AMHERST, Mass. - As the number of children diagnosed with autism spectrum disorders continues to grow and the shortage of speech/language pathologists and related specialists gets more acute, particularly in rural areas, researchers at the University of Massachusetts Amherst are using live, secure video teleconferencing over the Internet to provide remedial services and help more schools and families connect with professionals.
"The lack of trained specialists is a major obstacle when trying to provide services to individuals with disabilities. Rural areas are the hardest hit," says Michelle Boisvert, a doctoral candidate in the speech language pathology concentration at UMass Amherst. With Professor Mary Andrianopoulos, she is now conducting a pilot and feasibility study, bringing speech and language services to a grade-school boy with an autism spectrum disorder by live video link between the UMass Amherst campus and his Sunderland classroom.
Boisvert, with five other doctoral students, is funded by an $800,000 research-to-practice training grant from the U.S. Department of Education to Andrianopoulos and colleagues in UMass Amherst’s communication disorders department. Boisvert is a sought-after speaker on telepractice at workshops and task forces for those who wish to learn about using the new tools.
Telepractice, sometimes known as telemedicine, has the potential to significantly improve access to services for children with special needs, including children on the autism spectrum, says Boisvert. She will discuss her recent review of telepractice studies at the American Speech Hearing Association meeting in Philadelphia on Nov. 20. Most of the studies provided services using inexpensive, commonly available technology such as Skype and iChat with a laptop rather than a dedicated studio
Her review appears in this month’s issue of the journal Developmental Neurorehabilitation. It suggests that telepractice offers a promising approach to helping families obtain professional services while keeping cost and travel time down. One important finding, she says, is that "students achieve comparable progress through telepractice as they do when the session is conducted face-to-face."
Another of her findings is that therapists must frequently assess progress to make sure that the quality of telepractice is equivalent to that of appropriate face-to-face therapy. "But once the clinician, child and family have established a personal connection, ongoing telepractice therapy sessions allow for more consistent services and evidence-based practice as well as a reduction in travel time for all those involved," she says.
Parents can gain from the new tool, as well, because many teleconferencing setups allow more than two secure video links per session, allowing them to observe their child’s speech therapy session. "This allows parents to be more aware of what is going on in their child''s speech and language therapy session," Boisvert adds.
Telepractice has been used for some time to connect doctors with homebound patients recovering from chronic conditions such as heart disease and stroke, and for consultations. Boisvert says that as high-speed Internet access comes to more rural areas and as new technologies with more efficient delivery models emerge, introducing telepractice into educational settings is a next logical step.
In her recent review, Boisvert looked at eight published studies that reported on delivery of telepractice services to children with autism spectrum disorders. Services included behavioral and diagnostic assessments, educational consulting, behavioral interventions, coaching and training to a total of 46 participants. Boisvert’s current research is designed to show that telepractice works when properly administered in a reliable and valid manner.
At present, the speech language pathologist says, the most difficult obstacles to this new approach are related to technical issues such as bandwidth access and firewalls. However, with a strong on-site team that includes IT support, connections are being made. Boisvert notes, "The number of children in the United States diagnosed with an autism spectrum disorder has increased and is now reported to be as high as three to six cases per 1,000 children. It’s important that we provide services for all who need them. Early intervention using evidence-based practices is an effective vehicle for improving long-term outcomes for these children."