A Telehealth Approach to Parent Coaching in ASD

Background: Many barriers exist to parents seeking early intervention for their child with ASD, including long waiting lists, costly services, and a shortage of specialist providers. The introduction and development of advanced technologies can provide supplements to current early intervention services. Telehealth is one mechanism that may support parents in their pursuit to help their child learn and access intervention resources sooner from home or other locations at any time of day.

Objectives: The study attempted to identify acceptable components of a telehealth parent coaching delivery model so as to better understand how this resource translates into viable practice for families with ASD. A randomized controlled trial of a telehealth coaching model to treatment-as-usual compared parents’ intervention usage, program satisfaction, and online learning patterns. Children in both groups were expected to make gains so that the primary question remained about the feasibility and appropriateness of telehealth delivery to parents.

Methods: Parents received 12 weekly 1.5-hour video conferencing sessions and website access to self-guided learning resources of the parent coaching curriculum of the Early Start Denver Model (P-ESDM). The control group received monthly video conferencing sessions and website access to alternative intervention resources based on treatment-as-usual services. Parent-child interactions were recorded in real time across a six-month period to evaluate parents’ fidelity with the P-ESDM, program satisfaction, and website engagement.

Results: Telehealth coaching facilitated greater fidelity gains, program satisfaction, and website usage for parents in the P-ESDM than control group at the end of 12 weeks and three-month follow-up. Increases in children’s social-communication skills occurred for both groups.

Conclusions:

Findings suggest the feasibility of a telehealth approach to coaching parents with access to evidence-based intervention resources while waiting for other services to begin. 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.