can be managed safely and effectively through telehealth especially when remote physical exam equipment is used. Telehealth can also be especially useful in medical care of children with medical complexity. Traveling with medical equipment to multiple subspecialists can be incredibly challenging and often a similar quality visit can be conducted through telehealth in the comfort of a child's home environment. Well child care presents a unique problem while trying to maintain social distancing. Integrating a hybrid model using both an in-person exam and history through video conferencing can help balance limited face to face time with the need to ensure a full and appropriate physical exam. Integration of telehealth into the pediatric patient centered medical home can enable families to gain convenience while maintaining the essential relationship with their primary care office.
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Affiliation(s)
- Andrea Milne Wenderlich
- Department of Pediatrics, Golisano Children's Hospital, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave Box #777 Rochester, NY 14624, United States.
| | - Neil Herendeen
- Department of Pediatrics, Golisano Children's Hospital, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave Box #777 Rochester, NY 14624, United States
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