Telehealth offers Patients and Providers a New Tool in the Treatment of Autism

Telehealth can play an essential role in the early detection of Autism Spectrum Disorder (ASD). Early detection is vital to helping a child with autism, as research has shown that early diagnosis can significantly improve a child’s overall development. Research supports that young children who receive the early behavioral intervention (before two years) demonstrate substantial gains in functioning when compared to children diagnosed later.

Although increasing evidence shows that children with autism spectrum disorder can be accurately identified during their second year of life, the average age of diagnosis in both Tennessee and across the country remains well above four years of age.
One major contributing factor to delayed identification relates to challenges accessing diagnostic clinics and autism experts, as many families face long waiting periods for specialty clinics as well as geographic and travel burdens. These barriers can leave the families of children with a suspected diagnosis of autism in the dark for months or more than a year, delaying access to early interventions that can dramatically influence development.

ABA Treatment with telemedicine

 

Telehealth treatment autism

What is Applied Behavior Analysis?

  • How behavior works
  • How behavior is affected by the environment
  • How learning takes place

ABA therapy applies our understanding of how behavior works to real situations. The goal is to increase behaviors that are helpful and decrease behaviors that are harmful or affect learning.

ABA therapy programs can help:

  • Increase language and communication skills
  • Improve attention, focus, social skills, memory, and academics 
  • Decrease problem behaviors

The methods of behavior analysis have been used and studied for decades. They have helped many kinds of learners gain different skills – from healthier lifestyles to learning a new language. Therapists have used ABA to help children with autism and related developmental disorders since the 1960s.

According to the CDC, 1 in 59 children has a diagnosis of Autism Spectrum Disorder. Often, children with autism and their families live too far away from care and support or cannot access it due to high costs and/or limited availability. Telehealth can serve as an excellent resource for the ASD patient and their family. It can help in early detection be and diagnosis, therapy/treatment, and caregiver education

Expanding Access to ABA Therapy Through Parent Training

Applied Behavior Analysis (ABA) therapy is a standard therapy modality and best practice used for children with an ASD diagnosis. ABA, a therapy based on the science of learning and behavior, focuses on increasing behaviors that are desirable and decreasing behaviors that are harmful or affect learning. ABA therapy focuses on positive reinforcement and teaching skills of everyday life: how to deal with conflict, brush teeth, or make eye contact. It is a flexible treatment that is perfect for children with autism as it can be adapted to meet the requirements of each child; each therapy plan is designed specifically for the child’s needs and changes as those needs evolve. It can be provided in many different locations: at home, at school, or in the community.

Like many aspects of health care, ABA treatment is often hard to access for people living in rural or underserved areas. There is a shortage of therapists across the country, even in the most populated and medically advanced regions. The dearth of qualified therapists in rural communities is especially problematic. This shortage is a challenge that telehealth can address well – filling the missing piece of the puzzle.

According to an article in Health Recovery Solutions by Elizabeth Veringa titled “The Telehealth Era”, telehealth, parents, caregivers, and teachers can be trained on how to deliver quality ABA therapy to their children and children in their community. One study found that parents can successfully use functional analysis (FA) and functional communication training (FCT) to treat moderate to severe behavioral problems associated with ASD. Regardless of whether treatment is directed by behavior consultants in-person or via remote video coaching. The study, which analyzed 94 children with ASD, tested the efficacy of utilizing telehealth to train parents in ABA procedures.

The findings indicate that telehealth can successfully train parents in how to implement FA and FCT best to reduce their child’s problem behaviors, supporting that telehealth in place of in-person visits to a specialist.

Vanderbilt University and Virtual Treatment for Autism


 

Zachary Warren, PhD in his office at the Kennedy Center for reporter story on telemedicine.(John Russell/Vanderbilt University)

An NPR affiliate Nashville Public Radio recently reported, Vanderbilt University’s Treatment and Research Institute for Autism Spectrum Disorders (TRIAD) has been utilizing telemedicine to provide remote early-intervention services to children diagnosed with autism. “We aim to provide high-quality, evidence-based services and training for families and professionals in the topics and skills of most need,” said Dr. Alacia Stainbrook, the program’s director, in a Vanderbilt press release. “To accomplish this, we are working with our partners at the state level to increase access to all that need it. We very much believe that geography should not limit anyone’s ability to receive good services.”

