1
|
Wallisch A, Little LM, Dunn W, Tomchek S. Short report: Do parents use asynchronous materials in a hybrid coaching via telehealth intervention? AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:2140-2145. [PMID: 39104188 DOI: 10.1177/13623613241232467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/07/2024]
Abstract
LAY ABSTRACT Using telehealth to provide services to families and children with autism has grown since the start of the COVID-19 pandemic. Yet, we still know less about telehealth models that use both virtual sessions and online materials to support families. Research suggests it is important to make sure an intervention matches the characteristics of a child with autism, but fewer studies have examined the importance of matching an intervention to parent characteristics. In this study, we looked at parent characteristics (25 parents included in the study) before a parent coaching telehealth intervention for potty training in autism. We specifically looked at how parent competence (i.e. how confident and effective one feels with parenting) levels before the intervention influenced the usage of online education materials (i.e. podcasts/tip sheets). Results suggested that parents with lower competence used the online materials more often than parents with higher competence, and often made greater gains in parent competence during the intervention. Both parents with lower and higher competence found the intervention acceptable. Future research should study additional parent characteristics in a larger sample to better understand how to tailor interventions to meet both parent and child needs.
Collapse
|
2
|
B Idris A, Al-Mamari W, Al Humaidi TS, Al Ma'ashri KA, Alhabsi A, Jalees S, Gaber A, Al-Jabri M, Islam MM, Al-Futaisi A. Perception about telemedicine services among parents of children with neurodevelopmental disorders in a specialised tertiary centre in Oman. Glob Public Health 2024; 19:2381093. [PMID: 39052957 DOI: 10.1080/17441692.2024.2381093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 07/10/2024] [Indexed: 07/27/2024]
Abstract
ABSTRACTWhile telemedicine has shown promise for diagnosis and treatment, its integration into specialised clinics and mainstream healthcare is slow. A study at Sultan Qaboos University Hospital, Oman, investigated parental perceptions of virtual clinics and telemedicine experiences among parents of children with neurodevelopmental disorders (NDD) conducted from January 2021 to January 2022; the cross-sectional study involved 130 participants. The study revealed that 70% of participants were male, and the mean age of the children was 6.1 ± 0.26 years. Regarding telemedicine awareness, 53% of respondents were informed, yet encountered obstacles such as poor internet service and lack of awareness. Despite challenges, 46% of respondents viewed telemedicine positively. Parents showed significant differences in their perception of virtual interviews based on interview purpose (P = 0.034), clinic type (P < 0.001), internet service quality (P = 0.029), timing conflicts (P = 0.001), lack of technology experience (P = 0.041), and awareness gaps (P = 0.012). Our study identified challenges for parents of children with NDD in utilising telehealth, primarily stemming from limited awareness and internet connectivity issues. To enhance telemedicine quality, we suggest improving internet infrastructure and promoting telemedicine awareness. Further research is needed to optimise telemedicine implementation for both diagnosis and intervention in children with NDD.
Collapse
Affiliation(s)
- Ahmed B Idris
- Developmental Pediatric Unit, Child Health Department, Sultan Qaboos University, Sultan Qaboos University Hospital, Muscat, Oman
| | - Watfa Al-Mamari
- Developmental Pediatric Unit, Child Health Department, Sultan Qaboos University, Sultan Qaboos University Hospital, Muscat, Oman
| | | | | | - Ahmed Alhabsi
- Internship Program, Sultan Qaboos University, Muscat, Oman
| | - Saquib Jalees
- Developmental Pediatric Unit, Child Health Department, Sultan Qaboos University, Sultan Qaboos University Hospital, Muscat, Oman
| | - Ahlam Gaber
- Developmental Pediatric Unit, Child Health Department, Sultan Qaboos University, Sultan Qaboos University Hospital, Muscat, Oman
| | - Muna Al-Jabri
- Nursing Department, Sultan Qaboos University, Sultan Qaboos University Hospital, Muscat, Oman
| | - M Mazharul Islam
- Department of Statistics, College of Science, Sultan Qaboos University, Muscat, Oman
| | - Amna Al-Futaisi
- Pediatric Neurology Unit, Child Health Department, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| |
Collapse
|
3
|
Retamal-Walter F, Waite M, Scarinci N. Exploring engagement in telepractice early intervention for young children with developmental disability and their families: a qualitative systematic review. Disabil Rehabil Assist Technol 2023; 18:1508-1521. [PMID: 35287526 DOI: 10.1080/17483107.2022.2048098] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 02/23/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE This review aimed to (1) describe the nature of engagement in telepractice early intervention (EI) for families of young children with developmental disabilities; and (2) identify major barriers and facilitators for developing and maintaining engagement via telepractice. METHODS A qualitative systematic review was conducted, searching systematically across six databases (i.e., PUBMED, CINAHL, PsycINFO, Web of Science, EMBASE, and Scopus). The search identified 14 studies which met the inclusion criteria of peer-reviewed studies exploring EI professionals', families', managers', or service's views of engagement in telepractice EI using qualitative methodologies. The studies were appraised using the Critical Appraisal Skills Programme and data were analysed using thematic synthesis. RESULTS The synthesised data were grouped into four main themes reflecting the nuances of engagement in telepractice EI: (1) children and family engagement is facilitated and enhanced during telepractice interaction; (2) engagement may enhance therapy outcomes through telepractice multidisciplinary collaboration and communication; (3) there are challenges to engagement in the telepractice environment; and (4) preparation in telepractice can improve the development of engagement. CONCLUSION This review provides a comprehensive characterisation of engagement and describes a set of conceptual recommendations for establishing and maintaining engagement when using telepractice in EI.IMPLICATIONS FOR REHABILITATIONBuilding and maintaining engagement with families of young children with developmental disability/delay through telepractice is feasible.Despite some similarities between in-person and telepractice engagement, there are certain unique features of telepractice engagement that professionals and families may need to consider while providing/receiving early intervention services remotely.Preparation and training on how to engage in telepractice is recommended for professionals and families of young children with developmental disability/delay.Understanding how professionals and families engage with one another during telepractice interactions may improve targeted child and family intervention outcomes.
Collapse
Affiliation(s)
- Felipe Retamal-Walter
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Monique Waite
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Nerina Scarinci
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| |
Collapse
|
4
|
Kahlon E, Wachspress B, Berger I, Maeir A, Mazor-Karsenty T. A qualitative study on parents of autistic adolescents' experience of OT-ParentShip: A family-centred intervention. Aust Occup Ther J 2023; 70:627-640. [PMID: 37392163 DOI: 10.1111/1440-1630.12892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 05/30/2023] [Accepted: 06/01/2023] [Indexed: 07/03/2023]
Abstract
BACKGROUND OT-ParentShip intervention addresses the needs of autistic adolescents and the physical and emotional burden associated with parental caregiving. AIM This article describes the qualitative findings of a mixed-method, single-group, pre-test-post-test pilot study to determine whether this intervention has adequate potential for further, large-scale testing. METHOD The qualitative study sought to understand 14 parents' (N = 4 couples, N = 6 mothers) experiences in the intervention, examine their satisfaction, and receive their suggestions for improvement, using a grounded approach, with the aim of conceptualising a theoretical understanding of the data gathered. RESULTS A total of five key themes and 14 sub-themes describe parents' experiences. The key themes that were identified were parent-therapist relationship, parent-adolescent relationship, reframing, benefit for family, and parental resilience. Emerging themes shed light on the therapeutic components and change mechanisms of the intervention. CONCLUSION Self-determination theory was found to be an adequate theoretical framework to map these components and help in understanding their contribution to treatment outcomes. OT-Parentship directly enforces parents' basic psychological needs, who, in turn, support their adolescent child's need for relatedness, competence, and autonomy. An occupational therapy intervention that satisfies these basic needs has the potential to lead to therapeutic alliance and internalisation of goals, thus increasing therapy engagement and outcomes.
Collapse
Affiliation(s)
- Einav Kahlon
- School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Batel Wachspress
- School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Itai Berger
- Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
- Pediatric Neurology Service, Pediatric Division, Assuta-Ashdod University Hospital, Ashdod, Israel
- The Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Adina Maeir
- School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Tal Mazor-Karsenty
- School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| |
Collapse
|
5
|
Gately ME, Metcalf EE, Waller DE, McLaren JE, Chamberlin ES, Hawley CE, Venegas M, Dryden EM, O’Connor MK, Moo LR. Caregiver Support Role in Occupational Therapy Video Telehealth: A Scoping Review. TOPICS IN GERIATRIC REHABILITATION 2023; 39:253-265. [PMID: 37901356 PMCID: PMC10601380 DOI: 10.1097/tgr.0000000000000409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
Caregiver involvement may facilitate patient participation in occupational therapy (OT) video telehealth. However, little is known about the extent to which caregivers participate and what they do. This scoping review aims to, 1) describe the caregiver role supporting patient participation in OT video telehealth, and, 2) identify barriers and facilitators to caregiver involvement. Findings reveal caregiver involvement in a range of OT evaluation and intervention processes, with details on what caregivers did overall lacking. Barriers and facilitators are also described. This study underscores the need for clear and robust descriptions of caregiver participation to increase best practices in video telehealth.
