Date Presented 04/21/2023

This study compares the delivery of an intervention in person and via telehealth. Results have important implications for OT when considering intervention accessibility and adaptations from in-person to telehealth delivery.

Primary Author and Speaker: Sophia Banez

Additional Authors and Speakers: Clara Mack, Mary Sommers

Contributing Authors: Libby Hladik, Brittany St John, John Drew, Karla Ausderau

PURPOSE: COVID-19 required a rapid shift of intervention from in-person to telehealth with limited consideration for impact on intervention fidelity or accessibility. The purpose of this study is to understand the implications of transitioning a caregiver-mediated feeding intervention; the Engaged Eaters Program (EEP) for autistic children (ages 2 to 7) from in-home to a telehealth delivery model. This study examines benefits and challenges from transitioning in-person interventions for telehealth delivery.

DESIGN: This study is a mixed method convergent design. Data included demographic characteristics of families enrolled in the in-person and telehealth phases of the EEP feeding intervention and interviews with therapists delivering the EEP.

METHOD: A quantitative analysis was used to understand differences in child and caregiver demographics between in-home and telehealth delivery. Qualitative data was gathered via semi-structured interviews, and thematic analysis was used to understand therapist experiences of transitioning to telehealth delivery.

RESULTS: Significant differences in rurality and distance from the research center were identified for families in the telehealth group. Three primary themes emerged from interviews: Intervention Adaptations, Challenges for Interventionists, and Benefits of Telehealth with further sub-theme explanations.

CONCLUSION: This study provides preliminary evidence for how telehealth delivery of specialized services, such as feeding therapy, may increase access for families of autistic children. Clear benefits and challenges to telehealth adaptation of an in-home intervention were identified. This study has important implications for occupational therapy services as it informs future adaptations of interventions for delivery over telehealth, especially to address accessibility barriers for rural areas.

References

Hoel, V., von Zweck, C., & Ledgerd, R. (2021). Was a global pandemic needed to adopt the use of telehealth in occupational therapy? Work, 68(1), 13–20. https://doi.org/10.3233/WOR-205268

Abbott-Gaffney, C. R., Gafni-Lachter, L., Cason, J., Sheaffer, K., Harasink, R., Donehower, K., & Jacobs, K. (2022). Toward successful future use of telehealth in occupational therapy practice: What the COVID-19 rapid shift revealed. Work, 71(2), 385–394. https://doi.org/10.3233/WOR-210789

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. The American Journal of Occupational Therapy, 72(2), 7202205020p1–7202205020p7. https://doi.org/10.5014/ajot.2018.024786