TRIAD’s staff members provide enrolled families with specially programmed iPads that they control from program headquarters in Nashville. Many of the families live in Tennessee’s rural communities. Each week, parents and children—all of whom are three years old or younger—participate from home in remote therapy sessions via video with program staff members. As highlighted in Nashville Public Radio’s piece, which followed parent Stacey Copeland and her two-year-old recently diagnosed son through their video sessions with TRIAD staff, the visits can work even at a distance. “Without ever meeting in person, Copeland has worked solely through the weekly video sessions with Stainbrook and behavioral analyst Will Martin to develop new strategies,” the article notes. “She now pauses just before doing something [her son] River wants and prompts him to do something he doesn’t—whether that is saying a word or making eye contact.” The funding for the Vanderbilt study comes with a grant from the Tennessee Department of Education.

More information on the Vanderbilt program should read the following article dated March 7, 2019, by Kelsey Herbers located on the Vanderbilt University Medical Center website

SmartPhone Telemedicine

Missouri ABA Program Finds Success with Telemedicine

For those patients—and their families—living in rural communities or other underserved areas, it can be challenging to access many of the specialized services, including behavioral and speech therapists, that are necessary when living with the disorder. However, can telehealth help to remove some of these barriers by training providers in remote areas? As Science Magazine first reported, the University of Missouri’s ECHO Autism program has been successfully doing just that, serving as a training hub for primary care providers seeking to treat patients with autism since its launch in 2015 better. The program “[uses] high-quality, secure video conferencing technology to connect participating primary care clinics to a panel of experts,” a press release from the university explains.

Based at the MU Thompson Center for Autism and Neuro-developmental Disorders, the program is part of the broader Project ECHO (Extension for Community Healthcare Outcomes) network, which began at the University of New Mexico. It is dedicated to increasing access to specialty medical care in underserved communities. As ECHO Autism’s director Kristin Sohl, a professor of child health at the university, explains, “The program effectively increases the capacity for health care in under-served communities, which means that families can get the answers they need without traveling or waiting to see a specialist.” In an article detailing the program’s results published in the Journal of Clinical Pediatrics, Sohl and her colleagues note that primary care providers are “in an ideal position to help improve care for” children with autism, given the regularity with which they tend to see patients. Nevertheless, they often tend to “lack confidence, knowledge, and training” on how best to diagnose and treat autism. To that end, ECHO Autism seeks to empower providers—and its early results have been overwhelmingly positive. “Participating primary care providers demonstrated significant improvements in confidence across all sectors of health care for children with autism, including screening and identification, assessment and treatment of medical and psychiatric conditions, and knowledge of and referral to available resources,” per the university’s press release.

ECHO Autism, which has received funding from the Health Resources and Services Administration (HRSA) and the Missouri Telehealth Network, among other sources, is next set to expand to Alabama, Alaska, New Mexico, and Arizona. Notably, among those who will serve at the new program sites in the latter of the two states are Navajo communities. Sohl, for her part, sees the program going even further afield than that in its efforts to serve patients in under-served communities—indeed, program sites in Kenya planed in the future. “The success we have seen in Missouri and in other areas where ECHO Autism replicated means that this model can work in even more remote areas,” she said in the university’s press release. “Expanding the program from Africa to Alaska will help families around the world.”

Providing ABA treatment virtually does not require The Big Investment you might think

The delivery of services associated with ASD does not require providers to spend a large amount of money to purchase customized telehealth technology. Many of the available telehealth platforms available on the market can provide many of the tools necessary to improve access to quality care. 

In the ideal world, the clinician has in place Electronic Medical Record (EMR) of your dreams, and they offer a fully integrated Telehealth integrated that meets your practice needs. All sarcasm aside, hopefully, as technology improves, this kind of statement will become more the norm than the “unicorn” it is today.

However, before going out and purchasing or subscribing to the first telehealth company, a little prudent homework will go a long way.