Collapse
Affiliation(s)
- Megan E. Gately
- VA Bedford Health Care System, New England Geriatric Research Education and Clinical Center (GRECC), Bedford, MA, USA
- Boston University School of Medicine, Department of Medicine, Division of Geriatrics, Boston, MA, USA
| | - Emily E. Metcalf
- VA Palo Alto Health Care System, National Center for PTSD, Dissemination and Training Division, Menlo Park, CA, USA
| | - Dylan E. Waller
- VA Portland Health Care System, Center to Improve Veteran Involvement in Care (CIVIC), Portland, OR, USA
| | - Jaye E. McLaren
- VA Bedford Health Care System, New England Geriatric Research Education and Clinical Center (GRECC), Bedford, MA, USA
| | - Elizabeth S. Chamberlin
- VA Bedford Health Care System, New England Geriatric Research Education and Clinical Center (GRECC), Bedford, MA, USA
- VA Bedford Health Care System, VISN 1 Mental Illness Research, Education, and Clinical Center (MIRECC), Bedford, MA, USA
| | - Chelsea E. Hawley
- VA Bedford Health Care System, New England Geriatric Research Education and Clinical Center (GRECC), Bedford, MA, USA
- Boston University School of Medicine, Department of Medicine, Division of Geriatrics, Boston, MA, USA
| | - Maria Venegas
- Boston University School of Medicine, Department of Medicine, Division of Geriatrics, Boston, MA, USA
- VA Bedford Health Care System, Center for Healthcare Organization and Implementation Research (CHOIR), Bedford, MA, USA
| | - Eileen M. Dryden
- VA Bedford Health Care System, Center for Healthcare Organization and Implementation Research (CHOIR), Bedford, MA, USA
| | - Maureen K. O’Connor
- VA Bedford Health Care System, New England Geriatric Research Education and Clinical Center (GRECC), Bedford, MA, USA
- Boston University School of Medicine, Neurology Department, Boston, MA, USA
| | - Lauren R. Moo
- VA Bedford Health Care System, New England Geriatric Research Education and Clinical Center (GRECC), Bedford, MA, USA
- Massachusetts General Hospital, Cognitive Behavioral Neurology Unit, Cambridge, MA, USA
- Harvard Medical School, Boston, MA, USA
| |
Collapse
|
6
|
Dostie R, Gaboury I, Trottier N, Hurtubise K, Camden C. Acceptability of a Multimodal Telerehabilitation Intervention for Children Ages 3-8 Years with Motor Difficulties: Results of a Qualitative Study. Dev Neurorehabil 2023; 26:287-301. [PMID: 37403439 DOI: 10.1080/17518423.2023.2233020] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 06/29/2023] [Accepted: 07/01/2023] [Indexed: 07/06/2023]
Abstract
PURPOSE The purpose of this study is to explore the acceptability of a telerehabilitation intervention provided to parents of children with motor difficulties. MATERIAL AND METHODS Sixteen parents of children were purposefully recruited to participate in semi-structured interviews aimed at assessing the acceptability of the telerehabilitation intervention. Interviews were analyzed thematically. RESULTS All participants described evolving acceptability associated with their interactions with the web platform. The opportunities generated, suitability in relation to families' values and perceived effects positively impacted acceptability. The understanding and consistency of intervention delivery, the child's level of involvement, the associated parental burden of the intervention and the therapeutic alliances created also affected acceptability. CONCLUSION Our study findings support the acceptability of a telerehabilitation intervention for families of children with motor difficulties. Telerehabilitation seems to be more acceptable to families with children without suspected or confirmed diagnoses.
Collapse
|
7
|
Phillips AQ, Campi E, Talbott MR, Baranek GT. Assessment Fidelity of Parents Implementing a Standardized Telehealth Infant Autism Screener. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2023; 43:360-367. [PMID: 37089013 PMCID: PMC10330541 DOI: 10.1177/15394492231164943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
Telehealth is effective for service delivery in pediatric occupational therapy across ages and diagnoses. Remote parent coaching provides unique benefits for both parents and infants. As a result of COVID-19, practitioners and researchers pivoted to remote assessment and intervention without much preparation or training. It is critical that we evaluate the quality of these telehealth services. One important component of remote evaluations is assessment fidelity. To examine assessment fidelity of a telehealth-delivered observational autism screening tool for infants. An assessment fidelity checklist was applied as the primary outcome measure. Parents conducted assessments with 82% adherence to the fidelity checklist. Implications: A parent coaching telehealth approach may be valid for assessment in pediatric telehealth. Continually monitoring the assessment fidelity of a tool is critical for the valid administration of remote services.
Collapse
Affiliation(s)
| | - Emily Campi
- University of Southern California, Los Angeles, USA
| | | | | |
Collapse
|
8
|
Sterman J, Gustafson E, Eisenmenger L, Hamm L, Edwards J. Autistic Adult Perspectives on Occupational Therapy for Autistic Children and Youth. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2023; 43:237-244. [PMID: 35713212 PMCID: PMC10018055 DOI: 10.1177/15394492221103850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The Autistic community values neurodiversity-positive approaches rather than behavioral interventions for Autistic children; however, little is known about what that would look like in occupational therapy. Frequently, researchers seek parent perspectives for understanding Autistic children's preferences, while to date insufficient attention has been paid to Autistic adults as valuable informants on the Autistic experience of Autistic children. The objective of the study was to understand Autistic adult perspectives on pediatric occupational therapy for Autistic children. We sought and thematically analyzed data from a large Facebook group and an occupational therapy podcast on Autistic values, needs, and experiences in pediatric occupational therapy. Participants described wanting therapy that supported Autistic identities rather than trying to "fix" children, changing environments or tasks to promote participation, and setting goals that address self-advocacy and autonomy. Occupational therapy practitioners should critically reflect on their practice's alignment with Autistic values and start to shift their practice as needed.
Collapse
Affiliation(s)
- Julia Sterman
- Edinburgh Napier University, UK
- University of Minnesota, Minneapolis,
USA
- Julia Sterman, Occupational Therapy
Programme, School of Health and Social Care, Edinburgh Napier University, 9
Sighthill Court, Edinburgh EH11 4BN, UK.
| | | | | | - Lizzie Hamm
- Minnesota Neurodivergent Education
Advocacy and Therapy Services, White Bear Lake, USA
| | | |
Collapse
|
9
|
Marino F, Failla C, Bruschetta R, Vetrano N, Scarcella I, Doria G, Chilà P, Minutoli R, Vagni D, Tartarisco G, Cerasa A, Pioggia G. TeleRehabilitation of Social-Pragmatic Skills in Children with Autism Spectrum Disorder: A Principal Component Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3486. [PMID: 36834179 PMCID: PMC9967556 DOI: 10.3390/ijerph20043486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 02/07/2023] [Accepted: 02/14/2023] [Indexed: 06/18/2023]
Abstract
In many therapeutic settings, remote health services are becoming increasingly a viable strategy for behavior management interventions in children with autism spectrum disorder (ASD). However, there is a paucity of tools for recovering social-pragmatic skills. In this study, we sought to demonstrate the effectiveness of a new online behavioral training, comparing the performance of an ASD group carrying out an online treatment (n°8) with respect to a control group of demographically-/clinically matched ASD children (n°8) engaged in a traditional in-presence intervention (face-to-face). After a 4-month behavioral treatment, the pragmatic skills language (APL test) abilities detected in the experimental group were almost similar to the control group. However, principal component analysis (PCA) demonstrated that the overall improvement in socio-pragmatic skills was higher for ASD children who underwent in-presence training. In fact, dimensions defined by merging APL subscale scores are clearly separated in ASD children who underwent in-presence training with respect to those performing the online approach. Our findings support the effectiveness of remote healthcare systems in managing the social skills of children with ASD, but more approaches and resources are required to enhance remote services.
Collapse
Affiliation(s)
- Flavia Marino
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98164 Messina, Italy
| | - Chiara Failla
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98164 Messina, Italy
- Classical Linguistic Studies and Education Department, Kore University of Enna, 94100 Enna, Italy
| | - Roberta Bruschetta
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98164 Messina, Italy
- Department of Engineering, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 21, 00128 Rome, Italy
| | - Noemi Vetrano
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98164 Messina, Italy
- Department of Cognitive, Psychological and Pedagogical Sciences, and Cultural Studies, University of Messina, Via Concezione, 6/8, 98121 Messina, Italy
| | - Ileana Scarcella
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98164 Messina, Italy
- Faculty of Psychology, International Telematic University Uninettuno, Corso Vittorio Emanuele II, 39, 00186 Roma, Italy
| | - Germana Doria
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98164 Messina, Italy
- Faculty of Psychology, International Telematic University Uninettuno, Corso Vittorio Emanuele II, 39, 00186 Roma, Italy
| | - Paola Chilà
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98164 Messina, Italy
- Faculty of Psychology, International Telematic University Uninettuno, Corso Vittorio Emanuele II, 39, 00186 Roma, Italy
| | - Roberta Minutoli
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98164 Messina, Italy
- Faculty of Psychology, International Telematic University Uninettuno, Corso Vittorio Emanuele II, 39, 00186 Roma, Italy
| | - David Vagni
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98164 Messina, Italy
| | - Gennaro Tartarisco
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98164 Messina, Italy
| | - Antonio Cerasa
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98164 Messina, Italy
- S’Anna Institute, 88900 Crotone, Italy
- Pharmacotechnology Documentation and Transfer Unit, Preclinical and Translational Pharmacology, Department of Pharmacy, Health Science and Nutrition, University of Calabria, 87036 Arcavacata, Italy
| | - Giovanni Pioggia
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98164 Messina, Italy
| |
Collapse
|
10
|
Angell AM, Carreon ED, Akrofi JNS, Franklin MD, Taylor EE, Miller J, Crowley C, Maher SO. Challenges and Facilitators to Telehealth Occupational Therapy for Autistic Children During COVID-19. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2023:15394492221142597. [PMID: 36597578 DOI: 10.1177/15394492221142597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Pre-pandemic, telehealth occupational therapy (OT) for autistic children appeared promising, but research was limited. The pandemic provided a unique opportunity to investigate how clinics transitioned to telehealth. The purpose of this study was to examine barriers and facilitators that influenced delivery of OT services through telehealth for autistic children during the pandemic. We conducted semi-structured qualitative interviews with 13 participants (three administrators, six OTs, and four parents of autistic children) at three Los Angeles area clinics over a 7-month period. We used narrative and thematic analysis to identify four themes. We identified (a) Challenges and (b) Facilitators to Conducting Telehealth OT, including practical strategies for successful facilitation, and (c) Negative and (d) Positive Outcomes of Conducting Telehealth OT. As telehealth will likely remain a viable means of OT service delivery in the future, our findings provide insight into ways that it can be improved and sustained.
Collapse
Affiliation(s)
| | | | | | | | | | - Julie Miller
- Professional Child Development Associates, Pasadena, CA, USA
| | | | | |
Collapse
|
11
|
Read JS, Brown K, Wray J. The Feasibility and Acceptability of Remote Videoconference Use of the Brief Developmental Assessment Tool for Young Children with Congenital Heart Disease. Telemed J E Health 2023; 29:146-151. [PMID: 35649232 DOI: 10.1089/tmj.2021.0609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Background: Young children with congenital heart disease (CHD) are at heightened risk of developmental delay. The outbreak of COVID-19 and the ensuing lockdowns presented an opportunity to test the feasibility of using a short neurodevelopmental assessment tool-the Brief Developmental Assessment (BDA)-remotely via new technologies. Methods: We tested the feasibility and acceptability of remote testing of the tool's 6 domains of development with 30 children younger than 5 years with CHD and 10 healthy controls. Results: Despite some technical issues, parents largely responded positively to the use of the remote assessment as opposed to traditional face-to-face appointments, citing the beneficial saving of time, money, and childcare. Conclusions: The acceptability of the remote use of the BDA for the developmental screening of children with CHD will allow for the possibility of increased screening for more children and earlier identification of developmental problems, both during and after COVID-19 restrictions.
