Measuring Costs and Outcomes of Tele-Intervention When Serving Families of Children who are Deaf/Hard-of-Hearing

Kristina M. Blaiser, Diane Behl, Catherine Callow-Heusser, Karl R. White

Abstract


Background: Optimal outcomes for children who are deaf/hard-of-hearing (DHH) depend on access to high quality, specialized early intervention services. Tele-intervention – the delivery of early intervention services via telehealth technology - has the potential to meet this need in a cost-effective manner.

Method: Twenty-seven families of infants and toddlers with varying degrees of hearing loss participated in a randomized study, receiving their services primarily through TI or via traditional in-person home visits. Pre- and post-test measures of child outcomes, family and provider statisfaction, and costs were collected.

Results: The TI group scored statistically significantly higher on the expressive language measure than the in-person group (p =.03). A measure of home visit quality revealed that the TI group scored statistically significantly better on the Parent Engagement subscale of the Home Visit Rating Scales-Adapted & Extended (HOVRS-A+; Roggman, et al., 2012). Cost savings associate with providing services via TI increased as the intensity of service delivery increased. Although most providers and families were positive about TI, there was great variability in their perceptions.

Conclusions: Tele-intervention is a promising cost-effective method for delivering high quality early intervention services to families of children who are DHH.


References


American Speech-Language-Hearing Association. (2005a). Audiologists providing clinical services via telepractice. [Position statement].

American Speech-Language-Hearing Association. (2005b). Speech-language pathologists providing clinical services via telepractice. [Position statement].

Behl, D., Houston, K. T., & Stredler-Brown, A. (2012). The value of a learning community to support telepractice for infants and toddlers with hearing loss. Volta Review, 112, 313-296.

Blaiser, K., Edwards, M., Behl, D., & Muñoz, K. (2012). Tele-intervention services at Sound Beginnings at Utah State University. Volta Review, 112, 365-372.

Cason, J., Behl, D., & Ringwalt, S. (2012). Overview of states’ use of telehealth for the delivery of early intervention (IDEA Part C) services. International Journal of Telerehabilitation, 4, 39-46. doi: 10.5195/ijt.2012.6105

Center for Disease Control and Prevention (CDC). (2013). Summary of national CDC 2011 EHDI data. Retrieved from http://www.cdc.gov/ncbddd/hearingloss/ehdi-data2011.html

Hjelm, N. M. (2005). Benefits and drawbacks of telemedicine. Journal of Telemedicine and Telecare, 11, 60-70.

Hope Publishers. (2004). Language Development Scale. Retrieved from http://www.hopepubl.com

Koehlinger, K., Owen Van Horne, A. J., & Moeller, M. P. (2013). Grammatical outcomes of 3 & 6 year old children with mild to severe hearing loss. Journal of Speech-Language-Hearing Research. Manuscript in preparation.

Mashima, M. & Doarn, C. (2008). Overview of telehealth activities in speech-language pathology. Telemedicine and e-Health, 14, 1101-1117.

McCann, D.C., Worsfold, S., Law, C.M., Mullee, M., Petou, S., Stevenson, J.,… Kennedy, C.R. (2009). Reading and communication skills after universal newborn screening for permanent childhood hearing impairment. Archives of Disease in Childhood, 94, 293-297.

National Center for Hearing Assessment and Management. (2010). NCHAM 2010 Telehealth Survey. Retrieved from http://www.infanthearing.org/telehealth/docs/Telehealth%20Survey%20Summary.pdf

Outcomes of children with hearing loss: A study of children ages birth to six. 2013. Funded by the National Institute of Deafness and Other Communicative Disorders grant # DC009560. Retrieved from http://www.uiowa. edu/~ochl.

Roggman, L.A., Cook, G.A., Innocenti, M.S., Jump Norman, V.K., Christiansen, K., Boyce, L. K., … Hallgren, K. (2012). Home Visit Rating Scales—Adapted and Extended (HOVRS-A+). Baltimore, MD: Brooks Publishing.

Rosenfeld, M. (2002, October). Report on the ASHA speech-language pathology health care survey. Rockville, MD: American Speech-Language-Hearing Association.

Scott, R.E., McCarthy, F.G., Jennett, P.A., Perverseff, T., Lorenzetti, D., Saeed, A., … Yeo, M. (2007). Telehealth outcomes: A synthesis of the literature and recommendations for outcome indicators. Journal of Telemedicine and Telecare, 13(Suppl)2, 1-38.

Strong, C. J., Clark, T. C., Barringer, D. G., Walden, B. E., & Williams, S. A. (1992). SKI-HI home-based programming for children with hearing impairments: Demographics, child identification, and program effectiveness, 1979-1991. A three-year study conducted at the SKI-HI Institute. Logan, UT: SKI-HI Institute, Utah State University.

Tonelson, S. W. (1980). A validation study of the SKI-HI language development scale (Unpublished doctoral dissertation). University of Virginia, Charlottesville, VA. (AAT 8102583)

Toward Equality. (1988). A report to the Congress of the United States: Toward equality- Commission on Education of the Deaf. Washington, DC: U.S. Government Printing Office.

Vogel, C.A., Boller, K., Xue, Y., Blair, R., Aikens, N., Burwick, A., … Stein, J.. (2011). Learning as we go: A first snapshot of Early Head Start programs, staff, families, and children. Report No. 2011-7. Washington, DC: Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services.

White, K. R., (2007). Early intervention for children with permanent hearing loss: Finishing the EHDI revolution. The Volta Review, 106, 237-258.

White K. R., Forsman, I., Eichwald, J., & Muñoz, K. (2010). The evolution of early hearing detection and intervention programs in the United States. Seminars in Perinatology, 34, 170-179.

Wootton, R. (2001). Recent advances: Telemedicine. British Medical Journal, 323, 557-560.




DOI: https://doi.org/10.5195/ijt.2013.6129

  

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