Telehealth is the use of technology to educate and treat conditions related to health (Ferguson et al. 2018). Telehealth emerged as a result of innovation and expansion of the information technology industry. Telehealth platforms offer advice, training and treatment interventions vide telecommunications software. Some conditions have utilized such platforms to reach out to patients who may not necessarily get to the hospital for face to face treatment. The use of telehealth in managing ASD works for most parents, especially those in rural areas. Studies show that 88% of the UK population as able to access the internet.
Lack of enough qualified professionals strategically places telehealth as the most reliable means of ASD treatment. Internet access saves on time and cuts on travel expenses. A telehealth platform can bridge the geographical distance between a professional and a patient. In an education setting, FAs can be performed by graduates under the supervision of advanced graduates.
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Introduction
Children living with autism spectrum disorder experience a lot of challenges in their lifetime. Having a fragile lifestyle, they tend to rely heavily on the support and care of their parents and caregivers for their well-being. The biggest challenge they experience is by accessing professional health services. Poor access to professional health care is caused by lack of enough qualified professionals in the field. The most affected lot are families based in rural areas because of scarce healthcare centres. Their parents experience constraints when travelling for long distances and seeking professional help. In this paper, telehealth is exposed as the most effective way to receive treatment from anywhere for as long as there is internet access. Trough telehealth, parents can access different services that will aid them in taking care of their vulnerable children. The paper structured to include a discussion on autism spectrum disorder, an exposition on telehealth, followed by behavior intervention and finally a functions analysis section.
It is the contention of this paper that Telehealth platforms provide effective treatment for children with autism and developmental delays who have challenges with emotions and socialization behavior. In support of this, hospitals have established telehealth section in their facilities to reach 0ut to many patients as possible. Geographical distance is no longer a barrier to access to professional healthcare services needed by children with autism.
Autism spectrum Disorder
The American Psychiatric Association defines autism spectrum disorder (ASD) as a neurodevelopmental disorder characterized by difficulties in social communication and defective thought patterns and behavior (Ferguson et al. 2018). Sadly most people who have ASD struggle with it in their lifetime. Few individuals, after getting the right treatment, may be able to control their behavior. This condition calls for massive support in education, social and health spheres since the patients are always dependent on their families. Parents of affected children continually seek professional services to help their children manage the condition. Where appropriate help is offered, the sick child tends to experience some normalcy.
Children with ASD exhibit different behaviors ranging from aggressiveness, social impropriety, impulsiveness, instability, and general defiance (Woods et al . 2014). These behaviors inhibit a child from interacting well with those around them. The frequency at which a child will demonstrate such behavior differs from one child to another. Where they are not monitored, they might inflict injury to themselves (Woods et al . 2014).
Wacker et al. (2013), defines the disorders as follows; Aggression is any behaviour that may lead to damaging the tissues of another person. Elopement is a disorder that reflected when the patient attempts to leave the treatment area or from the persons giving instructions. Repetitive behavior could be the movement of objects or non-functional movement of parts of the body. Self-injury entails action that causes tissue injury to the perpetrator. Property destruction is any behavior that directs damage to property. Screaming involves any vocalization that exceeds the conversational level.
The interventions available for children and adults leaving with ASD are geared towards their general well-being. Educational and behavioral interventions are the most workable since they boost the patient’s social skills and enhance independence. This way, an individual reduces the chances of hurting themselves because most of the disorders characterizing ASD are related to a disease in the brain. Infusion of technology towards the provision of medical services to such children has gone a long way in improving their conditions.
Telehealth
Telehealth is the use of technology to educate and treat conditions related to health (Ferguson et al. 2018). Telehealth emerged as a result of innovation and expansion of the information technology industry. Telehealth platforms offer advice, training and treatment interventions vide telecommunications software. Several conditions have utilized such platforms to reach out to patients who may not necessarily get to the hospital for face to face treatment. The use of telehealth in managing ASD works for most parents, especially those in rural areas. Studies show that 88% of the UK population as able to access the internet.
Lack of enough qualified professionals strategically places telehealth as the most reliable means of ASD treatment. Internet access saves on time and cuts on travel expenses. The geographical distance between a professional and a patient can be bridged by a telehealth platform. In an education setting, FAs can be performed by graduates under the supervision of advanced graduates. Consultation services are also available on telehealth platforms.
Health facilities now have telehealth departments that specifically deal with the digital provision of health care services. Wacker et al. (2014) explain how an essential telehealth center should be equipped. Basically, a Teleconferencing Center should have teleconferencing work stations with personal computers attached with webcam and headset for video and sound. Parents who visit such centers are trained on all procedures and allowed to visit their regional clinics where they continue to receive live coaching. The knowledge supplies through teleconferencing are utilized during child care. Telehealth is very effective because all information and procedures conducted are recorded and saved for future reference.