Collapse
Affiliation(s)
- Julie S Read
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability, Great Ormond Street Hospital for Children National Health Service Foundation Trust, London, United Kingdom
| | - Katherine Brown
- Heart and Lung Division, Zayed Centre for Rare Diseases Research, Great Ormond Street Hospital for Children National Health Service Foundation Trust, London, United Kingdom
| | - Jo Wray
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability, Great Ormond Street Hospital for Children National Health Service Foundation Trust, London, United Kingdom
| |
Collapse
|
12
|
Lantheaume S, Doublet L, Mory JE, Durand T, Lebosse W, Heudel PE. A qualitative study of teleconsultation practices among French oncologists in a post-COVID-19 period. Digit Health 2023; 9:20552076231215906. [PMID: 38033511 PMCID: PMC10685777 DOI: 10.1177/20552076231215906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 11/06/2023] [Indexed: 12/02/2023] Open
Abstract
Background The Covid-19 pandemic has prompted healthcare professionals to adapt and implement new tools to ensure continuity of patient care. Teleconsultation became the only option for some practitioners who had never used it previously and boosted its use for others who already used it. Several studies have reviewed the use of teleconsultation in oncology during the epidemic, but few have addressed its continued use and how practitioners view it in a post-epidemic period. The aim of this survey was to conduct a qualitative exploration of how oncologists use teleconsultation in their daily practice in a post-COVID 19 period. Materials and Methods For this qualitative study, semi-structured interviews were conducted with oncologists in France who utilized teleconsultation in the field of oncology during the COVID-19 period. The interview guide included questions on the interests and limitations of using teleconsultation in oncology, on reluctance to use it among oncologists, and invited participants to formulate proposals for more optimal use. Results Fourteen oncologists participated in the survey. Currently, 12% of the consultations of the surveyed practitioners are conducted via teleconsultation. Seven themes were identified in the analysis of the interviews: (a) The oncologist and teleconsultation; (b) Clinical motivations for using teleconsultation; (c) Comparison between teleconsultation and in-person consultation; (d) Advantages and disadvantages of teleconsultation; (e) Technical modalities of teleconsultation; (f) Role of Covid and confinement in the use of teleconsultation; (h) Epistemic judgments about teleconsultation. Optimal teleconsultation occurs when seamlessly incorporated into patient care, offering reduced patient inconvenience, and providing economic and environmental benefits. Although there's a lack of unified agreement in research literature regarding time efficiency, teleconsultation facilitates more customized patient monitoring and addresses the challenge of "medical deserts" nationally. Considering patient preferences is crucial when contemplating the use of teleconsultation. Predominantly, technical issues stand as the principal barriers to teleconsultation implementation. Conclusion Even after the end of the health crisis, teleconsultation is still used in clinical practice. Recommendations for effective use are suggested.
Collapse
Affiliation(s)
- Sophie Lantheaume
- Ramsay Santé Hôpital Privé Drôme Ardèche, 07500 Guilherand-Granges, France
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, LIP/PC2S, 38000 Grenoble, France
| | - Louis Doublet
- Ramsay Santé Hôpital Privé Drôme Ardèche, 07500 Guilherand-Granges, France
| | - Jean-Eudes Mory
- Ramsay Santé Hôpital Privé Drôme Ardèche, 07500 Guilherand-Granges, France
- Centre de Coordination de Cancérologie Drôme Ardèche, 26000 Valence, France
| | - Thierry Durand
- Direction des systèmes d’information, centre Léon Bérard, 69008 Lyon, France
| | - William Lebosse
- Centre de Coordination de Cancérologie Rhodanien, Centre Léon Bérard, 69008 Lyon, France
| | - Pierre-Etienne Heudel
- Centre de Coordination de Cancérologie Rhodanien, Centre Léon Bérard, 69008 Lyon, France
- Département d’Oncologie Médicale, Centre Léon Bérard, 69008 Lyon, France
| |
Collapse
|
13
|
Lamash L, Little L, Hen-Herbst L. Telehealth Interventions to Promote Health and Behavior-Related Outcomes in Adolescents with Autism Spectrum Disorder. J Autism Dev Disord 2023; 53:405-423. [PMID: 35061162 PMCID: PMC8780047 DOI: 10.1007/s10803-022-05440-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2022] [Indexed: 02/03/2023]
Abstract
This systematic review examined the effectiveness in a hybrid telehealth model for adolescents with autism spectrum disorder (ASD), exploring the evidence base, methodology, and outcomes of health and behavior-related interventions for adolescents with ASD. The 11 included studies (a) were quantitative, (b) evaluated interventions delivered through a hybrid telehealth model (i.e., combined remote intervention with minimal in-person procedures), (c) measured health and behavior-related outcomes, and (d) considered adolescence as ages 12 through 25 years. The studies were a mixture of designs, methods, and outcome measures, and participant numbers were extremely low. Results demonstrated an overall lack of empirical evidence on the efficacy of hybrid-delivered interventions for adolescents with ASD, and more studies are needed to explore their effectiveness.
Collapse
Affiliation(s)
- Liron Lamash
- Department of Occupational Therapy, University of Haifa, Israel, 199 Aba Khoushy Ave. Mount Carmel, 3498838 Haifa, Israel
| | | | | |
Collapse
|
14
|
Smith SL, Aytur SA, Humphreys BP. Effects of Telehealth Parent Coaching in Supporting Family Participation, Cohesion, and Adaptability. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2023; 43:24-34. [PMID: 35574933 DOI: 10.1177/15394492221083664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Families provide foundational contexts in which most children develop and grow. For families of children with special health care needs (CSHCN), interdisciplinary supports can build family participation capacities, beyond individualistic child supports. This single-group pretest-posttest quasi-experimental study sought to determine the preliminary effects of the Healthy Families Flourish Program (HFFP), a telehealth occupation-based parent coaching intervention to promote participation, cohesion, adaptability, and communication for families of CSHCN. Eleven families, including 17 parents and 27 children, completed the 10-session intervention consisting of parent education and individualized coaching. Participants completed the Canadian Occupational Performance Measure, Goal Attainment Scaling, and the Family Adaptability and Cohesion Evaluation Scales pre-/post-intervention. Within-group comparisons showed improvements in family participation, cohesion, adaptability, and communication with Cohen's d effect sizes ranging from 0.55-3.32. Researchers found positive relationships between family participation and cohesion as well as participation and adaptability. Findings provide considerations for supporting families within socioecological contexts.
Collapse
|
15
|
González-García RJ, Martínez-Rico G, Escorcia-Mora C, García-Grau P. A Bibliometric Study on the Social Validity of Telepractice in Autism Spectrum Disorder. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:ijerph20010419. [PMID: 36612747 PMCID: PMC9819304 DOI: 10.3390/ijerph20010419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 12/23/2022] [Accepted: 12/24/2022] [Indexed: 06/01/2023]
Abstract
The field of telepractice is generating increasing interest in recent years. In recent years, early childhood services have used resources such as support for interventions in families with children with autism spectrum disorder. Due to this situation, the social validity of such resources has emerged in this sector, receiving individual attention from academics and practitioners. However, a further deepening of such analyses is needed. Therefore, the main objective of this work is to analyze papers published in the Web of Science on social validity and telepractice in autism spectrum disorders. Bibliometric analysis allows us to discover the current state of a research field, to identify the main authors, articles, and topics, and to propose future lines of research to develop it further. Articles published between 2000 and 2021 were analyzed quantitatively, and by co-occurrence of words and authors. Subsequently, through bibliographic linking, the articles were grouped into different clusters. Five central themes were found, with social skills and the effectiveness of intervention programs being the most developed areas of research. Furthermore, studies focusing on evidence-based practices are necessary for the development of this research field. Thus, the analysis of social validity in the field of telepractice in children with autism spectrum disorders is a developing field within the early childhood sector.
Collapse
Affiliation(s)
- Rómulo J. González-García
- Doctoral School, Catholic University of Valencia San Vicente Martyr, 46001 Valencia, Spain
- Campus Capacitas, Catholic University of Valencia San Vicente Martyr, 46001 Valencia, Spain
| | - Gabriel Martínez-Rico
- Campus Capacitas, Catholic University of Valencia San Vicente Martyr, 46001 Valencia, Spain
| | - Claudia Escorcia-Mora
- Campus Capacitas, Catholic University of Valencia San Vicente Martyr, 46001 Valencia, Spain
| | - Pau García-Grau
- Campus Capacitas, Catholic University of Valencia San Vicente Martyr, 46001 Valencia, Spain
| |
Collapse
|
16
|
Talbott MR, Lang E, Avila F, Dufek S, Young G. Short report: Experiences of Caregivers Participating in a Telehealth Evaluation of Development for Infants (TEDI). J Autism Dev Disord 2022; 52:5266-5273. [PMID: 35945386 PMCID: PMC9362962 DOI: 10.1007/s10803-022-05607-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2022] [Indexed: 11/02/2022]
Abstract
A growing literature supports the feasibility and validity of telehealth-based assessments for autism spectrum disorder (ASD). Better understanding families' experiences is crucial for sustained use beyond the COVID-19 pandemic. This study qualitatively examines caregiver experiences with the Telehealth Evaluation of Development for Infants (TEDI) protocol to better understand benefits and challenges of telehealth-based evaluations. Caregivers (N = 32) completed an online survey following a telehealth-based evaluation with their 6-12 month-old infants. Open-ended text responses to queries about perceived benefits, challenges, and suggestions for future adaptations were coded. Most caregivers reported positive experiences with minor feedback relating to tailoring of individual needs. Responses suggest the TEDI is a feasible approach and provide guidance for components of successful telehealth evaluations more broadly.
Collapse
Affiliation(s)
- Meagan R Talbott
- MIND Institute, University of California Davis, 2825 50th Street, 95817, Sacramento, CA, United States.
