Speech-Language-Hearing Clinic, Department of Communication Sciences and Disorders, Western Washington University, Bellingham, Washington 89225-9171, USA.
Telemed J E Health. 2010 Jul-Aug;16(6):727-31. doi: 10.1089/tmj.2010.0029.
There is a growing body of literature indicating that intense early intervention is current best practice for treating children with autism spectrum disorders (ASD). Several studies demonstrate the effectiveness of parents as agents of intervention in the child's home environment. However, this approach requires intense one-on-one supervision by highly trained professionals. Consequently, there is a significant gap between the intensive service requirements for children with ASD and the available resources to provide these services. In the current pilot study, the use of remote technology, telepractice, is evaluated as a tool for coaching parents of two children found to have ASD. Two clinical models of intervention are compared: a traditional model of twice-weekly speech and language therapy sessions (traditional clinical model) and a model where a once-a-week clinical session is followed by a home-based session administered by the parents and remotely supervised and coached by the clinician (clinic/telepractice model). Results suggest that gains obtained in traditional therapy can be maintained and even exceeded in a treatment model that uses telepractice. Parents reported that they perceived telepractice sessions to be as valuable as those delivered directly by the clinician, felt comfortable using the technology, and were willing to continue intervention with their children at home. These preliminary results suggest that use of telepractice holds promise for reducing the demands on available resources of service for this population. A study with a larger population is currently underway including cost-benefit analyses to examine the implications for such a treatment model to its users and to the healthcare system.
越来越多的文献表明,对于自闭症谱系障碍(ASD)儿童,早期强化干预是目前的最佳实践。多项研究表明,父母作为干预者在儿童的家庭环境中具有有效性。然而,这种方法需要高度训练有素的专业人员进行一对一的强化监督。因此,ASD 儿童的密集服务需求与提供这些服务的可用资源之间存在显著差距。在当前的试点研究中,远程技术——远程实践被评估为对两名被诊断为 ASD 的儿童的父母进行辅导的工具。比较了两种干预临床模式:每周两次的言语和语言治疗课程的传统模式(传统临床模式),以及每周一次临床会议后由父母进行家庭会议,由临床医生远程监督和辅导的模式(临床/远程实践模式)。结果表明,在使用远程实践的治疗模式中,可以维持甚至超过传统疗法中获得的收益。家长报告称,他们认为远程实践课程与临床医生直接提供的课程一样有价值,他们使用该技术感到舒适,并愿意继续在家中对孩子进行干预。这些初步结果表明,远程实践的使用有望减轻该人群对现有服务资源的需求。目前正在进行一项更大规模人群的研究,包括成本效益分析,以研究这种治疗模式对其使用者和医疗保健系统的影响。