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Using Telehealth To Treat Autism.

Autism Spectrum Disorder (ASD) is a common developmental disability occurring in children between the ages of 0-3 years old. ASD includes conditions that were previously thought to be separate; autism, Asperger’s syndrome, childhood disintegrative disorder, and an unspecified form of pervasive developmental disorder.
The exact cause of ASD is unknown, but it is believed to be influenced by genetics and some environmental factors.
By statistics, 1 in every 59 children suffers from this disorder.

The term “spectrum” in ASD refers to the wide range of symptoms and severity. According to the Center For Disease Control (CDC),
“People with ASD often have problems with social communication and interaction, and restricted or repetitive behaviors or interests. People with ASD may also have different ways of learning, moving, or paying attention.”

With ASD, there’s no cure, but it can be managed. So it’s always best to begin treatment early. But in many cases, children with ASD and their families cannot access treatment due to high costs, distance barriers, and/or limited availability of services.
And that’s where telehealth comes in. So how has telehealth been utilized in treating autism?

Role Of Telehealth In Treating Autism Spectrum Disorder.

  • Early Diagnosis Of Autism with Telehealth.

Autism generally can be identified in a child from 18 months of age. This involves screening them in their second year and beginning treatment on those who fall somewhere on the autism spectrum. However, many children are not screened at all. The parents only find out that their children are affected by the disorder when visible signs of Autism Spectrum Disorder begin to appear.

This is usually in the toddler or preschool stage of the child’s life.
Some in more rural communities, never do and tag the child as an ‘imbecile’ for life.

A lot of people, especially those from low-income communities, don’t have access to diagnostic services.
However, telehealth is used to augment the diagnostic process.
Recently, a study was carried out to test the effectiveness of telehealth in diagnosing autism.
Every remote diagnosis was followed by a physical one.
The remote doctors were able to accurately identify 78.9% of all the children who ultimately received ASD diagnoses.

This doesn’t just show that telehealth is only instrumental in early diagnosis. It also makes the diagnostic process available to everyone, regardless of location.

  • Widening Access to ABA Procedures Through Parent Training.

Applied Behavior Analysis or ABA therapy is the best and most common therapy method for children diagnosed with autism. The therapy focuses on behavioral improvement by encouraging the positive behaviors of an autistic child and discouraging the negative or harmful ones.

It also teaches the child everyday skills like basic communication, taking a bath, or brushing their teeth. It is a flexible procedure that can be tailored to meet the individual needs of every child and that’s what makes it an ideal treatment.
However, like most healthcare services, many people don’t have access to it. This is due to how expensive it is and the shortage of therapists, amongst other reasons.

What telehealth does is that it allows the child’s parents, teachers, and other caregivers to be trained on how to deliver quality ABA therapy to the children.
Through remote video coaching, parents can undergo training to effectively treat or reduce their child’s behavioral problems. This works in place of in-person consultant visits.

  • Remote Language Assessments for Children with ASD.

ASD also affects the child’s speech and communication skills so an aspect of treatment is speech therapy. To provide that service, speech-language pathologists evaluate the child’s attention or listening, their understanding of receptive language, their language of expression (i.e vocabulary and sentence formation), and social communication abilities amongst others.

Telehealth enables these assessments to be carried out remotely. It is true though that the needs of each child are different, so having a caregiver or parent assist the evaluator on one end eases the assessment.

  • Parent Coaching & Support with Telehealth.

A child with ASD displays a number of behaviors like tantrums, noncompliance, and aggression. So they require other forms of support apart from ABA therapy. Parents can be trained remotely to deliver this much support like a specialist would, if not better when emotions for the child are factored in.

  • Improving Access for the ASD Patients.

Telehealth solves the problem of scarcity of medical personnel through Remote Patient Monitoring (RPA) and better access to specialists. The services provided via telehealth include:

  • Diagnostic assessments.
  • Preference assessments
  • Early intervention.
  •  Applied Behavior Analysis (ABA)
  • Functional assessment and functional communication training.
  • Parent training.

It also addresses that challenge by equipping parents and other caregivers of the child with ASD with enough skills to care for them.
That way, they aren’t clueless about the needs of their child and can handle most situations themselves.