- Department of Psychiatry and Behavioral Science, University of California Davis, Sacramento, USA.
| | - Ellisa Lang
- MIND Institute, University of California Davis, 2825 50th Street, 95817, Sacramento, CA, United States
| | - Felipe Avila
- MIND Institute, University of California Davis, 2825 50th Street, 95817, Sacramento, CA, United States
| | - Sarah Dufek
- MIND Institute, University of California Davis, 2825 50th Street, 95817, Sacramento, CA, United States
- Department of Psychiatry and Behavioral Science, University of California Davis, Sacramento, USA
| | - Gregory Young
- MIND Institute, University of California Davis, 2825 50th Street, 95817, Sacramento, CA, United States
- Department of Psychiatry and Behavioral Science, University of California Davis, Sacramento, USA
| |
Collapse
|
17
|
Benz C, Norman R, Hendrie D, Welsh M, Huntley M, Robinson S. Use of Teletherapy for allied health interventions in community-based disability services: A scoping review of user perspectives. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e3934-e3948. [PMID: 36373233 PMCID: PMC10099871 DOI: 10.1111/hsc.14105] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 08/11/2022] [Accepted: 10/28/2022] [Indexed: 05/29/2023]
Abstract
Understanding the experiences and perspectives of users of teletherapy living with a disability and working with them, offers the potential to improve its capacity to meet their requirements. Literature examining the effectiveness of interventions delivered via teletherapy often fail to explore the motivators and implementation needs of the users. The scoping review aimed to examine the research evidence addressing user perspectives of teletherapy in delivery of allied health interventions to the disability community. The Joanna Briggs scoping review protocol methodology was employed with searches completed across five databases (ProQuest, CINAHL (EBSCO), Medline (OVID), Scopus, Google Scholar) in September 2021. The search yielded a total of 1365 results, 147 progressed to full text screening and 22 articles included in thematic analysis. Findings were split into themes addressing organisational and implementation based considerations for teletherapy, and secondly the social and contextual considerations of the Target Participants. The two areas of interest were addressed under each theme some of which include resourcing and upskilling, financial, challenging the status quo, moving from hands on to coaching and the utilisation of a hybrid model of intervention delivery. Teletherapy is viewed as creating a distinct set of benefits and challenges compared to in person service delivery, which impact individual members of the disability community differently. The scoping review identifies a strong need from recipients to trial teletherapy and experience it personally to facilitate understanding of how it can best suit an individual. More than being viewed as an alternative to in person services, teletherapy is viewed by users as better suited as a complementary service with flexibility of hybrid model opportunities valued above exclusive use of one over the other.
Collapse
Affiliation(s)
- Cloe Benz
- School of Population HealthFaculty of Health SciencesCurtin UniversityBentleyAustralia
| | - Richard Norman
- School of Population HealthFaculty of Health SciencesCurtin UniversityBentleyAustralia
| | - Delia Hendrie
- School of Population HealthFaculty of Health SciencesCurtin UniversityBentleyAustralia
| | | | | | - Suzanne Robinson
- School of Population HealthFaculty of Health SciencesCurtin UniversityBentleyAustralia
- Deakin Health Economics, Institute for Health TransformationDeakin UniveristyMelbourneAustralia
| |
Collapse
|
18
|
Portillo-Aceituno A, Calderón-Bernal A, Pérez-Corrales J, Fernández-de-Las-Peñas C, Palacios-Ceña D, Güeita-Rodríguez J. The impact of digital physical therapy during COVID-19 lockdown in children with developmental disorders: A qualitative study. Braz J Phys Ther 2022; 26:100445. [PMID: 36179573 PMCID: PMC9477961 DOI: 10.1016/j.bjpt.2022.100445] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 09/04/2022] [Accepted: 09/12/2022] [Indexed: 12/03/2022] Open
Abstract
Digital physical therapy may be a solution for continuity during lockdown, yet its development appears complex. Implementation difficulties seem to relate to physical, attentional, and training factors. Technological accessibility, adaptation of the therapist and involvement of the whole family appear to be facilitators. Future possibilities may support a better follow-up with fluid communication between families and therapists.
Background Digital physical therapy was performed within early intervention sessions for children with developmental disorders during the COVID-19 pandemic. There is no known qualitative study that addresses the perspectives of parents with digital practice for early intervention. Objective To describe the parents' experiences with digital physical therapy for early intervention in children during COVID-19 lockdown. Methods A qualitative phenomenological study. Purposive sampling was conducted, including 16 parents of the children participating in the early intervention program. Data were collected through semi-structured interviews and researchers' field notes. An inductive analysis was performed. Results Four themes emerged: a) ambivalent experiences about digital physical therapy: telehealth can be a good solution in times of COVID-19, however, it was also perceived as difficult and insufficient; b) barriers encountered for its implementation: describing factors related to physical aspects, training, and time, and difficulties maintaining the child's attention; c) perceived facilitators during its use: based on digital accessibility, availability, and adaptability of the therapist and the rest of the family; d) future possibilities of digital physical therapy: suggested uses for after the lockdown, such as a complement that facilitates communication and as a follow-up with older children. Conclusions Our findings help shed light on the possible benefits of digital physical therapy in children with developmental disorders, considering the perspectives of families. However, there are several difficulties to be overcome to successfully implement this type of therapy and optimize its future possibilities.
Collapse
Affiliation(s)
| | - Andrea Calderón-Bernal
- COVID-19 Tracer Service, Primary care management of the Community of Madrid, Madrid, Spain
| | - Jorge Pérez-Corrales
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Health Science Faculty, Alcorcón, Spain; Research Group of Humanities and Qualitative Research in Health Science (Hum&QRinHS), Universidad Rey Juan Carlos, Health Science Faculty, Alcorcón, Spain.
| | - César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Health Science Faculty, Alcorcón, Spain
| | - Domingo Palacios-Ceña
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Health Science Faculty, Alcorcón, Spain; Research Group of Humanities and Qualitative Research in Health Science (Hum&QRinHS), Universidad Rey Juan Carlos, Health Science Faculty, Alcorcón, Spain
| | - Javier Güeita-Rodríguez
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Health Science Faculty, Alcorcón, Spain; Research Group of Humanities and Qualitative Research in Health Science (Hum&QRinHS), Universidad Rey Juan Carlos, Health Science Faculty, Alcorcón, Spain
| |
Collapse
|
19
|
Filbay S, Bennell KL, Morello R, Smith L, Hinman RS, Lawford BJ. Exploring experiences with telehealth-delivered allied healthcare services for people with permanent and significant disabilities funded through a national insurance scheme: a qualitative study examining challenges and suggestions to improve services. BMJ Open 2022; 12:e065600. [PMID: 36104129 PMCID: PMC9476117 DOI: 10.1136/bmjopen-2022-065600] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES In people with a disability, or their caregivers, who reported suboptimal experiences, the objectives were to explore: (1) challenges with telehealth-delivered allied health services during the COVID-19 pandemic and (2) suggestions to improve such services. DESIGN Qualitative study based on an interpretivist paradigm and a phenomenological approach. SETTING Participants who accessed allied healthcare via telehealth during the pandemic. PARTICIPANTS Data saturation was achieved after 12 interviews. The sample comprised three people with permanent or significant disabilities, and nine carers/partners/family members of people with permanent or significant disabilities, who were funded by the Australian National Disability Insurance Scheme and had suboptimal experiences with telehealth. Semistructured one-on-one interviews explored experiences with telehealth and suggestions on how such services could be improved. An inductive thematic analysis was performed. RESULTS Six themes relating to the first study objective (challenges with telehealth) were developed: (1) evoked behavioural issues in children; (2) reliant on caregiver facilitation; (3) inhibits clinician feedback; (4) difficulty building rapport and trust; (5) lack of access to resources and (6) children disengaged/distracted. Five themes relating to the second study objective (suggestions to improve telehealth services) were developed: (1) establish expectations; (2) increase exposure to telehealth; (3) assess suitability of specific services; (4) access to support workers and (5) prepare for telehealth sessions. CONCLUSIONS Some people with permanent and significant disabilities who accessed allied healthcare via telehealth during the pandemic experienced challenges, particularly children. These unique barriers to telehealth need customised solutions so that people with disabilities are not left behind when telehealth services become more mainstream. Increasing experience with telehealth, setting expectations before consultations, supplying resources for therapy and assessing the suitability of clients for telehealth may help overcome some of the challenges experienced.
Collapse
Affiliation(s)
- Stephanie Filbay
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia
| | - Kim L Bennell
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia
| | - Renata Morello
- National Disability Insurance Agency, Melbourne, Victoria, Australia
| | - Lizzie Smith
- National Disability Insurance Agency, Melbourne, Victoria, Australia
| | - Rana S Hinman
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia
| | - Belinda J Lawford
- Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia
| |
Collapse
|
20
|
Exploring the Impact of a Hybrid Telehealth Program for Adults Living With Low Vision. TOPICS IN GERIATRIC REHABILITATION 2022. [DOI: 10.1097/tgr.0000000000000366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
21
|
Cheung WC, Aleman-Tovar J, Johnston AN, Little LM, Burke MM. A Qualitative Study Exploring Parental Perceptions of Telehealth in Early Intervention. JOURNAL OF DEVELOPMENTAL AND PHYSICAL DISABILITIES 2022; 35:353-373. [PMID: 35789590 PMCID: PMC9244129 DOI: 10.1007/s10882-022-09853-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 05/24/2022] [Indexed: 06/15/2023]
Abstract
UNLABELLED Using telehealth as a mode of service delivery has the potential to address some long-standing challenges in early intervention (EI) services such as waiting lists to access services. Yet, little is known about parent perceptions of telehealth in EI based on their lived experiences partnering with EI practitioners. The purpose of this study was to explore parent perceptions on using telehealth, especially on family-professional partnerships and coaching. Interviews were conducted with 15 parents of children receiving EI services via telehealth from June to August of 2021. Almost half of the participants reflected under-represented racial and ethnic backgrounds. Constant comparative analysis and emergent coding were used for data analysis. The findings showed that the advantages outnumbered the disadvantages regarding telehealth. Participants reported that telehealth provided a safe and flexible option and eliminated the wait to access EI services. However, participants identified some disadvantages to telehealth including telehealth precluded substantive interactions with therapists and limited access to technology. The findings also indicated that telehealth enhanced family-professional partnerships. Nearly all participants valued coaching during telehealth. Participants suggested initial supports to facilitate EI via telehealth, including stable internet access, telehealth training, and an initial in-person visit. Implications for research and practice are discussed. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s10882-022-09853-w.
