Comparison of Goal Achievement When Transitioning from In-Person Therapy to Teletherapy in the Westchester County Early Intervention Program Due to the COVID-19 Pandemic
Keywords:COVID-19, Early intervention, Telehealth
The sudden transition to virtual therapeutic services during the COVID-19 pandemic provided a unique opportunity to explore telehealth as a platform for delivering early intervention (EI) services. Through retrospective chart review of 93 children, we collected the following data: demographics, diagnosed conditions, therapy type, service format, and provider-reported participant goal achievement (1=no progress, 2=little progress, 3=moderate progress, 4=great deal of progress, 5=outcome achieved) over a six-month period before and after transitioning to telehealth. Pre- and post-transition progress scores were compared using the Wilcoxon signed-rank test. Results demonstrated maintained progress among children who transitioned from in-person to virtual services for similar therapy types. Children receiving speech therapy in-person and virtually demonstrated increased achievement (3.00 vs 3.33; p=0.032). Participants receiving a particular therapy post-transition but not in-person attained similar achievement as those who received the same therapy only in-person. Our research suggests that teletherapy may be a viable option for delivering EI services.
American Telemedicine Association. (2020). Telehealth: Defining 21st Century Care. https://www.americantelemed.org/resource/why-telemedicine/
Behl, D. D., Houston, K. T., Guthrie, W. S., & Guthrie, N. K. (2010). Tele-Intervention: The wave of the future fits families’ lives today. Exceptional Parent, 40(12), 23–28.
Behl, D. D., Blaiser, K., Cook, G., Barrett, T., Callow-Heusser, C., Brooks, B. M., Dawson, P., Quigley, S., & White, K. R. (2017). A multisite study evaluating the benefits of early intervention via telepractice. Infants & Young Children, 30(2), 147-161. https://doi.org/10.1097/iyc.0000000000000090
Blaiser, K. M., Behl, D., Callow-Heusser, C., & White, K. R. (2013). Measuring costs and outcomes of tele-intervention when serving families of children who are deaf/hard-of-hearing. International Journal of Telerehabilitation, 5(2), 3–10. https://doi.org/10.5195/ijt.2013.6129
Camden, C., Pratte, G., Fallon, F., Couture, M., Berbari, J., & Tousignant, M. (2020). Diversity of practices in telerehabilitation for children with disabilities and effective intervention characteristics: results from a systematic review. Disability and Rehabilitation, 42(24), 3424–3436. https://doi.org/10.1080/09638288.2019.1595750
Cason J. (2009). A pilot telerehabilitation program: Delivering early intervention services to rural families. International Journal of Telerehabilitation, 1(1), 29–38. https://doi.org/10.5195/ijt.2009.6007
Centers for Disease Control and Prevention. (2019). What is “early intervention”?. https://www.cdc.gov/ncbddd/actearly/parents/states.html
Chiu, S. J., Lin, I. F., Chou, Y. T., & Chien, L. Y. (2020). Family quality of life among Taiwanese children with developmental delay before and after early intervention. Journal of Intellectual Disability Research, 64(8), 589–601. https://doi.org/10.1111/jir.12754
Cole, B., Pickard, K., & Stredler-Brown, A. (2019). Report on the use of telehealth in early intervention in Colorado: Strengths and challenges with telehealth as a service delivery method. International Journal of Telerehabilitation, 11(1), 33–40. https://doi.org/10.5195/ijt.2019.6273
Constantinescu, G., Waite, M., Dornan, D., Rushbrooke, E., Brown, J., McGovern, J., Ryan, M., & Hill, A. (2014). A pilot study of telepractice delivery for teaching listening and spoken language to children with hearing loss. Journal of Telemedicine and Telecare, 20(3), 135–140. https://doi.org/10.1177/1357633X14528443
Eslami Jahromi, M., & Ahmadian, L. (2021). Determining the effect of tele-rehabilitation on patients with stutter using the goal attainment scaling (GAS). BMC Medical Informatics and Decision Making, 21(1), 280. https://doi.org/10.1186/s12911-021-01642-3
Fung, A., & Ricci, M. F. (2020). Rethinking 'essential' and 'nonessential': the developmental paediatrician's COVID-19 response. Paediatrics & Child Health, 25(5), 265–267. https://doi.org/10.1093/pch/pxaa077
Graham, F., Rodger, S., & Ziviani, J. (2013). Effectiveness of occupational performance coaching in improving children’s and mothers’ performance and mothers’ self-competence. American Journal of Occupational Therapy, 67(1), 10-18. https://doi.org/10.5014/ajot.2013.004648
Ingersoll, B., Wainer, A. L., Berger, N. I., Pickard, K. E., & Bonter, N. (2016). Comparison of a self-directed and therapist-assisted telehealth parent-mediated intervention for children with ASD: a pilot RCT. Journal of Autism and Developmental Disorders, 46(7), 2275–2284. https://doi.org/10.1007/s10803-016-2755-z
Kronberg, J., Tierney, E., Wallisch, A., & Little, L. M. (2021). Early intervention service delivery via telehealth during COVID-19: A research-practice partnership. International Journal of Telerehabilitation, 13(1), e6363. https://doi.org/10.5195/ijt.2021.6363
Lalios, A. P. (2012). ConnectHear teleIntervention program. Volta review, 112(3), 357–364.
