Telemed J E Health 2010 Jul-Aug;16(6):727-31
Speech-Language-Hearing Clinic, Department of Communication Sciences and Disorders, Western Washington University, Bellingham, Washington 89225-9171, USA.
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.