Clinical intervention with autistic adolescents and adults during the first two months of the COVID-19 pandemic: Experiences of clinicians and their clients

Abstract

This article describes clinical experiences of therapists with autistic clients during early stages of the COVID-19 pandemic while engaged in remote intervention in Canada. The authors polled their team of mental health clinicians through an email questionnaire and infused their own practice experiences to summarize mental health themes, and adaptation to technology-based intervention. Clinicians shared responses to the pandemic and reported on their transition to remote intervention.

Examining clinicians’ concerns delivering telemental health interventions directly to autistic individuals during COVID-19

“…Unlike prior ASD studies that have likewise investigated the delivery of direct remote interventions in routine services via an online survey (conducted during the pandemic; i.e. Southey & Stoddart, 2021 ; Spain et al, 2021 ), the ability of clinicians to recall challenges in open-ended questions was not solely relied upon, which likely explains why more challenges were identified. Open-ended questions were included before the endorsement of challenges however, in order to identify those of salience.…”

“…The present study is further distinguishable from these prior ASD studies (i.e. Southey & Stoddart, 2021 ; Spain et al, 2021 ) in that it focused on TMH (as opposed to telemedicine more broadly) and participants were asked to rate their level of concern over challenges and outline any considered to be ASD-specific. The latter included the exacerbation of those associated with in-person delivery in ASD (e.g.…”

“…building rapport, supporting understanding, and the need for visual-tactile resources; Cooper, Loades, & Russell, 2018 ; National Institute for Health & Care Excellence NICE, 2013 ) alongside privacy concerns - challenges found by prior studies on direct TMH and telemedicine interventions in ASD (including intervention studies; i.e. Cihon et al, 2021 ; Hepburn et al, 2016 ; Kalvin et al, 2021 ; Loveland, 2020 ; McCrae et al, 2021 ; Southey & Stoddart, 2021 ; Spain et al, 2021 ), but also difficulties with trust and appropriate remote social behaviour. It must be mentioned, however, that typically fewer than half of clinicians reported having experienced these, though the majority endorsed them as possible, and levels of concern were low.…”

“…study by Spain et al, 2021 ) and in graduate-trained therapists in social work, psychology, or behaviour analysis (i.e. study by Southey & Stoddart, 2021 ). The challenges identified largely overlapped with those in the existing TMH literature, although they were fewer in number and included additional challenges that are likely to be associated with ASD (e.g.…”

“…Both ASD studies (i.e. Southey & Stoddart, 2021 ; Spain et al, 2021 ) obtained telemedicine views more broadly and only via one or three questions that were embedded in a longer questionnaire which instead focused on the mental health impact of the pandemic. In addition, the questions were open-ended and so relied upon the participants’ ability to recollect challenges/benefits, and some participants in Spain et al’s (2021) study were researchers rather than clinicians within routine services.…”