Behaviour Intervention
Function-Based Analytic Intervention
Monlux et al. (2019), observe that telehealth is widely accessed for behavior analysis as an intervention for children with problematic behavior and developmental disorder. Their paper reveals that function-based analytic intervention for children aged between 3-10 years helped improve response from 78.8 to 95.3%. The children examined had fragile X syndrome (FXS). The authors contend that employing telehealth for behavioral treatment is comfortable and pocket friendly. However, much reliance on telehealth platforms may not entirely offer long-lasting solutions, and thus direct treatment is highly recommended.
Applied Behavior Analysis (ABA)
ABA examines the environmental factors that influence social behavior and provide appropriate intervention (Ferguson et al. 2018). Implementing ABA has not been easy due to several reasons. Evidence-based practice shows that only a few children can access this intervention because of lack of support from the government. More so, the lack of qualified personnel continues to frustrate the implementation of ABA. The extensive qualification prerequisites ensure that the services offered produce the best child outcomes. As a result, the few qualified persons are based in urban areas. Parents in rural areas have difficulties accessing such services and tend to experience lower service satisfaction. Ferguson et al. (2018) point out that in as much as ABA yields remarkable results; it remains unclear on how to bridge the gap between needs and services.
Woods et al . (2014), offer a practical example of behavior management for a child admitted in hospital after suffering a severe brain injury. They recommend that even in such environment parents or caregivers may regulate the sleep-wake cycle, reducing visual and auditory stimulation, familiarizing the child with the hospital, updating them on time and also adjusting the number of people who may visit. The intervention described above helps to achieve a stable behavior of the child adequately. However, the management should continue systematically even after leaving the hospital for a long-term behavioral change.
Signposts for building better behavior
Children with mental disabilities and problematic behavior need specialized care. The programme ‘Signposts for Building better Behavior’ aid parents with such children meet their needs. The programme is inclusive of three formats, namely self-directed, group support and telephone-support. All formats are useful. Parents are required to adjust their parenting strategies because they affect the adjustment of a child. Woods et al . (2014) report that parents employ both positive and negative parenting strategies. Parents with stress tend to use negative strategies, such as punishment. Negative strategies turn out to be dysfunctional and may escalate further problematic behaviors of a child. Through telephone conversations with therapists, parents can adjust accordingly. In group supports, the meetings help parents share their experiences and thereby learn new and appropriate strategies to use.
Functional Analysis
Functional analysis (FAs) of telehealth in the management and treatment of ASD in children is essential to assess their effectiveness. As noted above, children with ASD have challenging behaviors which require immediate and continuous treatment. The result of effective therapy contributes to the overall growth of the child and healthy mental status of the parents and caregivers (Wacker et al. 2013). Wacker et al. (2013), stress that behaviour intervention procedures such as Function Communication Training (FCT) contain erroneous behaviour by 90%.
Functional analyses are conducted in homes with children who have ASD. Parents are encouraged to conduct FAs. Behavior analysts can provide on-site coaching. Wacker et al . (2013) also recommend that Fa s must be coupled with behavioral analysis. When properly trained, parents can execute FAs with ease without professional knowledge on ABA (Wacker et al. 2013). Research demonstrates that FAs procedures are highly acceptable, feasible and cost-effective
Conclusion
The above discussion justifies that Telehealth platforms provide effective treatment for children with autism and developmental delays. Live coaching helps parents with a lack of formal knowledge on behavioral intervention are able to give effective treatment and care to their vulnerable children. More platforms should be availed to aid parents who are still frustrated by the lack of face-to-face clinical appointments.
References
Ferguson, J., Craig, E.A., & Dounavi , K. (2019). Telehealth as model for providing behavior
analytic interventions to individuals with autism spectrum disorder: A systematic review. Journal of Autism and Developmental Disorders, 49(2), 582- 616.
Monlux, K. D., Pollard, J. S., Bujanda Rodriguez, A., Y., & Hall, S. S. (2019). Telehealth
delivery of function-based behavioral treatment for problem behaviors exhibited by boys with fragile X syndrome. Journal of Autism and Developmental Disorders, 49(6), 2461-2475. doi:http://dx.doi.org.library.capella.edu/10.1007/s10803-019-03963-9
Wacker, D. P., Lee, J. F., Dalmau, Y. C. P., Kopelman, T. G., Lindgren, S. D., Kuhle, J., . . .
Waldron, D. B. (2013). Conducting Functional Analysis of Problem Behavior via Telehealth. Journal of Applied Behavior Analysis, 46(1), 31-46. Retrieved from http://library.capella.edu/login?qurl=https%3A%2F%2Fsearch.proquest.com%2Fdocview%2F1351567376%3Faccountid%3D27965
Woods, D. T., Catroppa, C., Godfrey, C., Giallo, R., Matthews, J., & Anderson, V. A. (2014). A
telehealth intervention for families caring for a child with traumatic brain injury (TBI). Social Care and Neurodisability, 5(1), 51-62. doi:http://dx.doi.org.library.capella.edu/10.1108/SCN-01-2013-0002