Readers may also find the following useful

 

 

 

45 Responses

  1. Youre so cool! I dont suppose Ive read anything like this before. So nice to search out any person with some unique thoughts on this subject. realy thank you for beginning this up. this website is one thing that is wanted on the web, somebody with a little bit originality. useful job for bringing one thing new to the internet!

  2. I simply wished to say thanks all over again. I do not know what I might have followed without those creative ideas shown by you regarding such subject. It truly was an absolute difficult condition in my position, however , looking at your expert avenue you solved the issue forced me to leap with joy. Now i’m happier for the service and even sincerely hope you really know what a great job you are always providing teaching some other people via a blog. I am sure you’ve never got to know all of us.

  3. I just could not leave your web site prior to suggesting that I actually loved the usual info an individual provide on your guests? Is going to be back steadily in order to investigate cross-check new posts

  4. I’m not sure where you’re getting your information, but good topic. I needs to spend some time learning more or understanding more. Thanks for fantastic info I was looking for this info for my mission.

  5. I just want to say I am all new to blogging and site-building and truly liked your web blog. More than likely I’m planning to bookmark your site . You definitely come with very good articles and reviews. Regards for sharing your web site.

  6. Hello there! I simply want to offer you a big thumbs up for the excellent information you’ve got here on this post. I will be coming back to your web site for more soon.

  7. May I simply just say what a relief to discover somebody who actually knows what they are discussing online. You actually know how to bring an issue to light and make it important. More and more people have to look at this and understand this side of the story. I was surprised that you’re not more popular given that you surely have the gift.

  8. I just want to say I’m very new to blogging and site-building and honestly enjoyed your page. Likely I’m likely to bookmark your blog post . You absolutely come with good well written articles. Thanks a bunch for revealing your web-site.

  9. I simply want to mention I’m beginner to weblog and truly savored you’re web site. Probably I’m want to bookmark your blog post . You certainly have tremendous articles and reviews. Many thanks for sharing your web site.

  10. This design is spectacular! You obviously know how
    to keep a reader amused. Between your wit and your videos, I
    was almost moved to start my own blog (well, almost…HaHa!) Great
    job. I really enjoyed what you had to say, and more than that, how you presented it.
    Too cool!

  11. Thank you for some other informative blog. Where else could I get that kind of information written in such a perfect means?I have a venture that I’m simply now operating on, and I’vebeen on the look out for such information.

  12. I discovered your blog site on google and inspect a few of your early messages. Continue to maintain the very good operate. I just extra up your RSS feed to my MSN Information Visitor. Looking for onward to learning more from you later!?

  13. I do enjoy the way you have presented this particular matter plus it does supply us some fodder for thought. Nonetheless, because of what precisely I have witnessed, I simply just hope when the reviews pack on that people today remain on point and don’t get started upon a tirade associated with some other news of the day. Still, thank you for this fantastic piece and though I do not concur with this in totality, I respect the perspective.

  14. Very interesting information!Perfect just what I was searching for! “I have a hundred times wished that one could resign life as an officer resigns a commission.” by Robert Burns.

  15. You really make it seem so easy with your presentation but I find this topic to be actually something that I think I would never understand. It seems too complex and very broad for me. I’m looking forward for your next post, I’ll try to get the hang of it!

  16. Thanks for the sensible critique. Me and my neighbor were just preparing to do a little research about this. We got a grab a book from our area library but I think I learned more clear from this post. I am very glad to see such great information being shared freely out there.

  17. Thank you for the sensible critique. Me & my neighbor were just preparing to do a little research on this. We got a grab a book from our local library but I think I learned more from this post. I am very glad to see such excellent info being shared freely out there.

    1. Good luck and I am glad to hear the article helped. We put a lot of time in talking to ABA providers on this article to try and provide information for both providers that treat Autism as well as patients and family member impacted by it.
      Eric

  18. I think this web site has some really great information for everyone :D. “This is an age in which one cannot find common sense without a search warrant.” by George Will.

  19. Appreciating the time and effort you put into your site and detailed information you offer. It’s nice to come across a blog every once in a while that isn’t the same old rehashed information. Fantastic read! I’ve bookmarked your site and I’m including your RSS feeds to my Google account.

Leave a Reply

Your email address will not be published. Required fields are marked *