Telehealth Versus Face-to-Face Fine Motor and Social Communication Interventions for Children With Autism Spectrum Disorder: Efficacy, Fidelity, Acceptability, and Feasibility

Author(s)Su, Wan-Chun
Author(s)Cleffi, Corina
Author(s)Srinivasan, Sudha
Author(s)Bhat, Anjana
Date Accessioned2024-02-14T20:04:15Z
Date Available2024-02-14T20:04:15Z
Publication Date2023-12-04
DescriptionThis article was originally published in American Journal of Occupational Therapy. The version of record is available at: https://doi.org/10.5014/ajot.2023.050282. Copyright © 2023 by the American Occupational Therapy Association, Inc.
AbstractImportance: The efficacy of telehealth (TH) interventions needs to be studied. Objective: To compare the efficacy, fidelity, acceptability, and feasibility of face-to-face (F2F) versus TH seated play (SP) interventions among children with autism spectrum disorder (ASD). Design: As part of a larger randomized controlled trial, children were assigned to the SP group and received TH and F2F interventions over 8 wk using a pretest–posttest study design. Setting: A research lab or through videoconferencing. Participants: Fifteen children with ASD (ages 5–14 yr) were randomly assigned to the SP group and received the intervention F2F or through TH. Intervention: Children received 16 SP intervention sessions (2 sessions per week for 8 wk). Outcomes and Measures: Pretests and posttests included standardized fine motor assessments. Video coding compared socially directed verbalization during training sessions. Parents and trainers provided feedback on their experiences. Results: Seven children received the intervention F2F, whereas 8 received TH intervention. Children in both subgroups showed similar training improvements in fine motor skills and socially directed verbalizations (ps > .01). Parents rated both interventions as acceptable and feasible; however, they reported longer preparation time and effort during TH interventions (ps < .01). Trainers reported greater parental involvement but more communication and technological issues during TH interventions. Fidelity checks indicated fewer reinforcements during TH versus F2F sessions. Conclusions and Relevance: TH intervention is feasible and effective in improving fine motor and social communication performance. Clinicians should reduce parental burden and overcome technological issues. What This Article Adds: This study confirmed the efficacy, fidelity, acceptability, and feasibility of delivering seated play, standard of care interventions for children with autism spectrum disorder via telehealth. However, clinicians should work on reducing parental burden and overcoming communication and technological issues related to telehealth.
SponsorWe thank all the children and families who participated in this study. We also thank the Simons Foundation Powering Autism Research for Knowledge (SPARK) clinical sites and the research participant match service staff for their help with recruitment. Finally, we thank Marissa Heino, Sarah Williams, Jill Dolan, and Hannah Laue (undergraduate students from the University of Delaware) and Catherine Myers, Madeline Kaba, Andrea Hernandez, and Amber Bardsley (undergraduate students from the University of Connecticut) for their help with data collection and data analyses. This work was supported by the Institutional Development Award (IDeA) program (National Institute of General Medical Sciences Grants P20-GM-103446 and U54-GM104941) and a Dana Foundation Clinical Neuroscience Award. Sudha Srinivasan’s work on this article was supported by a Research Excellence Program Award from the University of Connecticut. The coauthors have no financial or other conflicts of interest to disclose. We are not consciously aware of, but would acknowledge the possibility of, author biases that might influence equitable presentation of data related to social, ethnic, or cultural variables.
CitationWan-Chun Su, Corina Cleffi, Sudha Srinivasan, Anjana Bhat; Telehealth Versus Face-to-Face Fine Motor and Social Communication Interventions for Children With Autism Spectrum Disorder: Efficacy, Fidelity, Acceptability, and Feasibility. Am J Occup Ther November/December 2023, Vol. 77(6), 7706205130. doi: https://doi.org/10.5014/ajot.2023.050282
ISSN1943-7676
URLhttps://udspace.udel.edu/handle/19716/33988
Languageen_US
PublisherAmerican Journal of Occupational Therapy
Keywordsautism spectrum disorder
Keywordschild
Keywordstelehealth
Keywordspragmatics
TitleTelehealth Versus Face-to-Face Fine Motor and Social Communication Interventions for Children With Autism Spectrum Disorder: Efficacy, Fidelity, Acceptability, and Feasibility
TypeArticle
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