Remote Intensive Parent-Implemented Intervention for Young Children on the Autism Spectrum During Covid-19: The Experience of Parents and Therapists

Abstract

In the spring of 2020, autism intervention programs in Geneva, Switzerland, were forced to close during a state-mandated home confinement period, in the response to the beginning of the COVID-19 pandemic. Therapists from three programs were asked to move early, intensive intervention sessions to an online video-conferencing format, providing primarily remote parent-implemented intervention sessions over a two-month period. In this study, we assessed the participation and satisfaction of 45 families from diverse cultural and socio-economic backgrounds, with 43 young children on the autism spectrum, and 5 toddlers who were suspected of having autism, as they experienced intervention services via telehealth for the first time. We provided questionnaires, to both the parents and the therapists working with them. Parents, regardless of socioeconomic status or cultural background, were highly motivated and engaged to learn the intervention strategies, with most families reporting high levels of satisfaction with the intensive, remote parent coaching model. The majority of parents reported that they progressed more in their interaction skills with their child with the daily remote coaching sessions, compared to services they received prior to the pandemic. Additionally, parents reported a positive experience with a much higher frequency of coaching sessions than has previously been studied. In our monitoring of child developmental progress, we observed a pattern of continued significant improvement across domains, without any stagnation of progress during the telehealth period. Our findings support previous studies that have demonstrated the benefits of telehealth services for young families with children on the autism spectrum, and go further to demonstrate high levels of satisfaction and motivation with caregivers from diverse cultural and socio-economic backgrounds, when provided with a high frequency of remote parent-implemented intervention.

Remote Physiotherapy for Children with ASD during the COVID-19 Pandemic: A Thematic Analysis of Physical Therapists’ Perspectives

“…The PTs in our study repeatedly emphasized the tremendous contribution parental involvement had to the implementation of the RTIs. In fact, this observation is in line with previous studies that claim that parental involvement is an essential key to treating children with ASD [ 38 , 55 , 56 , 57 ]. Moreover, recent reports reinforce this consensus, especially following nationwide lockdowns, when RTIs were the only possible way to continue therapeutic work with patients, including children with ASD [ 36 ].…”

“…This was manifested by more regulated and calmer reactions, less stereotypical behavior, and better communication between the children and their kindergarten teams upon returning to kindergarten when the lockdown was lifted. Similar results (whereby most children improved and only a minority regressed) were reported by others [ 37 , 38 ]; according to these studies, among those children receiving RTI, 85% experienced benefits from this type of intervention.…”

“…Moreover, recent reports reinforce this consensus, especially following nationwide lockdowns, when RTIs were the only possible way to continue therapeutic work with patients, including children with ASD [ 36 ]. The unique lockdown conditions magnified the substantial role that parents played in the success of RTI sessions [ 38 ], as most children needed their parents to moderate the sessions.…”

Video-Feedback Approach Improves Parental Compliance to Early Behavioral Interventions in Children with Autism Spectrum Disorders during the COVID-19 Pandemic: A Pilot Investigation

“…With COVID-19, the public health emergency forced health-care services to switch to telehealth as a necessary tool for ensuring a continuum of care. Remote parent coaching represented an opportunity for supporting families with young children with special needs [ 31 ] and autism [ 44 ]. Studies about telehealth in the autism field, with reference to assessment or treatment programs, were already ongoing before the pandemic, but mostly represented circumscribed evidence in rigorous experimental and research settings [ 45 , 46 ].…”

Mobile Prototype for the Early Stimulation of Autistic Children with Augmented Reality

“…Children with ASD have learning difficulties as they have a low level of attention, so children can be easily distracted, and 70% of people with autistic problems do not have these intellectual disabilities [2]. In Switzerland, it was identified that children in covid-19 increased their stress level when they had no physical contact with the therapy specialists and parents were surveyed to verify these problems [3].…”