Remote Intensive Intervention for Young Children on the Autism Spectrum During COVID-19: the Experience of Caregivers and Service Providers

  1. Hilary Wood de Wilde
  2. Nada Kojovic
  3. Céline Robertson
  4. Catherine Karr
  5. Leyla Akman
  6. Florence Caccia
  7. Astrid Costes
  8. Morgane Etienne
  9. Martina Franchini
  10. Edouard Gentaz
  11. Marie Schaer

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Abstract

Objectives

Community-based early autism intervention programs in Geneva, Switzerland, converted their in-person services to a telehealth format during the COVID-19 home confinement period. The current study was aimed at measuring the engagement and satisfaction of service providers and caregivers as they experienced telehealth services for the first time and at monitoring child progress.

Methods

Forty-five families from diverse backgrounds and their 45 service providers had daily videoconferencing sessions of primarily parent-mediated intervention. Satisfaction questionnaires were completed at three time points over a 2-month period. Session frequency and program participation were recorded. Caregiver and service provider’s answers were compared. Results were also analyzed by family annual income. Child progress was monitored using the Early Start Denver Model Curriculum Checklist.

Results

Caregivers and service providers maintained high levels of participation and satisfaction throughout the telehealth service period and appreciated how the telehealth format allowed them to meet more frequently. Lower-income families tended to be more unanimously positive about the services when compared with mid- and high-income families. We found significant group differences in service providers’ and caregivers’ perceptions of each other’s comfort level with the remote sessions. Child progress followed a pattern of continued significant improvement across most developmental domains during the telehealth service period.

Conclusions

These findings underscore the potential of telehealth as a promising and appreciated approach for delivering intensive early autism interventions in community settings. Further research is needed to determine optimal session frequency for remote parent-mediated intervention and to determine ways to make telehealth services more accessible for low-income families.

Article activity feed

  1. Version published to 10.1007/s41252-023-00339-0
  2. Version published to 10.1101/2022.01.30.22270029v3 on medRxiv
  3. Version published to 10.1101/2022.01.30.22270029v2 on medRxiv
  4. ScreenIT

    SciScore for 10.1101/2022.01.30.22270029: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    NIH rigor criteria are not applicable to paper type.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Materials: The video-conferencing sessions took place using ZOOM software (Zoom Video Communications, Inc., Version 4.4; https://zoom.us/).
    ZOOM
    suggested: (ZOOM, RRID:SCR_002175)
    Statistical analyses were conducted using GraphPad Prism v.
    GraphPad Prism
    suggested: (GraphPad Prism, RRID:SCR_002798)
    8 and SPSS v.
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Limitations and future clinical considerations: The main limitation of this study was also what made it possible - the unexpected circumstance of supporting families during home-confinement orders. It was not possible to randomise groups or complete formal measures of child and parent outcome, and our satisfaction questionnaires needed to be created very quickly. This was a period of great uncertainty, and relative solidarity, where parents seemed open to try new modes of communication and were motivated to keep a sense of continuity for their child’s program, all of which may have impacted their level of participation and satisfaction. It should also be noted that the parents in our study had all met or worked with their therapists in-person prior to being asked to meet online, which may have increased their willingness to take part in the new approach.1,30 This study did not examine whether a family without previous experience in early intervention would have the same level of engagement with the remote delivery of services. In considering ideal sessions frequency, the current study did not compare parent experience between varying durations of sessions (30 vs 60 vs 90 minutes), which would be important to take into account in future research. The COVID-19 pandemic disrupted our intervention program for children on the autism spectrum, forcing us to re-think our service provision model and giving us the chance to experience very frequent interactions with the families. It r...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We found bar graphs of continuous data. We recommend replacing bar graphs with more informative graphics, as many different datasets can lead to the same bar graph. The actual data may suggest different conclusions from the summary statistics. For more information, please see Weissgerber et al (2015).

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  5. Version published to 10.1101/2022.01.30.22270029v1 on medRxiv