Increasing resources for autism evaluation and support for under‐resourced schools through a state‐wide school telehealth initiative

Abstract

Autism spectrum disorder (ASD) is a neurodevelopmental disability affecting 1 in 44 children nationally. Timely referral to intervention and support services for ASD has consistently demonstrated significant long‐term positive effects on symptoms and subsequent skills and family outcomes. This paper highlights a novel and innovative approach of short‐term consultations for best practices to ultimately increase access to timely ASD evaluations and support through a state‐wide school telehealth initiative. The goal of the initiative was to facilitate rapid access to ASD evaluation and support (within 2 weeks of referral in school‐age youth) among under‐resourced school systems in Central Texas. First, this paper provides background relative to current disparities that many children face when attempting to obtain ASD evaluations and support. Second, a statewide legislative response is described that created a mental health consortium targeting increased access to broad‐based mental health services and supports, particularly in underserved areas. Next, the Texas Child Health Access Through Telemedicine (TCHATT) program is outlined with a particular focus on day‐to‐day operationality and concentrated efforts to increase mental health literacy among school teams relative to ASD symptoms and co‐occurring behavioral health concerns. Year 1 utilization data metrics (September 2020–May 2021) and representative case examples are presented. Finally, early “lessons learned” and future directions are discussed.

Nursing Practice and Telehealth in School Health Services: A Scoping Review

“…Notably, two reviewed articles reported no limitations [47,65]. These findings demonstrate the potential of school-based telehealth, underscoring the importance of addressing associated challenges and limitations.…”

“…(a) Hearing screenings and speech and communication problems in five studies (15.62%) [48,60,66,72,74]; (b) Promoting healthy habits and lifestyles, with a focus on healthy eating and physical activity in four studies (12.5%) [49,53,55,61]; (c) Promoting mental health and emotion management in four studies (12.5%) [45,52,70,73]; (d) Prevention and management of respiratory problems, especially asthma, in four studies (12.5%) [50,59,67,69]; (e) Oral health screening and hygiene in three studies (9.37%) [51,56,65]; (f) Prevention of tobacco, alcohol, and other substance use in two studies (6.25%) [57,76]; (g) Reproductive health and pregnancy prevention in two studies (6.25%) [54,63]; (h) Screening and monitoring of mental health problems in two studies (6.25%) [46,75]; (i) Care and behaviour in one study (3.12%) [68]; (j) Prevention of psychosocial problems in one study (3.12%) [56]; (k) Autism assessment in one study (3.12%) [47]; (l) Diagnosis and management of skin scabies in one study (3.12%) [71]; (m) Prevention of skin cancer and photoaging in one study (3.12%) [64]; (n) Screening for metabolic syndrome in one study (3.12%) [58].…”

“…Intervention strategies across these studies comprised tele-education using customised information content in capsule format in fifteen studies (46.87%) [46,49,[51][52][53][54]57,[61][62][63][64]69,73,75,76]; telediagnosis or telemonitoring using wearable devices to detect signs, improve treatment adherence, and prevent complications in eight studies (25%) [48,55,56,58,65,66,72,74]; and teleconsultation (telehealth) in nine studies (28.12%) [45,47,50,59,60,67,68,70,71]. Notably, all these interventions were implemented within the context of school health services or school settings.…”

“…Children actively engaged in their health [55,62,76], promoting a positive public health impact [71]. In addition, remote care enabled improved monitoring of health problems in rural communities with difficult access to health services and immigrant populations with language difficulties [46,47,65,70];…”