Overview of States' Use of Telehealth for the Delivery of Early Intervention (IDEA Part C) Services
Background: Early intervention (EI) services are designed to promote the development of skills and enhance the quality of life of infants and toddlers who have been identified as having a disability or developmental delay, enhance capacity of families to care for their child with special needs, reduce future educational costs, and promote independent living (NECTAC 2011). EI services are regulated by Part C of the Individuals with Disabilities Education Improvement Act (IDEA); however, personnel shortages, particularly in rural areas, limit access for children who qualify. Telehealth is an emerging delivery model demonstrating potential to deliver EI services effectively and efficiently, thereby improving access and ameliorating the impact of provider shortages in underserved areas. The use of a telehealth delivery model facilitates inter-disciplinary collaboration, coordinated care, and consultation with specialists not available within a local community. Method: A survey sent by the National Early Childhood Technical Assistance Center (NECTAC) to IDEA Part C coordinators assessed their utilization of telehealth within states’ IDEA Part C programs. Reimbursement for provider type and services and barriers to implement a telehealth service delivery model were identified. Results: Representatives from 26 states and one jurisdiction responded to the NECTAC telehealth survey. Of these, 30% (n=9) indicated that they are either currently using telehealth as an adjunct service delivery model (n=6) or plan to incorporate telehealth within the next 1-2 years (n=3). Identified telehealth providers included developmental specialists, teachers of the Deaf/Hard of Hearing (DHH), speech-language pathologists, occupational therapists, physical therapists, behavior specialists, audiologists, and interpreters. Reimbursement was variable and included use of IDEA Part C funding, Medicaid, and private insurance. Expressed barriers and concerns for the implementation of telehealth as a delivery model within Part C programming included security issues (40%; n=11); privacy issues (44%; n=12); concerns about quality of services delivered via telehealth (40%; n=11); and lack of evidence to support the effectiveness of a telehealth service delivery model within IDEA Part C programming (3%; n=1). Reimbursement policy and billing processes and technology infrastructure were also identified as barriers impacting the implementation of telehealth programming. Conclusions: Provider shortages impact the quantity and quality of services available for children with disabilities and developmental delay, particularly in rural areas. While many states are incorporating telehealth within their Early Intervention (IDEA Part C) services in order to improve access and overcome personnel shortages, barriers persist. Policy development, education of stakeholders, research, utilization of secure and private delivery platforms, and advocacy may facilitate more widespread adoption of telehealth within IDEA Part C programs across the country.
Baharav, E. & Reiser, C. (2010). Using telepractice in parent training in early autism. Telemedicine and e-Health, 16, 727-731.
Behl, D., Houston, K. T, Guthrie, W. S., & Guthrie, N. (2010). Tele-intervention: The wave of the future fits families’ lives today. Exceptional Parent, 40, 23-28.
Boyle, C., Boulet, S., Scheve, L., Cohen, R., Blumber, S., Yeargin-Allsopp, M…Kogan, M. (2011). Trends in the prevalence of developmental disabilities in US children, 1997-2008. Pediatrics, 127, 1034-1043. doi: 10:10.1542/peds.2010-2989. Available at: http://pediatrics.aappublications.org/content/early/2011/05/19/peds.2010-2989.full.pdf+html
Cason, J. (2009). A pilot telerehabilitation program: Delivering early intervention services to rural families. International Journal of Telerehabilitation, 1, 29-37.
Cason, J. (2011). Telerehabilitation: An adjunct service delivery model for early intervention services. International Journal of Telerehabilitation, 3(1), 19-30. doi: 10.5195/IJT.2011.6071
Center for Disease Control and Prevention [CDC]. (2011). Cerebral Palsy occurrence in the US. Retrieved from http://www.cdc.gov/features/dscerebralpalsy/index.html
Center for Disease Control and Prevention [CDC]. (2012). Autism Spectrum Disorders: Data and statistics. Retrieved from http://www.cdc.gov/NCBDDD/autism/data.html
Heimerl, S., & Rasch, N. (2009). Delivering developmental occupational therapy consultation services through telehealth. Developmental Disabilities Special Interest Section Quarterly, 32(3), 1-4.
Individuals with Disabilities Education Improvement Act [IDEA] of 2004, 20 U.S.C 1400 et seq. (2004).
Kelso, G., Fiechtl, B., Olsen, S., & Rule, S. (2009). The feasibility of virtual home visits to provide early intervention: A pilot study. Infants & Young Children, 22, 332-340.
Liu, C.L., Farrell, J., MacNeil, J.R., Stone, S., & Barfield, W. (2008). Evaluating loss to follow-up in newborn hearing screening in Massachusetts. Pediatrics, 121, e335-e343.
National Early Childhood Technical Assistance Center [NECTAC]. (2011). The importance of early intervention for infants and toddlers with disabilities and their families. Retrieved from http://www.nectac.org/~pdfs/pubs/importanceofearlyintervention.pdf
National Early Childhood Technical Assistance Center [NECTAC]. (2012a). Early intervention program for infants and toddlers with disabilities (IDEA Part C). Retrieved from http://www.nectac.org/partc/partc.asp
National Early Childhood Technical Assistance Center [NECTAC]. (2012b). Annual appropriations and number of children served under Part C of IDEA: Federal fiscal years 1987-2012. Retrieved from http://www.nectac.org/partc/partcdata.asp
National Early Childhood Technical Assistance Center [NECTAC]. (2012c). Part C SPP/APR indicator analyses: 2012 SPP/APR indicator analyses FFY 2010-2011. Retrieved from http://www.nectac.org/partc/partcapr.asp
National Institute of Health. (2009, December). Cerebral palsy: Hope through research. National Institute of Neurological Disorders and Stroke. NIH Publication No. 10-159. Retrieved from http://www.ninds.nih.gov/disorders/cerebral_palsy/detail_cerebral_palsy.htm
Rosenberg, S., Zhang, D. & Robinson, C. (2008). Prevalence of developmental delays and participation in early intervention services for young children. Pediatrics, 121, e1503-e1509. doi: 10.1542/peds.2007-1680.
SurveyGizmo [Computer software]. (2012). Boulder, Colorado: SurveyGizmo.
Vohr, B.R., Carty, L.M., Moore, P.E., & Letourneau, K. (1998). The Rhode Island Hearing Assessment Program: Experience with statewide hearing screening (1993-1996). Journal of Pediatrics, 133, 353-357.
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