Teletherapy for children with developmental disorders during the COVID‐19 pandemic in the Philippines: A mixed‐methods evaluation from the perspectives of parents and therapists

  1. Kathlynne F. Eguia
  2. Catherine M. Capio

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Abstract

Objectives

As a response to the lockdown associated with COVID‐19 in the Philippines, therapy services for children with developmental disorders shifted to telehealth (i.e., teletherapy). This study evaluated the delivery of teletherapy from the perspectives of parents and therapists.

Methods

Participants consisted of parents ( n  = 47) and therapists ( n  = 102) of children with developmental disorders who were receiving teletherapy during the lockdown. A mixed‐methods triangulation design‐convergence model was adopted; participants were invited to respond to an online survey with closed‐ and open‐ended questions. Quantitative data were analysed using descriptive and non‐parametric inferential tests, while qualitative data were examined using thematic analysis.

Results

Overall satisfaction with teletherapy was positive, with parents reporting significantly higher satisfaction compared with therapists. Satisfaction was positively associated with the frequency of teletherapy sessions for parents and with their years of experience for therapists. The top enabling factors were family participation and effective communication. The main challenges were time constraints and difficulty with instruction and monitoring associated with the two‐dimensional nature of teletherapy. The benefits included parents' empowerment and enhanced understanding of their children's needs.

Discussion

Delivery of teletherapy was enabled by a heightened focus on family‐centred care. The evaluation findings suggest that the general satisfaction with teletherapy and the benefits associated with family‐centred care would potentially promote teletherapy as a service delivery mode to continue beyond the pandemic.

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  1. Version published to 10.1111/cch.12965
  2. ScreenIT

    SciScore for 10.1101/2021.05.04.21256662: (What is this?)

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

    Table 1: Rigor

    EthicsIRB: Design and Procedures: The study was approved by the research ethics committee of the corresponding author’s affiliation (Reference: 2019-2020-0448).
    Consent: Participants had opportunities to seek clarifications, provided informed consent, and participated anonymously.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    SPSS 26.0 was used for statistical analysis and NVivo 12.0 supported thematic analysis.
    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:
    These findings suggest that a wider implementation of teletherapy in the Philippines could be hindered by current technology limitations which are mostly linked to economic resources. Parents and therapists were generally satisfied with teletherapy service delivery, but more so the parents. Parents who participated in more frequent sessions tended to have higher overall satisfaction. Presumably, greater exposure and participation with teletherapy facilitated effective communication, which is the most widely reported enabler by parents. Therapists’ relatively lower overall satisfaction is likely linked to the difficulties with instruction and monitoring, as a consequence of being limited to two-dimensional interactions (i.e., visual, audio). However, those who have longer professional experience tended to have better overall satisfaction and confidence. This highlights the role of professional development and expertise despite teletherapy being a novel service delivery model for therapists in the Philippines. Indeed, professionals shifting to telehealth have been shown to draw from their existing professional knowledge and skills to educate and assess their patients in the online service model (Heckemann, Wolf, Ali, Sonntag, & Ekman, 2016). Therapists who delivered teletherapy more frequently also tended to be more satisfied with their communication, further emphasizing the benefits associated with professional experience. Highlighting family-centered care: The commonly report...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    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.

  3. Version published to 10.1101/2021.05.04.21256662v1 on medRxiv