Date Presented 04/01/2022
Therapists explored the perceptions of caregivers of children with developmental disabilities who did, and did not. do telehealth and whether they found it feasible, effective, and supportive. Results show that telehealth can be effective if there is internet access, as well as effective communication between the caregiver and therapist. Our study indicates that therapists should be flexible during telehealth to accommodate for language barriers and children who have difficulty attending to telehealth.
Primary Author and Speaker: Daniella Soba
Additional Authors and Speakers: Carol Terilli, Sherly Kornhaber, Elizabeth Ridgway, Ida Barresi, Tamelly Jimenez
PURPOSE: During COVID-19, therapeutic services at our Bronx center for people with developmental disabilities (DD) abruptly transitioned to telehealth. With telehealth literature focusing on remote/rural populations, adults, and medical appointments, occupational (OT), physical (PT), and speech and language therapists (ST) in the Bronx had limited academic resources to reference for providing quality, virtual, developmental services. Therapists observed difficulties with family participation and sought to examine the experiences of caregivers of children with DD who used telehealth during the Stay-At-Home period. Our aim was to determine whether OT, PT, and ST telehealth services were supportive, feasible, and effective for diverse families and clients with DD during COVID-19.
DESIGN: This was a descriptive study using an electronic and paper survey. A sample of convenience was used of current clients receiving OT, PT and/or ST services in-person or via telehealth at our center from January to June 2020. There were no exclusionary criteria. Participants were notified that they were under no obligation to complete the survey and their therapy services would not be affected. The study was approved by our center’s IRB.
METHOD: Researchers created a survey guided by standardized examples to examine factors related to developmental therapy for caregivers of children with DD. The survey included multiple choice questions, rating scales and open-ended questions, was in English/Spanish and sent electronically and in paper format to 182 caregivers exploring synchronous telehealth. Data was analyzed using Excel and R Studio. Descriptive statistics described the results of the survey. Differences were statistically compared between families that did and did not use telehealth.
RESULTS: Sixty respondents: 59 caregivers and 1 patient. 89% identified as Black or Latino/Hispanic, 65% spoke Spanish and 89% lived in the Bronx. 82% of participants used telehealth finding it feasible and supportive. Telehealth difficulties reported by whole group included lack of patient cooperation and patient attending to directions using video. Families with children who require less assistance found telehealth more helpful. In comparing those who participated in telehealth (telehealth group 82%), to a no telehealth group (18%), significant differences were found: difficulty with access to devices (p = 0.04), WiFi/Internet access (p<0.001) and use of technology or video platform (p = 0.02). Significant barriers were communication in primary language with therapist (p = 0.04) and accessing video platforms in their primary language (p = 0.04). Other barriers significantly impacting participation in telehealth included the therapist’s ability to guide a session using video (p = 0.02), patient’s cooperation using video (p = 0.02) and patient’s attention to directions (p = 0.05).
CONCLUSION: As the Bronx was hard-hit by COVID-19, clients were greatly affected by changes in their therapeutic service delivery. Our results revealed OT, PT, and ST telehealth services were supportive, feasible, and effective for most of our families during this time. Families reported telehealth to be most effective when: therapists were culturally and linguistically competent, sessions were individualized to match available client resources, and they had access through technology. Telehealth became the bridge between people with DD and their therapies during COVID-19. Our study serves as a springboard to improving the delivery of telehealth for the future and to advocate for continuation of telehealth as an alternative mode of therapy delivery. Limitations to our study included dependence on digital and postal distribution. In-person completion may have yielded a more inclusive cohort.
References
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Little, L. M., Pope, E., Wallisch, A., & Dunn, W. (2018). Occupation-based coaching by means of Telehealth for families of young children with autism spectrum disorder. American Journal of Occupational Therapy, 72(2), 7202205020. https://doi.org/10.5014/ajot.2018.024786
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