Collapse
Affiliation(s)
- W. C. Cheung
- University of Illinois at Urbana-Champaign, 288 Education, 1310 South Sixth Street, Champaign, IL 61820 USA
| | - J. Aleman-Tovar
- University of Illinois at Urbana-Champaign, 288 Education, 1310 South Sixth Street, Champaign, IL 61820 USA
| | - A. N. Johnston
- University of Illinois at Urbana-Champaign, 288 Education, 1310 South Sixth Street, Champaign, IL 61820 USA
| | - L. M. Little
- Rush University, 600 S. Paulina St, Chicago, IL 1009A AAC60612 USA
| | - M. M. Burke
- University of Illinois at Urbana-Champaign, 288 Education, 1310 South Sixth Street, Champaign, IL 61820 USA
| |
Collapse
|
22
|
Araiba S, Čolić M. Preliminary Practice Recommendations for Telehealth Direct Applied Behavior Analysis Services with Children with Autism. JOURNAL OF BEHAVIORAL EDUCATION 2022; 32:1-35. [PMID: 35464786 PMCID: PMC9013273 DOI: 10.1007/s10864-022-09473-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/28/2022] [Indexed: 06/14/2023]
Abstract
This article provides preliminary practice recommendations for telehealth direct applied behavior analysis (ABA) services for children with autism. In the face of COVID-19, there is an immediate need for discussion on how to implement various ABA procedures via telehealth for ABA practitioners. Alongside emerging scientific evidence on the effectiveness of telehealth direct service as well as various service-related guidelines, we provide preliminary practice recommendations that are based on the existing literature on in-person and telehealth ABA procedures. We also discuss these recommendations with case studies of two boys with autism. Social validity measures indicated that families were satisfied with telehealth direct services. Even after the COVID-19 pandemic has resolved itself, telehealth direct ABA service will still be a valuable option for remote and international locations where direct ABA service is limited, and thus, practice recommendations continue to be relevant for all practitioners that use telehealth direct service.
Collapse
Affiliation(s)
- Sho Araiba
- Positive Behavior Support Corporation, 1645 Ala Wai Blvd., Honolulu, HI 96815 USA
| | - Marija Čolić
- Special Education Department, University of Hawai’i at Manoa, Honolulu, HI USA
| |
Collapse
|
23
|
Cleffi C, Su WC, Srinivasan S, Bhat A. Using Telehealth to Conduct Family-Centered, Movement Intervention Research in Children With Autism Spectrum Disorder During the COVID-19 Pandemic. Pediatr Phys Ther 2022; 34:246-251. [PMID: 35184077 PMCID: PMC8986576 DOI: 10.1097/pep.0000000000000872] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE After the COVID-19 pandemic, several randomized controlled trials came to a halt; however, we chose to reinvent our study and shifted to a home-based, telehealth intervention delivery format to support children with autism spectrum disorder and their families. Children with autism spectrum disorder have social communication impairments as well as perceptuomotor and cognitive comorbidities. Continued access to care is crucial for their long-term development. METHODS We created a general movement intervention to target strength, endurance, executive functioning, and social skills through goal-directed games and activities delivered using a telehealth intervention model. FINDINGS Our family-centered approach allowed for collaboration between trainers and caregivers and made it easy for families to replicate training activities at home. CONCLUSIONS While more studies comparing telehealth and face-to-face interventions are needed, we encourage researchers and clinicians to consider family-centered telehealth as a valid and feasible intervention delivery method, to increase the likelihood of carryover of skills into the daily lives of children and ultimately enhance their long-term development.
Collapse
Affiliation(s)
- Corina Cleffi
- Department of Physical Therapy, University of Delaware, Newark, DE, USA
- Biomechanics & Movement Science Program, University of Delaware, Newark, DE, USA
| | - Wan-Chun Su
- Department of Physical Therapy, University of Delaware, Newark, DE, USA
- Biomechanics & Movement Science Program, University of Delaware, Newark, DE, USA
| | - Sudha Srinivasan
- Physical Therapy Program, Department of Kinesiology, University of Connecticut, Storrs, CT, USA
- Institute for Health, Intervention and Policy, University of Connecticut, Storrs, CT, USA
| | - Anjana Bhat
- Department of Physical Therapy, University of Delaware, Newark, DE, USA
- Biomechanics & Movement Science Program, University of Delaware, Newark, DE, USA
- Department of Psychological & Brain Sciences, University of Delaware, Newark, DE, USA
| |
Collapse
|
24
|
Kaur M, Eddy EZ, Tiwari D. Exploring Practice Patterns of Pediatric Telerehabilitation During COVID-19: A Survey Study. Telemed J E Health 2022; 28:1505-1516. [PMID: 35263191 PMCID: PMC9618374 DOI: 10.1089/tmj.2021.0506] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background and Objective: Sudden transition to telerehabilitation during the coronavirus disease 2019 (COVID-19) pandemic was challenging for pediatric therapists, including physical therapists and occupational therapists, due to lack of prior experience and knowledge. The primary goal of the current study was to survey the pediatric therapists regarding the practice trends and specific challenges/strengths of delivering telerehabilitation during the pandemic. Materials and Methods: An electronic survey was developed by the research term and validated through cognitive interviews with three pediatric therapists. A total of 107 therapists completed the survey. Descriptive statistics were used to summarize the trends for the survey questions. Results: The majority of therapists (92.5%) reported no prior experience with telerehabilitation. When comparing telerehabilitation with standard-of-care, the therapists reported similar session durations and frequencies, but greater caregiver-initiated cancellations of telerehabilitation sessions. Furthermore, a greater percentage of therapists modified the intervention activities compared with assessments, which impacted therapists' perceptions about quality of telerehabilitation as a greater percentage of therapists expressed confidence in treating children compared with assessing children virtually. One of the commonly reported telerehabilitation challenges was reduced virtual engagement of children, and strength was better assessment of home environment. Lastly, a greater percentage of therapists relied on consultations and fewer therapists used empirical evidence to guide their delivery of virtual care. Conclusions: Telerehabilitation is a cost-effective health care model that offers remote accessibility and flexible scheduling. However, several limitations in the current pediatric telerehabilitation model, including lack of teleassessments and empirical evidence, could limit post-COVID use of telerehabilitation.
Collapse
Affiliation(s)
- Maninderjit Kaur
- Department of Physical Therapy, MGH Institute of Health Professions, Charlestown, Massachusetts, USA
| | - Emily Z Eddy
- Department of Occupational Therapy, MGH Institute of Health Professions, Charlestown, Massachusetts, USA
| | - Devashish Tiwari
- Department of Physical Therapy, Simmons University, Boston, Massachusetts, USA
| |
Collapse
|
25
|
Gentile M, Messineo L, La Guardia D, Arrigo M, Città G, Ayala A, Cusimano G, Martines P, Mendolia G, Allegra M. A Parent-Mediated Telehealth Program for Children with Autism Spectrum Disorder : Promoting Parents' Ability to Stimulate the Children's Learning, Reduce Parenting Stress, and Boost Their Sense of Parenting Empowerment. J Autism Dev Disord 2022; 52:5285-5300. [PMID: 35235129 DOI: 10.1007/s10803-022-05482-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2022] [Indexed: 01/05/2023]
Abstract
This study investigates the effectiveness of a 6-month parent-mediated early intervention telehealth program for children with an autism spectrum disorder. The participants comprised a total of 27 parents. The findings showed that participation in the program promotes parents' empowerment and reduce parental stress and a general improvement in the parents' ability to stimulate children's learning. Moreover, the study reveals an effect of parents' age in mediating the relationship among the parents' ability, stress, and empowerment levels. These results suggest that an early intervention telehealth program may help parents become aware of how to benefit from interactions with their children, promote their empowerment, and reduce parenting stress.
Collapse
Affiliation(s)
- Manuel Gentile
- Istituto per le Tecnologie Didattiche, Consiglio Nazionale delle Ricerche, via Ugo la Malfa, 153, 90146, Palermo, Italy
| | - Linda Messineo
- Istituto per le Tecnologie Didattiche, Consiglio Nazionale delle Ricerche, via Ugo la Malfa, 153, 90146, Palermo, Italy.
| | - Dario La Guardia
- Istituto per le Tecnologie Didattiche, Consiglio Nazionale delle Ricerche, via Ugo la Malfa, 153, 90146, Palermo, Italy
| | - Marco Arrigo
- Istituto per le Tecnologie Didattiche, Consiglio Nazionale delle Ricerche, via Ugo la Malfa, 153, 90146, Palermo, Italy
| | - Giuseppe Città
- Istituto per le Tecnologie Didattiche, Consiglio Nazionale delle Ricerche, via Ugo la Malfa, 153, 90146, Palermo, Italy
| | - Antonia Ayala
- Istituto per le Tecnologie Didattiche, Consiglio Nazionale delle Ricerche, via Ugo la Malfa, 153, 90146, Palermo, Italy
| | - Gaspare Cusimano
- Istituto per le Tecnologie Didattiche, Consiglio Nazionale delle Ricerche, via Ugo la Malfa, 153, 90146, Palermo, Italy
| | - Pio Martines
- Azienda Sanitaria Provinciale di Trapani, Cittadella della Salute, viale della Provincia, 2, 91016, Erice Casa-Santa, Trapani, Italy
| | - Giovanna Mendolia
- Azienda Sanitaria Provinciale di Trapani, Cittadella della Salute, viale della Provincia, 2, 91016, Erice Casa-Santa, Trapani, Italy
| | - Mario Allegra
- Istituto per le Tecnologie Didattiche, Consiglio Nazionale delle Ricerche, via Ugo la Malfa, 153, 90146, Palermo, Italy
| |
Collapse
|
26
|
Lawford BJ, Hinman RS, Morello R, Oliver K, Spittle A, Bennell KL. Perceptions about the efficacy and acceptability of telephone and video-delivered allied healthcare for adults with disabilities during the COVID-19 pandemic: a cross-sectional national survey. Arch Phys Med Rehabil 2022; 103:1368-1378. [PMID: 35041838 PMCID: PMC8760738 DOI: 10.1016/j.apmr.2021.12.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 12/14/2021] [Accepted: 12/18/2021] [Indexed: 12/04/2022]
Abstract
Objective To investigate and compare perceptions about the efficacy and acceptability of allied health care delivered via telephone and video call for adults with disabilities during the COVID-19 pandemic. Design Cross-sectional national survey. Setting Participants who accessed occupational therapy, physiotherapy, psychology, or speech pathology care via telephone or via video call from June to September 2020. Participants Five hundred eighty-one adults with permanent or significant disabilities, or their carers, partners, or family members, who were funded by the Australian National Disability Insurance Scheme. Interventions Not applicable. Main Outcome Measures Experiences (eg, safety, efficacy, ease of use) with telephone and video-delivered care. Data were analyzed by calculating response proportions and chi-square tests to evaluate differences in experiences between allied health professions and between telephone and video modalities. Results Responses were obtained for 581 adults with disabilities. There was no evidence of differences between experiences with telephone or video-delivered services or across allied health professions. Overall, 47%-56% of respondents found telehealth technology easy to use (vs 17%-26% who found it difficult), 51%-55% felt comfortable communicating (vs 24%-27% who felt uncomfortable), 51%-67% were happy with the privacy and/or security (vs 6%-9% who were unhappy), 74% were happy with the safety (vs 5%-7% who were unhappy), and 56%-64% believed the care they received was effective (vs 17% who believed it was ineffective). Despite this, 48%-51% were unlikely to choose to use telephone or video consultations in the future (vs 32%-36% who were likely). Conclusions Adults with disabilities in Australia had generally positive experiences receiving allied health care via telehealth during the COVID-19 pandemic, although some experienced difficulties using and communicating via the technology. Findings indicated no differences between satisfaction with telephone or video modalities, or between physiotherapy, speech pathology, occupational therapy, or psychology services.
