Telemedicine and its cutting-edge technologies have enabled health care providers to offer care and expert guidance to patients in remote areas that have traditionally been underserved. These technologies have also been found particularly useful in the care and monitoring of patients with certain specific ailments, including stroke and mental illness.
However, until relatively recently, telemedicine was not seen as a particularly useful tool in dealing with the unique behavioral issues seen among children on the autism spectrum. In fact, most medical professionals insisted that in-person care was the only really effective way to treat such problems.
Study Debunks Theory
This long-held theory has been effectively called into question by a research team at the University of Iowa that discovered that video chats with doctors helped parents of autistic children to better cope with sudden behavioral and/or communications problems.
The study, published in the February 2016 issue of “Pediatrics,” compared both the relative efficacy and cost of three service delivery models: At-home therapy, clinic-based telehealth, and home-based telehealth. All three models were found to be effective at reducing problem behavior by teaching parents how to conduct functional analysis (FA) and functional communication training (FCT) with their children. Regardless of the delivery model, parents who were schooled in these techniques were able to reduce problem behavior by about 90 percent.
However, the cost of home-based telehealth was only about one-third of what it cost for at-home therapy provided by medical professionals. The savings resulted from the absence of travel expenses and the sharp reduction in staff hours for all parties involved.
The University of Iowa researchers began their study with 107 children who had been diagnosed with some form of autism or other neurodevelopmental disorder. The data analyzed to produce the study’s ultimate findings was based on the 94 children who actually completed the study.
In the past, most doctors involved in the treatment of autistic children maintained that there was no way to properly diagnose their problems without seeing them in person at the doctors’ offices or hospitals. However, the availability of video consultative technology now gives medical professionals the opportunity to see these children in their normal home environment. By seeing how the children behave and communicate in the setting that is most comfortable and relaxed for the patients, doctors are better able to understand the patients and the types of incidents or interactions that trigger their problem behaviors.
Provides Useful Insights
Seeing how the autistic patients act and react in their normal home environments provides doctors with valuable insights that help them to customize their training of parents in FA and FCT techniques to their individual children’s needs. In a press release, lead researcher Scott Lindgren, Ph.D., a professor of pediatrics at the University of Iowa, explained that the coaching of parents and other family members is much more than just a “casual talk.”
Lindgren went on to say: “It’s setting up a variety of situations in which problem behavior may occur, and helping parents find ways to address problems constructively, and to better understand why that behavior is occurring. For 90 percent of the kids we evaluate, we can find a social reason for what that child is doing.” And seeing autistic children in their home setting can sometimes help professionals to spot typical problem scenarios.
Earlier Study Cited
The findings of the University of Iowa study mirror in many respects the results of an earlier study conducted by researchers at the University of California, Davis. That study appeared in a 2012 issue of “Autism Research and Treatment,” a peer-reviewed journal that is published by Cairo-based Hindawi Publishing Corporation. Although much smaller in scale than the Iowa study, the UC Davis study found that telehealth technology can help parents to “understand and use early intervention practices more often in their daily interactions with [autistic] children.”
UC Davis researchers focused on the failure of parental intervention alone to produce “consistent, generalized gains” in the development of young children with autism spectrum disorder (ASD). The researchers set out to see if telehealth coaching could improve the results of parental intervention on the behavior of children with ASD.
Nine Families Recruited
To test their theory that telehealth technology could be used to improve the quality of parental interventions, researchers recruited nine families with ASD children who were 3 years old or younger. For 12 weeks, the researchers conducted one-hour weekly telemedicine consultations to train parents on how to use intervention techniques to improve their children’s behavior.
For each of the 12 weekly one-hour sessions, both the parent and the therapist assigned to the parent logged onto a secure software program to commence the video conferencing call. This allowed both parties to see, hear, and communicate with one another in real time. The first 5 to 10 minutes of each session (except for the first session) were devoted to a review of the parents’ progress in using the techniques covered in the previous telehealth session.
The next 10 minutes of the session were devoted to a period of parent-child play activity during which the therapist could evaluate the parent’s skill in using techniques that were taught in previous sessions. Where the therapist detected weaknesses, he could coach the parent accordingly so that that particular technique could be perfected.
The coaching session would then move on to the explanation of another technique that could be used in addressing problem behavior. Once the therapist had explained the technique and how it was to be used, the parent could then raise questions about its use in the context of his child’s unique behavior patterns. After a thorough discussion of the new technique or set of strategies, the parent would then practice in the context of at least two play or caretaking activities in the home.
More Choice for Parents
Based on the findings gathered during their 12-week study, researchers expressed the hope that telehealth will significantly improve parental intervention “by offering parents more choice in what skills they want their children to learn, when and where they want to teach them, and how such interactions can translate into observable achievements. . . .” Acknowledging that the study was small in scale and preliminary in its findings, the research team said it is optimistic “that such technology presents advantages to accessing more families and making interventions easier to use in the context of daily life.”
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