Impressive Positive Outcomes with Telehealth
Recent studies are showing that Autism and Telehealth make useful partners.
Chen et al (2022) systematically reviewed 112 studies from databases of PubMed, Web of Science and Cochrane Library, that were published in English between the dates of January 2010 to April 1st, 2022. Their study incorporates the largest body of literature that we have seen to date. Their focus was on Extended Reality and Telehealth usage with Autism.
The authors found that after interventions, positive improvements for participants with Autism were observed in a range of outcomes. The positive outcomes of using Telehealth with Autism individuals were clustered under,
- social interaction,
- acceptance and engagement,
- communication and speech,
- emotion recognition and control,
- daily living skill,
- problem behaviour reduction,
- cost reduction,
- anxiety symptom reduction,
- pretend play,
- contextual processing,
- match to sample skill, and
- insomnia control.
The author’s findings concluded that there is a “solid and positive evidence” of Extended Reality and Telehealth based technology interventions in “improving the treatment outcomes for children and adolescents” with Autism.
A Range of Benefits Using Telehealth
An older study by Sutherland et al (2018) conducted a systematic review of the literature around Autism and telehealth. The authors examined the nature and outcomes of studies that spoke to telehealth assessment and/or intervention in Autism. The study included 284 participants with Autism across 14 included studies. Participants ranged in age from 19 months to adulthood.
They reported that the quality of the studies varied and a range of services were provided via telehealth. Services included were diagnostic assessment, early intervention, and language therapy. The results of the analysis suggested that services delivered via telehealth were equivalent to services
delivered face to face. Telehealth was found to be superior to comparison groups without telehealth sessions.
The authors found that there are a range of benefits in using telehealth with individuals with Autism, their families, and teachers. They also recommended that further research needs to explore the use of telehealth directly with children with Autism for assessment and intervention.
Covid 19 and Telehealth Experiences
Back to the present, Stavropoulos et al (2022), like several other studies recently being published, looked at the use of Telehealth during the Covid-19 pandemic. We note that findings from these types of studies will continue to be tabled over the coming months and years. As well, we will see a range of opinions being discussed as lived experience among participants and therapists comes to light.
The authors focused on early intervention given how crucial this service is for improving outcomes in children with Autism. They explained that the need for timely assessments and diagnoses remains in spite of lockdowns and social distancing brought about by COVID‐19‐related closures.
Their study offered data collected from 23 children who were assessed through a no‐cost Autism clinic in Southern California. They used a novel (to them) Telehealth model. The approach included an adapted Telehealth version of their existing in‐person observational assessment techniques for diagnosing Autism.
Findings from Stavropoulos et al (2022) suggested that caregivers found Telehealth assessment procedures acceptable and convenient. Participants were overall satisfied with both the assessment and the written report/verbal feedback. The positive outcomes led the authors to suggest further research into the use of Telehealth to help with a range of other needs and issues, such as with decision‐making, school‐based services, and/or placement identification and support.
Real Live Experience of Telehealth
Our experience of working with Telehealth has been extremely positive. One of the key findings from outcome studies over several decades is that when clients want to engage with a type of therapy, they tend to have positive outcomes. This robust insight has stood the test of time, irregardless of the type of therapy on offer. Hence, when NDIS participants and their parents or support staff want to engage with Telehealth therapy assessment, behaviour support, counselling, capacity building training, etc… they also tend to have positive outcomes.
Of course, Telehealth like any form of therapy is not for everyone. This is what choice and control under the NDIS Act 2013 is all about. We also see that participants with disabilities in communication need help from family or staff to use technology effectively.
People with severe cognitive and behavioural disabilities may not be able to use Telehealth directly. But they can benefit a great deal when Telehealth is used indirectly to the help their needs. In these cases Telehealth can be used to meet the need for assessment, treatment planning, reviews, and by supporting carers, parents, staff, and/or managers who step in to use the Telehealth services on behalf of the individual with severe disabilities.
We have found that our interventions and the data we receive from participants has improved in quality and scope. The reason for this increase of quality comes from the fact that handheld devices, iPads, and computers of various kinds are used everyday. This normalises therapy online as people are now at ease with these types of technologies. Video quality has vastly increased even in many rural and remote areas. Clients can take a short one or two minute video and share with their therapist, making behavioural observation much more effective than a lengthy drive across region to a clinic for a one hour meeting.
We have thus found that service quality increases with greater accessibility combined with quality data. The combination of factors with greater personal choice and control over the therapy process (literally holding the therapist in hand while sharing one’s life in the ways you want in your own home setting) lead to increased participant satisfaction from feeling more directly engaged by the therapy process.
Interestingly enough, our recent independent audit gave our service a commendation for innovation in regards to our services. They were impressed by the ways that we have answered the call to adjust how we offer services and how our policies have evolved to meet these needs in behaviour support, therapy assessment, counselling, and early childhood intervention.
Yuhan Chen, Zhuoren Zhou, Min Cao, Min Liu, Zhihao Lin, Weixin Yang, Xiao Yang, Denzel Dhaidhai, Peng Xiong, 2022,, Extended Reality (XR) and telehealth interventions for children or adolescents with autism spectrum disorder: Systematic review of qualitative and quantitative studies,
Neuroscience & Biobehavioral Reviews, Volume 138, 104683, ISSN 0149-7634, https://doi.org/10.1016/j.neubiorev.2022.104683.
Stavropoulos, K. K., Heyman, M., Salinas, G., Baker, E., & Blacher, J. (2022).Exploring telehealth during COVID for assessing autism spectrum disorder in a diverse sample.Psychology inthe Schools,1–16.https://doi.org/10.1002/pits.2267216|STAVROPOULOSET AL.
Rebecca Sutherland, David Trembath & Jacqueline Roberts, 2018,
Telehealth and autism: A systematic search and review of the literature, International Journal
of Speech- Language Pathology, 20:3, 324-336, DOI: 10.1080/17549507.2018.1465123
To link to this article: https://doi.org/10.1080/17549507.2018.1465123
Featured image by Photo by Tara Winstead