Collapse
Affiliation(s)
- Belinda J Lawford
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne. Victoria, Australia.
| | - Rana S Hinman
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne. Victoria, Australia
| | | | - Kathryn Oliver
- Department of Physiotherapy, The University of Melbourne, Victoria, Australia
| | - Alicia Spittle
- Department of Physiotherapy, The University of Melbourne, Victoria, Australia; Victorian Infant Brain Studies, Murdoch Children's Research Institute
| | - Kim L Bennell
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne. Victoria, Australia
| |
Collapse
|
27
|
Dostie R, Gaboury I, Cinar E, Camden C. Acceptability of Pediatric Telerehabilitation Interventions Provided by Physical Therapists and Occupational Therapists-A Scoping Review. Phys Occup Ther Pediatr 2022; 42:615-634. [PMID: 35440285 DOI: 10.1080/01942638.2022.2064203] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AIMS The purpose of this scoping review was to explore the available literature and identify gaps regarding the acceptability of telerehabilitation interventions provided by pediatric physical therapists and occupational therapists. METHODS We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-ScR) framework to guide this scoping review. We systematically searched eight scholarly databases (CINAHL, Medline, SPORTDiscus, AMED, APA PsychInfo, SCOPUS, PEDro, OTseeker), five gray literature databases (MedlinePlus, Gray Literature Report, OpenGrey, National Institute for Health, ProQuest Dissertation & Theses Global [PQDT]), conducted a manual search of selected references and contacted international experts. We included articles published between 2000 and 2021. Acceptability was defined in accordance with the Theoretical Framework of Acceptability of Sekhon et al. RESULTS From a total of 1567 unique references, 123 were deemed eligible for full-text review. Eighteen studies published between 2011 and 2021 were included in this review. Even though every aspect of the Theoretical Framework of Acceptability was assessed from a variety of angles, a complete appreciation of the concept is still lacking for pediatric telerehabilitation. CONCLUSIONS This review highlights important gaps in our knowledge regarding the acceptability of pediatric telerehabilitation interventions and supports the need for further research focusing on the subject.
Collapse
Affiliation(s)
- Rosalie Dostie
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Isabelle Gaboury
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Quebec, Canada
| | - Eda Cinar
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Chantal Camden
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| |
Collapse
|
28
|
Habilitative Teletherapy for Children with Autism Spectrum Disorder: A Survey of Parents. J Dev Behav Pediatr 2022; 43:454-460. [PMID: 35943378 PMCID: PMC9837790 DOI: 10.1097/dbp.0000000000001106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 05/05/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVE The purpose of this study was to investigate whether service losses during the coronavirus disease 2019 (COVID-19) pandemic were associated with worsened parent mental health or child behavioral health among families of children with autism spectrum disorder and to identify factors associated with favorable parent appraisals of habilitative teletherapy (applied behavior analysis; speech, occupational, physical therapy) for their child. METHOD This web-based survey study was conducted from May to July 2021 with parents whose children were receiving habilitative therapy for autism from an integrated health system. A total of 322 parents responded to the survey (20% response rate). The outcome variables were pandemic-related parent mental health, pandemic-related child behavioral health, and appraisal of habilitative teletherapy. Predictors were COVID-19-related services changes in health care or child care, COVID-19 history (COVID-19 stress, testing positive for COVID-19), and child autism factors (autistic behaviors, caregiving strain). RESULTS Loss of regular child care was associated with higher odds of worsened parent mental health (odds ratio [OR] = 2.7, 95% confidence interval [CI] = 1.5-4.8); higher levels of caregiving strain were associated with worsened child behavioral health (OR = 2.3, 95% CI = 1.4-3.8). Higher levels of COVID-19 stress were associated with more favorable appraisals of telehealth (β = 0.4, p < 0.01), whereas higher caregiving strain scores were associated with less favorable appraisals of telehealth (β = -0.2, p < 0.01). CONCLUSION During COVID-19, caregiving factors were associated with worsened parent mental health and worsened child behavioral health, and telehealth is not preferred by all families. Policy interventions to support caregivers, such as affordable, high-quality child care and paid family leave, are a high priority.
Collapse
|
29
|
Terrell EA, Aftab S, Babitz A, Butler L, Hernandez NG, Hornik B, Lee K, Perez J, Sotolongo E, Thomas J. The Evolution of Telehealth From Pre-COVID-19 Pandemic Through A Hybrid Virtual Care Delivery Model: A Pediatric Hospital's Journey. Int J Telerehabil 2021; 13:e6432. [PMID: 35646232 PMCID: PMC9098127 DOI: 10.5195/ijt.2021.6432] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The COVID-19 pandemic transformed care delivery and influenced telehealth adoption by rehabilitation professionals and their patients. The purpose of this paper is to describe a pediatric health system's telehealth services pre-pandemic and how those services were scaled during the pandemic. A secondary aim is to provide a roadmap for the operational delivery of telehealth and rehabilitation services, including transition to a hybrid care delivery model. Findings suggested that telehealth can be rapidly scaled to address patient healthcare needs for an early intervention population during a pandemic. Telehealth use during the pandemic helped ensure continuity of care and likely reduced the risk of exposure to patients and staff to the virus. Benefits included enhanced access to care, and savings in time and money for families. Interestingly, as the pandemic declined, the use of telehealth services declined due to patient preference, with many families opting to request a return to in-person care.
Collapse
Affiliation(s)
- Evelyn Abrahante Terrell
- Nicklaus Children's Pediatric Virtual Care, Telehealth Center, Nicklaus Children's Hospital, Miami, Florida, USA
| | - Saima Aftab
- Nicklaus Children's Pediatric Virtual Care, Telehealth Center, Nicklaus Children's Hospital, Miami, Florida, USA
| | - Anne Babitz
- Department of Rehabilitation Services, Nicklaus Children's Hospital, Miami, Florida, USA
| | - Lauren Butler
- Department of Rehabilitation Services, Nicklaus Children's Hospital, Miami, Florida, USA
| | | | - Bianca Hornik
- Department of Rehabilitation Services, Nicklaus Children's Hospital, Miami, Florida, USA
| | - Keysla Lee
- Department of Rehabilitation Services, Nicklaus Children's Hospital, Miami, Florida, USA
| | - Jennifer Perez
- Department of Rehabilitation Services, Nicklaus Children's Hospital, Miami, Florida, USA
| | - Elizabeth Sotolongo
- Nicklaus Children's Pediatric Virtual Care, Telehealth Center, Nicklaus Children's Hospital, Miami, Florida, USA
| | - Jessica Thomas
- Department of Rehabilitation Services, Nicklaus Children's Hospital, Miami, Florida, USA
| |
Collapse
|
30
|
Vilaseca R, Ferrer F, Rivero M, Bersabé RM. Early Intervention Services During the COVID-19 Pandemic in Spain: Toward a Model of Family-Centered Practices. Front Psychol 2021; 12:738463. [PMID: 34858273 PMCID: PMC8631765 DOI: 10.3389/fpsyg.2021.738463] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 10/04/2021] [Indexed: 11/18/2022] Open
Abstract
Early intervention services (EIS) worked hard to continue serving children and their families during the COVID-19 lockdown, using online applications. This study aimed to determine families’ and professionals’ perceptions of the functioning of the early intervention (EI) model in Spain during the pandemic. The study sample comprised two subsamples: 81 families of children attended at an EIS (72 mothers and 9 fathers) and 213 professionals recruited from EIS. The survey was conducted online several weeks after the end of the strict lockdown in Spain. Descriptive statistics of the questionnaire answered by families and professionals were compiled, comparisons were made between the families’ and the professionals’ responses, and the relationships with several sociodemographic variables were analyzed. The results indicated that parents who cared for their children and were fully responsible for housework, parents who had used telematic tools before the lockdown, and younger professionals had a more positive perception of the EI model and the incorporation of family-centered practices (FCP) during the pandemic. The results also showed statistically significant differences in some items between parents and professionals: for example, professionals perceived more advantages than families during the lockdown, quoting the greater participation of families in the intervention and a greater focus on families’ needs. The data obtained from professionals suggested a more positive attitude toward FCP: however, the results show that they continued to adopt a directive role in the intervention, a position that is at odds with the tenets of FCP. There is a clear need for more training if a paradigm shift to FCP is to be achieved. Families’ and caregivers’ perceptions of telerehabilitation, and their adherence to telerehabilitation programs, are discussed. The implications of this study with regard to guiding future telematic interventions and family support are also considered.
