Telehealth Services for Children With Autism Spectrum Disorders in Rural Areas of the Kingdom of Saudi Arabia: Overview and Recommendations

Abstract

Autism spectrum disorders (ASD) are the most-prevalent neurodevelopmental disorders. However, each child diagnosed with ASD presents with a unique range of behavioral and communication problems and issues with social skills. Many studies have highlighted the importance of early interventions for children with ASD to improve their skills and provide their families with the necessary support. However, in the Kingdom of Saudi Arabia (KSA), the earliest that a child with ASD in the major cities receives an intervention is at the age of 4 years, owing to limited services and a lack of awareness of the importance and benefits of early interventions. Families who live in rural areas of KSA arguably have a greater need for these services, as they have to travel to cities such as Riyadh for help. The use of telehealth services may be effective for ASD intervention among children living in rural areas, since such services use technology to provide consultations, interventions, diagnosis, training, and education. Research indicates that telehealth services are as valuable as traditional face-to-face treatment, allow families to obtain support from their homes, and help them improve their quality of life. This review will discuss the application of telehealth services to support families in rural areas of KSA who are dealing with issues of ASD, considering the cultural and religious contexts. In addition, it will examine ways in which technology can be employed to suit KSA’s culture and needs.

Families With Children With Neurodevelopmental Disorders During COVID-19: A Scoping Review

“…They also promote parenting confidence and parental psychological wellbeing, increase family empowerment, and decrease family chaos ( Grindle et al, 2009 ; Pfiffner & Haack, 2014 ). In recent years, the adaptation of such therapies, parent trainings, and professional consultations through telehealth has produced equally favorable outcomes while creating more cost-effective and easily accessible support for parents ( Alkhalifah & Aldhalaan, 2018 ; Lindgren et al, 2016 ; Spencer et al, 2020 ; Sutherland et al, 2018 ; Vismara et al, 2013 ). Therefore, during the COVID-19 pandemic, the use of telehealth care is critical in supporting families and children with neurodevelopmental disorders.…”

Use of telehealth for facilitating the diagnostic assessment of Autism Spectrum Disorder (ASD): A scoping review

“…By offering families with a chance to play an important role in the child's development, telehealth technology could expedite diagnostic process and early intervention services [26,28]. However, limited access to the required technologies such as computers and mobile phones could hamper the widespread use of telehealth [29]. In prior telehealth evaluations for children with ASD, parents required good internet access [20,26,30].…”

“…Especially, individuals in rural and underserved areas may be disadvantaged by lack of mobile coverage [31]. Slow internet speed, poor quality and unreliable connectivity problems may result in frustration and unwillingness to use telehealth approaches among families and adults with ASD [29]. Some families have concerns that children may change their behaviours if they know they are observed distantly [28,32].…”

A systematic review of cultural adaptations in the global application of ABA‐based telehealth services

“…Thus, the global distribution of behavior analytic interventions that have been predominantly developed and tested in North American settings requires careful consideration. For example, having animated conversation with children might seem unusual in some Asian cultures (Kim et al, 2015); mixing of genders and having a male interventionist coaching a child's mother might be considered inappropriate in some Middle Eastern families (Alkhalifah & Aldhalaan, 2018); and providing quick behavior‐specific praise might not be possible in certain languages (e.g., Georgian; Barkaia et al, 2017). Such a mismatch between intervention procedures and the family's context might then lead to high attrition rates or poor fidelity in implementation (Hall et al, 2016).…”