Feasibility of a Telehealth Coaching Intervention for Families of Children With Autism

PURPOSE: The purpose of this study was twofold: (1) Test the feasibility (i.e., cost-effectiveness, acceptability) of an occupational therapy (OT) coaching intervention provided via live video streaming for families of children with autism spectrum disorder (ASD) in early intervention and (2) evaluate the preliminary efficacy of a telehealth intervention for families of young children with ASD on child participation and parent factors.

RATIONALE: Families of children with ASD often have difficulty accessing early intervention (EI) services, which has a negative impact on family and child health. Telehealth has been shown to be a promising way to deliver OT EI services to an increased number of families. When professionals partner with parents to identify solutions together (called coaching), parents get better at finding ways to support their child. Although coaching has been shown to help families with ASD, delivering this intervention via telehealth has not been tested.

DESIGN: This study used a within-group, pre–post quasi-experimental design.

PARTICIPANTS: Recruitment is ongoing; this study will recruit 15 families of children with ASD ages 12 mo–6 yr.

METHOD: We are using parent-report measures gathered pre– and post–12 wk of telehealth intervention of child participation (i.e., Assessment of Preschool Children’s Participation; Goal Attainment Scaling; Canadian Occupational Performance Measure) as well as Parenting Sense of Competence. We are also using the Sensory Profile–2 and the Social Responsiveness Scale to describe the sample. Additionally, we are administering the Telehealth Acceptability Questionnaire to determine parent perceptions about the experience.

ANALYSIS: Because data collection is ongoing, we will analyze data by the time of presentation. To address the cost-effectiveness and acceptability of the telehealth intervention, we will calculate the number of driving miles saved at $0.49/mile. To test the acceptability of the intervention, we will analyze differences in the Telehealth Acceptability Questionnaire from pre- to postintervention. To analyze preliminary efficacy, we will use analysis of variance to test pre- to postintervention participation and parent efficacy measures.

DISCUSSION: The rising emphasis on early ASD-specific screening is translating into an increased number of children being referred for EI services. However, there is a discrepancy between the demand for and the availability of EI services for children with ASD. Families are subject to a shortage of EI providers, which has a negative impact on children’s developmental trajectories by limiting access to evidence-based interventions during the critical early years.

By sharing the results of the current study, we will be addressing critical barriers to progress in EI. Evidence shows that occupational therapists produce parent efficacy and child participation outcomes when employing coaching practices. Given that OPC has been shown to be efficacious in school-age children with ASD, the current study research tests its efficacy in EI. Telehealth technology provides the possibility for individuals in rural communities to gain better access to high quality and efficient EI services.

IMPACT STATEMENT: Evidence-based practice using telehealth for families of children with ASD is needed; OT service delivery can be expanded with the emergence of efficacy research using this method. By expanding the capacity of occupational therapists to provide intervention via telehealth, findings from this study will have an impact on practice, policy, and science.