“This Is Going To Be Different, But It’s Not Impossible”: Adapting To Telehealth Occupational Therapy For Autistic Children

Authors

  • Amber M. Angell USC Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
  • Elinor E. Taylor USC Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
  • Joana Nana Serwaa Akrofi Department of Occupational Therapy, New York University, New York, New York, USA
  • Elaine D. Carreon Nurture Collective, Whittier, California, USA
  • Marshae D. Franklin USC Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
  • Julie Miller Professional Child Development Associates, Pasadena, California, USA
  • Catherine Crowley USC Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
  • Shona Orfirer Maher Devoted Educational Solutions, Los Angeles, California, USA

DOI:

https://doi.org/10.5195/ijt.2024.6608

Keywords:

Autism, Covid-19, Occupational therapy, Pandemic, Telehealth, Telerehabilitation

Abstract

This qualitative study examined participants’ experiences of transitioning to telehealth-delivered pediatric occupational therapy for autistic children during the COVID-19 pandemic. We interviewed three clinic administrators, four occupational therapists, and six parents of autistic children (n=13) from three Los Angeles area clinics over a 7-month period. Our narrative and thematic analyses yielded three overarching themes: Transformative Experiences, Reimagining Therapy, and Going Forward. Overall, we found that the transition to telehealth shifted participants’ preconceptions about themselves, their relationships, and the nature of occupational therapy. Many deepened their relationships; adapted interventions; uncovered surprising capabilities; and challenged the occupational therapy status quo to advocate for ongoing virtual delivery. Our findings bear relevance to the body of current literature debating the post-pandemic viability of telehealth-delivered occupational therapy.

  

References

Angell, A. M., Carreon, E. D., Akrofi, J. N. S., Franklin, M. D., Taylor, E. E., Miller, J., Crowley, C., & Maher, S. O. (2023). Challenges and facilitators to telehealth occupational therapy for autistic children during COVID-19. Occupational Therapy Journal of Research, 1–10. https://doi.org/10.1177/15394492221142597

Angell, A. M., Empey, A., & Zuckerman, K. E. (2018). A review of diagnosis and service disparities among children with autism from racial and ethnic minority groups in the United States. In R. M. Hodapp & D. J. Fidler (Eds.), International Review of Research in Developmental Disabilities, 55, 145–180). Academic Press. https://doi.org/10.1016/bs.irrdd.2018.08.003

Ashburner, J., Vickerstaff, S., Beetge, J., & Copley, J. (2016). Remote versus face-to-face delivery of early intervention programs for children with autism spectrum disorders: Perceptions of rural families and service providers. Research in Autism Spectrum Disorders, 23, 1–14. https://doi.org/10.1016/j.rasd.2015.11.011

Ayres, A. J. (1972). Sensory integration and learning disorders. WPS.

Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. https://doi.org/10.1191/1478088706qp063oa

Camden, C., & Silva, M. (2021). Pediatric telehealth: Opportunities created by the COVID-19 and suggestions to sustain its use to support families of children with disabilities. Physical and Occupational Therapy in Pediatrics, 41(1), 1–17. https://doi.org/10.1080/01942638.2020.1825032

Dallman, A. R., Williams, K. L., & Villa, L. (2022). Neurodiversity-affirming practices are a moral imperative for occupational therapy. The Open Journal of Occupational Therapy, 10(2), 1–9. https://doi.org/10.15453/2168-6408.1937

Ellison, K. S., Guidry, J., Picou, P., Adenuga, P., & Davis, T. E. (2021). Telehealth and autism prior to and in the age of COVID-19: A systematic and critical review of the last decade. Clinical Child and Family Psychology Review, 24(3), 599–630. https://doi.org/10.1007/s10567-021-00358-0

Gibbs, V., & Toth-Cohen, S. (2011). Family-centered occupational therapy and telerehabilitation for children with autism spectrum disorders. Occupational Therapy in Health Care, 25(4), 298–314. https://doi.org/10.3109/07380577.2011.606460

Greenspan, S., & Wieder, S. (2008). DIR®/FloortimeTM Model. The International Council on Developmental and Learning Disorders.

