Rebecca Sutherland, David Trembath, and Jacqueline Roberts from the Autism Centre of Excellence and the Menzies Health Institute Queensland of Griffith University, Gold Coast in Australia, have published a summary of their study in which they investigated whether challenging behavior in young children with autism and other developmental disorders can be successfully treated using Applied Behavior Analysis (ABA) delivered through telehealth at a lower cost than traditional treatment and whether the same can be used to train parents.
The study compared the results and costs of treatment aimed at reducing challenging behavior in children with autism using three models of behavioral therapy services:
– in-home therapy;
– clinic-based telehealth;
– home-based telehealth.
The participants of the study were over 100 young children diagnosed with autisms or other neurodevelopmental disorders, and result analysis was conducted among 94 children who completed the assigned period of therapy.
All three models of autism therapy delivery reduced challenging behavior in the children. Mean percentage decrease in challenging behavior following therapy was >90% across the three models, and according to the parents in all three groups, the effects were considerable. Total implementation costs of telehealth were the lowest for in-home therapy.
The study showed that parents can use ABA methods and procedures to provide effective therapy for children with autism, regardless whether the therapy is conducted directly by behavioral advisors or through remote video coaching.
Similar conclusions can be drawn from a study by Scott Lindgren and David Wacker, professor of pediatrics at the Stead Family Department of Pediatrics of the UI Carver College of Medicine (April 2016).
The study tested whether telehealth can reduce treatment costs, improve a family’s ability to communicate with a child with autism (parent coaching), and improve clinical results and reduce stress in children.
The study found that using telehealth instead of face-to-face therapy sessions can reduce the treatment costs for children with autism or challenging behavior almost three times over a year, from USD 6,000 to about 2,100.
Between 1996 and 2014, the progress of 107 children aged between 21 months and 6 years who due to ASD or a similar developmental disorder underwent telehealth therapy was tracked. The children and their families were divided into three groups:
– the first group underwent in-home therapy conducted by behavioral consultants;
– the second group underwent in-clinic therapy;
– the third group, after their parents were coached, underwent in-home therapy through the Internet, supervised by specialists.
“When we were starting to do this with telehealth a few years ago, a lot of people said there’s no way to work with children with autism without seeing them in person,” says Scott Lindgren, co-director of the UI Children’s Hospital Autism Center. “Usually the way they had been managed was that the family would come to the hospital and see Dr. Wacker and he’d evaluate the children,” after which behavioral consultants would be sent to the family’s home for therapy.
Lindgren underlines three aspects of telehealth that can make it effective and satisfactory:
A platform for communication and supervision of telehealth. An online platform reduced travel costs and allowed consultants to train parents to use ABA methods in specific situations, improve the quality of in-home therapy, and reduce stress in parents and children.
Parent coaching and role. “A lot of kids who are on the autism spectrum have significant problems with behavior,” says Lindgren. “These kids may have trouble following directions, or have problems when there are changes in their schedule or routine. They also don’t always have good enough communication skills to be able to explain to someone why they’re getting upset or having a meltdown. This coaching is more than having a casual talk with families. It’s setting up a variety of situations in which problem behavior may occur, and helping parents find ways to address problems constructively”.
Access to specialists. The number of specialists with the education and knowledge required to work with children with autism is limited, which means that many families have no means of accessing the services they need. Telehealth lets specialist use the time they save on traveling to conduct therapy sessions with more patients.
Since telehealth can provide similar results to traditional behavioral therapy at a lower cost than in-home or in-clinic therapy, tools based on ABA can be a viable part of telehealth and have the potential to support the therapy of children with autism for families with access to the web.
Similarly, ABA DrOmnibus also minimizes the barriers related to behavioral therapy in terms of:
– travel: the specialist can lead a therapy session with the child without leaving the office;
– finances: the prize for a single child’s account is low for the parent, and the cost of therapy can be lower than a face-to-face session;
– limited access to specialists: no need to travel to the clients, collect extra materials for therapy, or register data by hand means that the specialist can supervise more clients.
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Read more: https://www.ncbi.nlm.nih.gov/pubmed/26908472