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The Benefits of Using a Telehealth Service Delivery Model to Improve Communication Skills in Children with Autism Spectrum Disorder.
Computerized technologies, video modeling, and robots, are reported to be reinforcing for many children with Autism. The use of computer-assisted instruction and videoconferencing platforms (i.e., telepractice) have become very popular to deliver a variety of services to individuals with autism. A systematic review of the literature during the 1994 - 2016 period regarding the use of telepractice to improve or enhance communication skills in individuals with autism and/or to train families to facilitate language development in young children with autism, revealed that only 3 studies among the total of 53 specifically investigated the effects of delivering Speech Language Pathology (SLP) intervention services to children with autism. Published research over the past 22 years supports positive outcomes of using telepractice to improve early identification of autism, parent/guardian training for early intervention, and applied behavioral therapy services for children and individuals with autism.
Objectives:
1) To empirically investigate student outcomes using a telepractice platform compared to on-site services to deliver speech and language intervention to students with autism between the ages of 9 to 12 years; and 2) To empirically study the effectiveness and satisfaction of using telepractice as a service delivery method among 3 cohorts of participants: a) the 7 children with autism receiving speech language services; b) 9 pre-professional masters SLP graduate clinicians enrolled in a specialty training program in autism, and c) 3 SLP supervisors.
Methods:
An alternating ABA single case time-series research design (Kazdin, 2011) was utilized. Participants included 7 middle school-aged students on the autism spectrum between the ages of 9 to 12 years. Individual and group comparisons were conducted to evaluate student outcomes (Dependent variables) when SLP services were delivered using telepractice vs. on-site vs. telepractice (Independent variables) (TeleTx vs. On-site vs. TeleTx). The 7 students with autism, 9 pre-professional SLP graduate students, and 3 SLP supervisors completed satisfactions surveys at the end of the three service phases.
An equal number of intervention services for the 7 students were delivered in 3 six-week phases: TeleTx-Onsite-TeleTx. The 9 formally trained SLP graduate clinicians delivered the services using stimuli and activities created using the Smart Notebook (Smart Technologies) software applications for each student’s intervention program targeting students’ treatment goals and objectives. The clinician-student dyads remained constant, as did the computer technologies and software used for intervention
Results:
Comparable outcomes and no significant differences were observed in student performance when SLP services were delivered using telepractice compared to on-site face-to-face. Significant individual and group differences were observed in the number of prompts and reinforcers during intervention when services were delivered via telepractice. Students with autism required a greater number of prompts and reinforcers during speech language therapy when delivered on-site compared to telepractice. A five-point satisfaction survey ranging from 1 (strongly disagree) -5 (strongly agree), yielded a median score of 4 for 7 students with autism; 4 for 9 SLP graduate students; and 4 for SLP supervisors.
Conclusions:
Speech and language intervention outcomes were comparable when services were delivered to students with autism using telepractice vs. on-site.