Lamash, L., Gal, E., & Bedell, G. (2023). Social participation and navigation: Formative evaluation of a remote intervention for autistic adolescents and young adults. OTJR: Occupational Therapy Journal of Research, 43(3), 505–512. https://doi.org/10.1177/15394492221146726

Letts, L., Wilkins, S., Law, M., Stewart, D., Bosch, J., & Westmorland, M. (2007). Guidelines for critical review form: Qualitative studies (version 2.0) (pp. 1–12).

Little, L. M., Pope, E., Wallisch, A., & Dunn, W. (2018). Occupation-based coaching by means of telehealth for families of young children with autism spectrum disorder. American Journal of Occupational Therapy, 72(2), 1–7. https://doi.org/10.5014/ajot.2018.024786

Little, L. M., & Proffitt, R. (2023). OTJR special issue on telehealth editorial. Occupational Therapy Journal of Research, 43(3), 339–341. https://doi.org/10.1177/15394492231177330

Little, L. M., Wallisch, A., Dunn, W., & Tomchek, S. (2023). A telehealth delivered toilet training intervention for children with autism. Occupational Therapy Journal of Research, 43(3), 390–398. https://doi.org/10.1177/15394492231159903

Little, L. M., Wallisch, A., Pope, E., & Dunn, W. (2018). Acceptability and cost comparison of a telehealth intervention for families of children with autism. Infants and Young Children, 31(4), 275–286. https://doi.org/10.1097/IYC.0000000000000126

Pineda, R., Smith, D., Richter, M., Gruskin, B. A., Dusing, S., & Peden, C. J. (2023). Health care professionals’ perceptions about a telehealth model of therapy after NICU discharge. Occupational Therapy Journal of Research, 43(3), 495–504. https://doi.org/10.1177/15394492231153997

Ranjan, G. K., Gandhi, S., & Sivakumar, T. (2023). Experiences of the occupational therapists during the COVID-19 pandemic: A scoping review. Journal of Psychosocial Rehabilitation and Mental Health, 1–17. https://doi.org/10.1007/s40737-023-00338-3

Reissman, C. K. (1993). Narrative analysis. Sage Publications, Inc.

Rogers, S. (2016). Early Start Denver Model. In Comprehensive models of autism spectrum disorder treatment (pp. 45–62). Springer.

Rosenfeld, K., & Brooks, R. (2023). Occupational therapists’ perspectives of using telehealth for youth with autism amidst the COVID-19 pandemic in the UK: A pilot qualitative study. Journal of Occupational Therapy, Schools, & Early Intervention, 0(0), 1–15. https://doi.org/10.1080/19411243.2023.2215756

Sleight, A. G., Klein, C. M., Feldman, A. E., & Stein Duker, L. I. (2023). Telehealth utilization among occupational therapists in oncology: Results from a national survey. Occupational Therapy Journal of Research, 43(3), 523–530. https://doi.org/10.1177/15394492221148985

Taylor, E. (2022). Beyond ‘bad’ behaviors: A call for occupational scientists to rethink autism. Journal of Occupational Science, 30(4), 575-590. https://doi.org/10.1080/14427591.2022.2136231

Downloads

Published

2024-06-28

How to Cite

Angell, A., Taylor, E., Akrofi, J. N. S., Carreon, E. D., Franklin, M., Miller, J., Crowley, C., & Maher, S. (2024). “This Is Going To Be Different, But It’s Not Impossible”: Adapting To Telehealth Occupational Therapy For Autistic Children. International Journal of Telerehabilitation, 16(1). https://doi.org/10.5195/ijt.2024.6608

Issue

Section

Occupational Therapy Telehealth