A Telehealth Approach to Working with Families with ASD

Background:  There are various challenges to delivering parent coaching to families with ASD including long waiting lists, costly services, and few specialist providers. Telehealth, or using technology to deliver treatment, can support parents in their pursuit to help their children learn at home; however there is little information as to how this resource may translate into actual practice for families with ASD.

Objectives:  The current randomized controlled trial examined parent-child behavior and program satisfaction from a telehealth-delivered parent coaching approach. Parents in the telehealth treatment versus control group were predicted to provide higher-quality learning with their children inside daily play and caretaking activities at home, resulting in larger gains in children’s social, affective, communicative, and play development. 

Methods:  The intervention offered website-delivered information and live video conferencing to families either in the Early Start Denver Model (ESDM) or other evidence-based practices across a six-month period. Parent-child interactions were recorded in real time and coded by two independent, naïve raters on the frequency, quality, and generalization of parents’ ESDM usage and changes in children’s social-communicative behaviors. Parent-child activity was also tracked on the website to gauge goal performance during daily interactions at home as well as usage and satisfaction with the interactive learning features.  

Results: Telehealth delivery facilitated frequent, competent, and generalized ESDM usage across more daily activities at home and with larger child gains than comparison families. Surprisingly, both groups failed to use all of the website features outside of sessions in spite of their ratings of perceived helpfulness.

Conclusions:  Findings suggest the feasibility of a telehealth approach to working with families with ASD. However, not all technology options may be embraced by parents and or lead to effective change in parent-child behaviors. Additional research must confirm the promise and utility of telehealth for increasing the availability and quality of parent-delivered interventions.