Collapse
Affiliation(s)
- Rosa Vilaseca
- Department of Cognition, Development and Educational Psychology, University of Barcelona, Barcelona, Spain
| | - Fina Ferrer
- Municipal Institute of Social Services of Barcelona, Barcelona, Spain
| | - Magda Rivero
- Department of Cognition, Development and Educational Psychology, University of Barcelona, Barcelona, Spain
| | - Rosa M Bersabé
- Department of Psychobiology and Methodology of Behavioral Sciences, University of Malaga, Málaga, Spain
| |
Collapse
|
31
|
Harris L, Gilmore D, Hanks C, Coury D, Moffatt-Bruce S, Garvin JH, Hand BN. "It was surprisingly equivalent to the appointment I had in person": Advantages and disadvantages of synchronous telehealth for delivering primary care for autistic adults. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 26:1573-1580. [PMID: 34847744 DOI: 10.1177/13623613211060589] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
LAY ABSTRACT Autistic adults face many barriers to receiving quality primary health care like clinics that are far away and sensory sensitivities. Real-time telehealth visits, called "virtual visits," are live video chats between the patient and provider. Virtual visits may minimize barriers to care for autistic adults. We wanted to describe advantages and disadvantages of using virtual visits for delivering primary health care for autistic adults. We interviewed 7 autistic adults and 12 caregivers of autistic adults who receive primary care through one clinic. Autistic adults and caregivers said advantages to virtual visits were that (1) patients were more comfortable at home, (2) patients could get health care while avoiding physical contact with other people during the pandemic, and (3) virtual visits were similar to or better than in-person visits. The disadvantages included that (1) there could be technology problems like grainy video, (2) the doctor could not physically examine the patient (e.g. look in ears), and (3) patients sometimes participated less in the virtual visit than they would in person. Virtual visits may be beneficial for autistic adults by eliminating travel to the clinic and avoiding stressful sensory stimuli. We recognize that virtual visits may not work for all patients or in all situations. However, our study shows that primary care virtual visits may be beneficial for autistic adults during and beyond the pandemic.
Collapse
|
32
|
Johnsson G, Bulkeley K. Practitioner and Service User Perspectives on the Rapid Shift to Teletherapy for Individuals on the Autism Spectrum as a Result of COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11812. [PMID: 34831567 PMCID: PMC8620428 DOI: 10.3390/ijerph182211812] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 11/09/2021] [Accepted: 11/09/2021] [Indexed: 11/26/2022]
Abstract
Prior to COVID-19, research into teletherapy models for individuals on the autism spectrum was slowly progressing. Following the onset of COVID-19, teletherapy became a necessity for continuity of services, however, research was still emerging for how to translate best practice autism support to the online environment. The aim of this research was to gain insight into the rapid shift to teletherapy for practitioner and service users and the implications for the broader disability sector. Survey responses were collected from 141 allied health practitioners (speech pathologists, occupational therapists, psychologists, educators, and social workers) from four Australian states and territories. A total of 806 responses were collected from service users following an individual teletherapy session. Five themes were identified during the qualitative analysis; (1) technology-love it or hate it; (2) teletherapy as a "new normal"; (3) short term pain, for long term gain; (4) the shape of service delivery has changed; (5) is teletherapy always an option? Data from the quantitative analysis provided further insights into the first two themes. While COVID-19 has brought forward significant advances in telehealth models of practice, what is needed now is to delve further into what works, for who, and in which context, and explore the potentiality, efficiencies, and scalability of a post-pandemic hybrid approach. This will inform practice guidelines and training, as well as information for service users on what to expect.
Collapse
Affiliation(s)
- Genevieve Johnsson
- Individual and Community Services, Autism Spectrum Australia, Sydney 2153, Australia
- Centre for Disability Research and Policy, University of Sydney, Sydney 2153, Australia;
| | - Kim Bulkeley
- Centre for Disability Research and Policy, University of Sydney, Sydney 2153, Australia;
| |
Collapse
|
33
|
Al Awaji NN, Almudaiheem AA, Mortada EM. Assessment of caregivers' perspectives regarding speech-language services in Saudi Arabia during COVID-19. PLoS One 2021; 16:e0253441. [PMID: 34157033 PMCID: PMC8219133 DOI: 10.1371/journal.pone.0253441] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 06/06/2021] [Indexed: 12/01/2022] Open
Abstract
Background As a consequence of stay-at-home and other lockdown measures, such as social distancing, all health care service provisions during the COVID-19 pandemic have been affected, including the provision of speech therapy. Telehealth services can play a major role in maintaining access to health care, help speech and language pathologists (SLPs) overcome physical barriers by providing patients and caregivers with access to health care, and limit the discontinuity of patient care. To have a better understanding of the changes that have occurred in these services during COVID-19, this research was conducted to explore the nature and current situation of speech-language services in Saudi Arabia based on caregivers’ perspectives. It also investigated whether changes have occurred in these services during the COVID-19 lockdown. The study also determined the perception of caregivers in delivering SLS sessions remotely. Method A cross-sectional study was conducted with 385 caregivers in Saudi Arabia. An online survey asked whether children were experiencing any SLS problems and if they had received any intervention. The survey also assessed the perception of changes in service during the COVID-19 lockdown and the perceptions, acceptance, and willingness of the caregivers to deliver telehealth speech services in Saudi Arabia. Results About 50% of the respondents had or were suspected to have a child with SLS problems, and just over half of them had accessed SLS services. Most of the respondents reported suspension of therapy sessions as a response to the COVID-19 pandemic. While the respondents had little experience using telehealth prior to the pandemic, they generally showed a willingness to use telehealth in therapy sessions, expressing a preference for video calls over other options. Conclusion The study revealed that SLS services in Saudi Arabia are limited and that accessing these services is challenging. Alternative service delivery using remote services could help caregivers overcome such challenges. When telehealth was introduced as an option for service delivery, the caregivers showed welcoming responses, particularly with video calls.
Collapse
Affiliation(s)
- Nisreen Naser Al Awaji
- Department of Health Communication Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
- * E-mail:
| | - Alanoud A. Almudaiheem
- King Abdullah Specialized Children Hospital-King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Eman M. Mortada
- Health Sciences Department, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
- Community, Environmental & Occupational Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| |
Collapse
|
34
|
Bican R, Christensen C, Fallieras K, Sagester G, O'Rourke S, Byars M, Tanner K. Rapid Implementation of Telerehabilitation for Pediatric Patients During Covid-19. Int J Telerehabil 2021; 13:e6371. [PMID: 34345345 PMCID: PMC8287708 DOI: 10.5195/ijt.2021.6371] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The COVID-19 pandemic necessitated a sudden limitation of in-person outpatient occupational and physical therapy services for most patients at a large, multisite pediatric hospital located in the Midwest, United States. To ensure patient and staff safety, the hospital rapidly shifted to deliver most of these services via telerehabilitation. The purposes of this study were to (1) describe the rapid implementation of telerehabilitation during the COVID-19 pandemic, (2) describe the demographic characteristics of patients who continued in-person services and those who received telerehabilitation, and (3) evaluate the therapists' perceptions of telerehabilitation for physical and occupational therapy. Most of the children (83.4% of n=1352) received telerehabilitation services. A family was more likely to choose to continue in-person visits if their child was <1-year-old, had a diagnosis of torticollis, received serial casting, or was post-surgical. Occupational and physical therapy therapists (n=9) completed surveys to discern their perceptions of the acceptability of telerehabilitation, with most reporting that telerehabilitation was as effective as in-person care.
Collapse
Affiliation(s)
- Rachel Bican
- Division of Clinical Therapies, Nationwide Children's Hospital, Columbus, Ohio, USA
- School of Health and Rehabilitation Sciences, College of Medicine, the Ohio State University, Columbus, Ohio, USA
| | - Catie Christensen
- Division of Clinical Therapies, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Kristin Fallieras
- Division of Clinical Therapies, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Grace Sagester
- Division of Clinical Therapies, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Sara O'Rourke
- Division of Clinical Therapies, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Michelle Byars
- Division of Clinical Therapies, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Kelly Tanner
- Division of Clinical Therapies, Nationwide Children's Hospital, Columbus, Ohio, USA
| |
Collapse
|
35
|
Hermes SS, Rauen J, O'Brien S. Perceptions of School-Based Telehealth in a Rural State: Moving Forward After COVID-19. Int J Telerehabil 2021; 13:e6370. [PMID: 34345344 PMCID: PMC8287715 DOI: 10.5195/ijt.2021.6370] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
The purpose of this study was to discern the barriers faced by school-based clinicians, chiefly occupational therapists (OTs) and speech-language pathologists (SLPs) who provided telehealth in a primarily rural state during an unexpected declaration of a state of emergency in response to the COVID-19 pandemic. Survey results found the major barriers to implementation of telehealth services to be lack of practitioner training, a lack of access to technology for students, and concerns that the quality of intervention might not be equivalent to in-person service delivery. This article discusses both the benefits and barriers to providing telehealth services in school-based practice and offers considerations for future studies on this topic.
Collapse
Affiliation(s)
- Susan Skees Hermes
- Department of Occupational Science and Occupational Therapy, College of Health Sciences, Eastern Kentucky University, Richmond, Kentucky, USA
| | - Jade Rauen
- Department of Occupational Science and Occupational Therapy, College of Health Sciences, Eastern Kentucky University, Richmond, Kentucky, USA
| | - Shirley O'Brien
- Department of Occupational Science and Occupational Therapy, College of Health Sciences, Eastern Kentucky University, Richmond, Kentucky, USA
| |
Collapse
|
36
|
Kronberg J, Tierney E, Wallisch A, Little LM. Early Intervention Service Delivery via Telehealth During COVID-19: A Research-Practice Partnership. Int J Telerehabil 2021; 13:e6363. [PMID: 34345340 PMCID: PMC8287712 DOI: 10.5195/ijt.2021.6363] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Coaching has been identified as a best practice for early intervention (EI) services provided through the Individuals with Disabilities Education Act (IDEA) Part C. The current study describes the establishment and progress of a research-relationship partnership to deliver coaching via telehealth during the COVID-19 pandemic. Community-based EI providers implemented 9-weeks of telehealth coaching and evaluated the extent to which child and caregiver outcomes differed between families that had previously received in-person services versus telehealth only. Four EI providers completed the intervention with n=17 families of children aged 6-34 months during the pandemic (April-August 2020). We used the Canadian Occupational Performance Measure (COPM) and Goal Attainment Scaling (GAS) to collect outcomes on caregiver identified goals; we used Wilcoxon Signed Rank Tests to examine pre- to post-intervention data. Results showed significant improvements in parent satisfaction, child performance, and goal attainment (all p<.01). Findings suggest that telehealth coaching procedures implemented by community-based EI providers resulted in improvements in caregiver identified goals for young children.
