Vanderbilt Kennedy Center/Treatment and Research Institute for Autism Spectrum Disorders, Vanderbilt University Medical Center, 1207 17th Avenue South, Nashville, TN, 37203, USA.
Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.
J Neurodev Disord. 2021 Sep 15;13(1):38. doi: 10.1186/s11689-021-09387-w.
Families of young children with autism spectrum disorder (ASD) frequently experience barriers to accessing evidence-based early intervention services. Telemedicine presents an opportunity to increase access to these services, particularly for families in rural and under-resourced areas. The present article describes a brief behavioral intervention and support model for families of young children with concerns for ASD. In the context of the COVID-19 pandemic, this service model shifted to telemedicine-only service delivery, resulting in an opportunity to analyze intervention outcomes from services delivered either via traditional in-person visits, telemedicine-only sessions, or a hybrid model including both in-person and telemedicine sessions.
Data are presented for 115 families with toddlers 16-33 months of age who participated in a six-session behavioral intervention and support service model either in-person, through telemedicine, or through a hybrid service model. This intervention was available for families referred for ASD evaluation through the state Part C early intervention program. Intervention feasibility, fidelity of implementation, child outcomes, and stakeholder satisfaction are compared across service delivery models.
Caregivers, behavioral consultants, and Part C early intervention providers reported satisfaction with services, regardless of service delivery model. Caregivers and consultants also reported positive child outcomes. Statistically significant differences emerged for caregiver- and consultant-reported child outcomes in some domains, with stakeholders in the telemedicine-only group reporting slightly less improvement, compared to stakeholders in the in-person-only group. Caregivers and consultants in the telemedicine-only group also provided qualitative feedback on benefits and challenges related to telemedicine services.
Both caregivers and behavioral consultants reported positive outcomes following a brief behavioral intervention and support model targeted at families of young children with concern for ASD. Stakeholders reported improvement in child behavior and satisfaction with services across in-person, telemedicine-only, and hybrid models of service delivery. These results suggest that telemedicine presents a promising opportunity for increasing service access. Additional research is needed to continue optimizing the experience of telemedicine-based service delivery for both families and intervention providers.
患有自闭症谱系障碍（ASD）的幼儿的家庭在获得循证早期干预服务方面经常面临障碍。远程医疗提供了增加这些服务的机会，特别是对于农村和资源匮乏地区的家庭。本文介绍了一种针对有 ASD 担忧的幼儿家庭的简短行为干预和支持模式。在 COVID-19 大流行期间，这种服务模式转变为仅远程医疗服务交付，从而有机会分析通过传统面对面访问、仅远程医疗会议或包括面对面和远程医疗会议的混合模式提供的服务的干预结果。
为 115 名 16-33 个月大的幼儿的家庭提供了数据，这些家庭参加了一个六节的行为干预和支持服务模式，该模式通过面对面、远程医疗或混合服务模式提供。该干预措施适用于通过州 Part C 早期干预计划转介进行 ASD 评估的家庭。比较了不同服务交付模式下的干预可行性、实施保真度、儿童结果和利益相关者满意度。
无论服务交付模式如何，照顾者、行为顾问和 Part C 早期干预提供者都报告对服务满意。照顾者和顾问还报告了积极的儿童结果。在某些领域，照顾者和顾问报告的儿童结果存在统计学上的显著差异，与仅面对面组的利益相关者相比，仅远程医疗组的利益相关者报告的改善略少。仅远程医疗组的照顾者和顾问还就远程医疗服务的相关利益和挑战提供了定性反馈。
简短的行为干预和支持模式针对有 ASD 担忧的幼儿家庭，照顾者和行为顾问都报告了积极的结果。利益相关者报告了在面对面、仅远程医疗和混合服务交付模式下儿童行为和对服务的满意度的改善。这些结果表明远程医疗为增加服务机会提供了有希望的机会。需要进一步的研究来继续优化远程医疗服务提供的家庭和干预提供者的体验。