  • Improving Patient Outcomes and Satisfaction.

By increasing the frequency of patient monitoring and communication with patients and caregivers, we’ve seen better results with telehealth.
Specialists can modify treatment plans according to regular assessments and intervene more frequently compared to when healthcare was limited to physical visits.
The regular parent or caregiver remote training with direct-support professionals has also helped to improve the quality of healthcare. This, in turn, improves the patient’s response and outcomes to treatment.

Conclusion

Telehealth has not only bridged the gap between specialists and patients living with Autism Spectrum Disorder, but it has also raised awareness about it.
Before telehealth, many people, especially those in low-income or rural communities, had no idea of what ASD is.
Autistic symptoms were labeled as witchcraft or a disability and getting a diagnosis and treatment was out of the question.

But with telehealth on the rise, more and more children with ASD are able to get the healthcare they need, without their locations posing a problem.
Research has even argued that the services provided are equivalent, if not better, to in-person care. However, in telehealth, there’s always more ground to be covered and more depth to reach.

Author: 

Ogboi Miracle Nwachukwu.

References:
  • Bearss, K., Burrell, T. L., Challa, S. A., Postorino, V., Gillespie, S. E., Crooks, C., & Scahill, L. (2017).
    Feasibility of Parent Training via Telehealth for Children with Autism Spectrum Disorder and Disruptive Behavior: A Demonstration Pilot. Journal of Autism and Developmental Disorders, 48(4), 1020-1030. doi:10.1007/s10803-017-3363-2.
  • Signs and Symptoms of Autism Spectrum Disorders | CDC.
    https://www.cdc.gov/ncbddd/autism/signs.html
    Accessed on 10th October, 2022.
  • Telehealth & Autism – A Piece in the Puzzle | Telehealth Insights.
    https://www.healthrecoverysolutions.com/blog/telehealth-autism-diagnosis
    Accessed on 10th October, 2022.
Online medical consultation. Black sick guy talks with a therapist female doctor by video call uses laptop, getting medical consultation,receives answers to questions and recommendations for treatment

Impact Of Telehealth/Telemedicine on the Healthcare Sector.

With technology gaining more ground in medicine, it is important that we understand where we have been without it in order to truly appreciate where we are now.
That’s why this article aims to discuss the impact that telehealth and telemedicine have had on health care so far so that we can also draw up a picture of where remote care is headed in the future.

What Is Telehealth In Healthcare?

The American Academy of Family Physicians defines telehealth as “electronic and telecommunications technologies and services used to provide care and services at-a-distance.”

They also define telemedicine as “the practice of medicine using technology to deliver care at a distance. A physician in one location uses a telecommunications infrastructure to deliver care to a patient at a distant site.”

Simply put, telehealth is the umbrella term for all forms of remote care services both clinical and non-clinical while telemedicine just consists of clinical services.

Impacts of Telemedicine on Patients and Providers.

The main impact of telehealth in the health sector has been in the areas of expansion of healthcare access, reduction of costs, and enhancement of patient outcomes.

  • Reduction Of Health Care Costs.

This has been achieved by cutting down visits to the hospital, especially the emergency department for non-urgent cases. Emergency care is expensive and research has shown that about two-thirds of these visits are actually for non-urgent cases and are thus avoidable. Instead, patients can save money by using telehealth from their homes. Providers like hospitals can also cut down on costs of treatment when more people opt for remote care or home hospital services with remote patient monitoring (RPM) instead of hospital visits.

Before telehealth, the reach of medical care was considerably poor, especially in rural areas and areas cut off by geographical challenges. Death rates from negligible causes were high and there was a shortage of healthcare workers in those areas.
However now, various access barriers have been broken with the invention of remote care through factors like:
•Convenience.
People no longer have to travel to see a doctor physically thus eliminating the variable of transportation. They can now see a doctor whenever and wherever they are with just a smart device.
•Encouraging continuity.
Remote care has encouraged a continuous patient-provider relationship. This means that regardless of location, a medical care provider can continually monitor and evaluate a patient’s real-time vitals and administer treatment accordingly. This was especially important during the COVID-19 pandemic when restrictions were placed on movement. People living with chronic diseases that required constant medical attention were able to receive the care they needed.