Collapse
Affiliation(s)
| | | | - Anna Wallisch
- Juniper Gardens Children's Project, University of Kansas, Kansas City, Kansas, USA
| | - Lauren M Little
- Department of Occupational Therapy, Rush University Medical Center, Chicago, Illinois, USA
| |
Collapse
|
37
|
Valentine AZ, Hall SS, Young E, Brown BJ, Groom MJ, Hollis C, Hall CL. Implementation of Telehealth Services to Assess, Monitor, and Treat Neurodevelopmental Disorders: Systematic Review. J Med Internet Res 2021; 23:e22619. [PMID: 33326409 PMCID: PMC7819544 DOI: 10.2196/22619] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 09/29/2020] [Accepted: 10/26/2020] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND In response to COVID-19, there has been increasing momentum in telehealth development and delivery. To assess the anticipated exponential growth in telehealth, it is important to accurately capture how telehealth has been used in specific mental health fields prior to the pandemic. OBJECTIVE This systematic review aimed to highlight how telehealth has been used with clinical samples in the neurodevelopmental field, including patients with neurodevelopmental disorders (NDDs), their families, and health care professionals. To identify which technologies show the greatest potential for implementation into health services, we evaluated technologies for effectiveness, economic impact, and readiness for clinical adoption. METHODS A systematic search of literature was undertaken in April 2018 and updated until December 2019, by using the Medline, Web of Science, Scopus, CINAHL Plus, EMBASE, and PsycInfo databases. Extracted data included the type of technology, how the technology was used (ie, assessment, treatment, and monitoring), participant characteristics, reported outcomes and authors' views on clinical effectiveness, user impact (ie, feasibility and acceptability), economic impact, and readiness for clinic adoption. A quality review of the research was performed in accordance with the Oxford Centre for Evidence-Based Medicine Levels of Evidence. RESULTS A total of 42 studies met the inclusion criteria. These studies included participants and family members with autism spectrum disorders (21/42, 50%), attention deficit hyperactivity disorders (8/42, 19%), attention deficit hyperactivity or autism spectrum disorders (3/42, 7%), communication disorders (7/42, 17%), and tic disorders (2/42, 5%). The focus of most studies (33/42, 79%) was on treatment, rather than assessment (4/42, 10%) or monitoring (5/42, 12%). Telehealth services demonstrated promise for being clinically effective, predominantly in relation to diagnosing and monitoring NDDs. In terms of NDD treatment, telehealth services were usually equivalent to control groups. There was some evidence of positive user and economic impacts, including increased service delivery efficiency (eg, increased treatment availability and decreased waiting times). However, these factors were not widely recorded across the studies. Telehealth was demonstrated to be cost-effective in the few studies that considered cost-effectiveness. Study quality varied, as many studies had small sample sizes and inadequate control groups. Of the 42 studies, only 11 (26%) were randomized controlled trials, 12 (29%) were case studies or case series, 6 (14%) were qualitative studies, and 5 (12%) were noncomparative trials. CONCLUSIONS Telehealth has the potential to increase treatment availability, decrease diagnosis waiting times, and aid in NDD monitoring. Further research with more robust and adequately powered study designs that consider cost-effectiveness and increased efficiency is needed. This systematic review highlights the extent of telehealth technology use prior to the COVID-19 pandemic and the movement for investing in remote access to treatments. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews CRD42018091156; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42018091156.
Collapse
Affiliation(s)
- Althea Z Valentine
- Institute of Mental Health, School of Medicine, Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, United Kingdom
| | - Sophie S Hall
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Centre for Medicine, Leicester, United Kingdom
| | - Emma Young
- Nottinghamshire Healthcare National Health Service Foundation Trust, Library and Knowledge Services, Duncan Macmillan House Staff Library, Nottingham, United Kingdom
| | - Beverley J Brown
- Institute of Mental Health, School of Medicine, Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, United Kingdom
| | - Madeleine J Groom
- Institute of Mental Health, School of Medicine, Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, United Kingdom
| | - Chris Hollis
- Institute of Mental Health, School of Medicine, Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, United Kingdom
- National Institute for Health Research MindTech MedTech Co-operative, Institute of Mental Health, School of Medicine, Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, United Kingdom
- Department of Child and Adolescent Psychiatry, Queen's Medical Centre, Nottingham, United Kingdom
| | - Charlotte L Hall
- Institute of Mental Health, School of Medicine, Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, United Kingdom
| |
Collapse
|
38
|
White LC, Law JK, Daniels AM, Toroney J, Vernoia B, Xiao S, Feliciano P, Chung WK. Brief Report: Impact of COVID-19 on Individuals with ASD and Their Caregivers: A Perspective from the SPARK Cohort. J Autism Dev Disord 2021; 51:3766-3773. [PMID: 33387233 PMCID: PMC7775834 DOI: 10.1007/s10803-020-04816-6] [Citation(s) in RCA: 76] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2020] [Indexed: 01/13/2023]
Abstract
The impact of the 2019 coronavirus pandemic (COVID-19) in the United States is unprecedented, with unknown implications for the autism community. We surveyed 3502 parents/caregivers of individuals with an autism spectrum disorder (ASD) enrolled in Simons Powering Autism Research for Knowledge (SPARK) and found that most individuals with ASD experienced significant, ongoing disruptions to therapies. While some services were adapted to telehealth format, most participants were not receiving such services at follow-up, and those who were reported minimal benefit. Children under age five had the most severely disrupted services and lowest reported benefit of telehealth adaptation. Caregivers also reported worsening ASD symptoms and moderate family distress. Strategies to support the ASD community should be immediately developed and implemented.
Collapse
Affiliation(s)
- L Casey White
- Simons Foundation, 160 5th Avenue, New York, NY, 10010, USA
| | - J Kiely Law
- Maryland Center for Developmental Disabilities, Kennedy Krieger Institute, Baltimore, MD, 21211, USA
| | - Amy M Daniels
- Simons Foundation, 160 5th Avenue, New York, NY, 10010, USA
| | - Jaimie Toroney
- Maryland Center for Developmental Disabilities, Kennedy Krieger Institute, Baltimore, MD, 21211, USA
| | | | - Sabrina Xiao
- Simons Foundation, 160 5th Avenue, New York, NY, 10010, USA
| | | | | | - Wendy K Chung
- Simons Foundation, 160 5th Avenue, New York, NY, 10010, USA. .,Department of Pediatrics and Medicine, Columbia University Irving Medical Center, New York, NY, 10032, USA.
| |
Collapse
|
39
|
Dahl-Popolizio S, Carpenter H, Coronado M, Popolizio NJ, Swanson C. Telehealth for the Provision of Occupational Therapy: Reflections on Experiences During the COVID-19 Pandemic. Int J Telerehabil 2020; 12:77-92. [PMID: 33520097 PMCID: PMC7757642 DOI: 10.5195/ijt.2020.6328] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
During the COVID-19 pandemic of 2020, healthcare professionals worldwide abruptly shifted from an in-person to a telehealth service delivery model. Many did so without advanced training or preparation. This cross-sectional study explored how occupational therapy practitioners (OTPs) used telehealth during the COVID-19 pandemic, and whether they found it to be an effective service delivery model that should be a permanent option for providing occupational therapy services. An online survey was disseminated; it included Likert scale questions, multiple option questions, and open-ended questions regarding telehealth use during the COVID-19 pandemic. Of the 230 respondents, 176 (77%) support telehealth as a substitute for in-person services; 179 (78%) support telehealth as a permanent option for occupational therapy service delivery. This information lends support to the uninterrupted use of telehealth by OTPs when government emergency orders in response to COVID-19 expire.
Collapse
|
40
|
Tenforde AS, Borgstrom H, Polich G, Steere H, Davis IS, Cotton K, O'Donnell M, Silver JK. Outpatient Physical, Occupational, and Speech Therapy Synchronous Telemedicine: A Survey Study of Patient Satisfaction with Virtual Visits During the COVID-19 Pandemic. Am J Phys Med Rehabil 2020; 99:977-981. [PMID: 32804713 PMCID: PMC7526401 DOI: 10.1097/phm.0000000000001571] [Citation(s) in RCA: 157] [Impact Index Per Article: 39.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The COVID-19 pandemic transformed health care delivery, including rapid expansion of telehealth. Telerehabilitation, defined as therapy provided by physical therapy, occupational therapy, and speech and language pathology, was rapidly adopted with goals to provide access to care and limit contagion. The purpose of this brief report was to describe the feasibility of and satisfaction with telerehabilitation. A total of 205 participants completed online surveys after a telerehabilitation visit. Most commonly, participants were women (53.7%), 35-64 yrs old, and completed physical therapy (53.7%) for established visits of 30-44 mins in duration for primary impairments in sports, lower limb injuries, and pediatric neurology. Overall, high ratings ("excellent" or "very good" responses) were observed for all patient-centered outcome metrics (range, 93.7%-99%) and value in future telehealth visit (86.8%) across telerehabilitation visits. Women participated more frequently and provided higher ratings than male participants did. Other benefits included eliminating travel time, incorporating other health care advocates, and convenience delivering care in familiar environment to pediatric patients. Technology and elements of hands-on aspects of care were observed limitations. Recognizing reduced indirect costs of care that telerehabilitation may provide along with high patient satisfaction are reasons policy makers should adopt these services into future health care delivery models.
Collapse
Affiliation(s)
- Adam S Tenforde
- From the Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts (AST, HB, GP, HS, ISD, JKS); Spaulding Rehabilitation Hospital, Boston, Massachusetts (AST, HB, GP, HS, ISD, JKS); Brigham and Women's Hospital, Boston, Massachusetts (GP, JKS); Spaulding Outpatient Center Wellesley, Wellesley, Massachusetts (KC); Spaulding Outpatient Center for Children Lexington, Lexington, Massachusetts (MO); and Massachusetts General Hospital, Boston, Massachusetts (JKS)
| | | | | | | | | | | | | | | |
Collapse
|