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Telehealth Cuts Treatment Costs, Improves Outcomes for Autistic Children and Their Families

A University of Iowa study has found that parents can use an online platform to meet with specialists and learn communication techniques that improve treatment at home.

By Eric Wicklund

- A new study out of the University of Iowa finds that parents of children on the autism spectrum can greatly reduce their treatment costs by using telehealth.

The platform could also improve a family’s ability to communicate with an autistic child, improving clinical outcomes and reducing stress on caregivers.

Conducted by Scott Lindgren, PhD, a professor of pediatrics in the Stead Family Department of Pediatrics at the University of Iowa’s Carver College of Medicine and recently reported in Pediatrics, the study found that annual treatment costs for a child with challenging behaviors could be reduced from $6,000 to about $2,100 when the families used an online connection rather than relying on in-person treatments.

The online platform was used not only to connect families with specialists, but to train parents in applied behavior analysis (ABA), an intervention technique often used on children diagnosed as having an autism spectrum disorder.

The UI study isn’t the only one to test mHealth platforms on autism and other behavioral disorders. Others are using home-based videoconferencing platforms to enable specialists to work with children and their families/caregivers at home. And Dr. Ricky Bloomfield at Duke University is using Apple’s ResearchKit platform to connect with families through their Autism & Beyond app.

For the study, Lindgren, co-director of the UI Children’s Hospital Autism Center, and David Wacker, PhD, a professor of pediatrics in the Stead Family Department of Pediatrics at UI Carver College of Medicine, tracked the progress of 107 children between the ages of 21 months and 6 years who were treated for ASD or a similar developmental disability between 1996 and 2014. The children and their families were divided into three groups, with some treated by behavioral consultants in their home, some traveling to a clinic for treatment via a telehealth connection, and some trained at home via a telehealth connection.

"When we were starting to do this with telehealth a few years ago, a lot of people said there's no way to work with children with autism without seeing them in person," Lindgren, co-director of the UI Children’s Hospital Autism Center, recently told ScienceDaily. "Usually the way they had been managed was that the family would come to the hospital and see Dr. Wacker and he'd evaluate the children,” after which behavioral consultants would be sent to the family’s home.

While an online platform reduced travel costs and hardships and improved access for families in rural locations, it also enabled consultants to train parents to use ABA in certain situations, improving treatment at home and reducing stress among parents and their children.

"A lot of kids who are on the autism spectrum have significant problems with behavior," Lindgren told ScienceDaily. "These kids may have trouble following directions, or have problems when there are changes in their schedule or routine. They also don't always have good enough communication skills to be able to explain to someone why they're getting upset or having a meltdown."

"This coaching is more than having a casual talk with families," he added. "It's setting up a variety of situations in which problem behavior may occur, and helping parents find ways to address problems constructively, and to better understand why that behavior is occurring. For 90 percent of the kids we evaluate, we can find a social reason for what that child is doing."

Lindgren also noted that the state’s telehealth capabilities improved greatly during the course of the study. As the study progressed, 14 clinics around the state were equipped with videoconferencing capabilities so that families could visits with specialists there, instead of driving to the doctor’s office or a hospital. And from 2012-2014, some families were able to use telehealth platforms at home to connect with their specialists.

“There are a limited number of professionals with the training and expertise needed to work with these children, which means a lot of families can't get access to the services they need," he said. "That's the situation we have in Iowa."


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