•Encouraging specialty care.
There’s a general scarcity of specialist physicians. More and more medical facilities lack on-site medical specialist services each year. However, telehealth has improved the situation by allowing one specialist to see multiple patients even from a distance, thus deepening the reach of quality healthcare services.

  • Improving Medical Care Outcomes.

Telehealth is majorly just as effective as in-person visits. For certain patient groups, it even improves the treatment outcomes. Groups like emergency patients, ICU patients, and patients with chronic diseases generally have better outcomes with health technologies. This is because it improves communication, collaboration, productivity, response, and speed among the care workers over these patients.

Impact of Telemedicine During COVID-19 Pandemic.

In December 2019, the coronavirus virus broke out in the city of Wuhan, China and the World Health Organization announced it as a pandemic on 11th March 2020. Spreading to more than 100 countries, governments all over the world began to enforce safety measures to control the spread. Partial or total lockdowns were decreed to limit movement. As a result, taking trips to the doctor’s office wasn’t so easy anymore. That’s where telemedicine came in.

The COVID pandemic saw a huge boom in telehealth, changing the face of medical care forever. The hospitals were filled with those infected with the coronavirus and priority was given to them. So other people had limited access to healthcare systems like hospitals and clinics. Many countries began to use telemedicine to provide patients with care so as not to endanger them by risking bringing them in contact with the infected.
A Center for Disease Control (CDC) report revealed that:
•Telehealth visits in the last week of March 2020 increased by 154% compared with the same period in 2019.
•Visits during the first quarter of 2020 rose by 50% year-over-year. Most visits were unrelated to COVID-19.

Consultations were made virtually and patients were monitored remotely. Telehealth proved useful in making sure patients still had access to quality health services while still efficiently controlling the virus spread by preventing exposure. It maintained continuity and cost-effectiveness in care as well as prioritized patient and provider safety which was just what the world needed at the time.

The Center for Disease Control and Prevention (CDC) summarizes its impact by saying it helped:
•Reduce the transmission risk of COVID-19.
•Preserve personal protective equipment (PPE).
•Minimize the patient demand on health care facilities.
Since then, the use of telehealth has considerably increased globally.

How Will Telemedicine Impact The Future Of Healthcare?

Right now in the world, there are still differences in the level of awareness of the importance of telemedicine across geographic locations. Other factors like variation in infrastructural quality, the difference in levels of telehealth education in healthcare professionals, and lack of funding still hinder the impact of remote care in the global health sector.

However, we can be sure that years from now, as more countries grow in development, telehealth will be at the forefront of care services in the world, deepening the reach of medical services and cutting down mortality rates.

Conclusion.

According to the “Telemedicine Market – Forecasts from 2016 to 2021” report by Research and Markets, the global telemedicine market was estimated to be worth US$19.336 billion as of August 2016. The global telemedicine market grew at a compound annual growth rate (CAGR) of 16.76% over the forecast period and reached US$48.985 billion by 2021.

There’s still so much uncovered ground but more and more medical providers are turning to remote care and its market is rapidly expanding. Telemedicine is definitely the future of medical care.

Author:

Ogboi Miracle Nwachukwu.

References.

“Telemedicine Market – Forecasts from 2016 to 2021.” Accessed on 16th September, 2022 from
https://www.researchandmarkets.com/research/pfg6t4/telemedicine

“Top 3 Ways Telehealth is Impacting Health Care.” – Texas Woman’s University. Accessed on 16th September, 2022 from
https://onlinenursing.twu.edu/blog/top-3-ways-telehealth-impacting-health-care

“What’s The Difference Between Telemedicine And Telehealth?” – American Academy of Family Physicians. Accessed on September 16th, 2022 from
https://www.aafp.org/news/media-center/kits/telemedicine-and-telehealth.html

“Trends In The Use Of Telehealth During The Emergence Of COVID-19 Pandemic- United States January-March 2020” – Center For Disease Control and Prevention Morbidity and Mortality Weekly Report. Accessed on 16th September, 2022 from
https://www.cdc.gov/mmwr/volumes/69/wr/mm6943a3.htm