Little, L. M., & Stoffel, A. (2021). Adaptations to early intervention service delivery during COVID-19. The Open Journal of Occupational Therapy, 9(3), 1-9. https://doi.org/10.15453/2168-6408.1845
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 & Young Children, 31(4), 275–286. https://doi.org/10.1097/IYC.0000000000000126
Milne Wenderlich, A., & Herendeen, N. (2021). Telehealth in pediatric primary care. Current Problems in Pediatric and Adolescent Health Care, 51(1), 100951. https://doi.org/10.1016/j.cppeds.2021.100951
Murphy, A., Pinkerton, L. M., Bruckner, E., & Risser, H. J. (2021). The impact of the novel coronavirus disease 2019 on therapy service delivery for children with disabilities. The Journal of Pediatrics, 231, 168–177.e1. https://doi.org/10.1016/j.jpeds.2020.12.060
New York State Department of Health. (2020). New York State Department of Health Bureau of Early Intervention guidance to early intervention providers regarding novel coronavirus (COVID-19). https://www.health.ny.gov/community/infants_children/early_intervention/docs/doh_covid19_eiproviders_04.01.20
Olsen, S., Fiechtl, B., & Rule, S. (2012). An evaluation of virtual home visits in early intervention: Feasibility of "virtual intervention." Volta Review, 112, 267-281. https://doi.org/10.17955/tvr.112.3.m.702
Palisano, R. J., & Murr, S. (2009). Intensity of therapy services: What are the considerations? Physical & Occupational Therapy in Pediatrics, 29(2), 107–112. https://doi.org/10.1080/01942630902805186
Philipps, J., De Leon, I.C., Yoegel, M., Byrnes, J., & Kase, J. (2021). Remote early intervention therapy experience from the perspective of both the child/family dyad and the provider during the COVID-19 pandemic [Unpublished Manuscript]. School of Medicine, New York Medical College.
Smythe, T., Zuurmond, M., Tann, C.J., Gladstone, M., & Kuper, H. (2021). Early intervention for children with developmental disabilities in low and middle-income countries – the case for action. International Health, 13(3), 222-231. https://doi.org/10.1093/inthealth/ihaa044
Theodoros D. (2012). A new era in speech-language pathology practice: innovation and diversification. International Journal of Speech-Language Pathology, 14(3), 189–199. https://doi.org/10.3109/17549507.2011.639390
Wales, D., Skinner, L., & Hayman, M. (2017). The efficacy of telehealth-delivered speech and language intervention for primary school-age children: A systematic review. International Journal of Telerehabilitation, 9(1), 55–70. https://doi.org/10.5195/ijt.2017.6219
Wallisch, A., Little, L., Pope, E., & Dunn, W. (2019). Parent perspectives of an occupational therapy telehealth intervention. International Journal of Telerehabilitation, 11(1), 15–22. https://doi.org/10.5195/ijt.2019.6274
How to Cite
Authors who publish with this journal agree to the following terms:
- The Author retains copyright in the Work, where the term “Work” shall include all digital objects that may result in subsequent electronic publication or distribution.
- Upon acceptance of the Work, the author shall grant to the Publisher the right of first publication of the Work.
- The Author shall grant to the Publisher and its agents the nonexclusive perpetual right and license to publish, archive, and make accessible the Work in whole or in part in all forms of media now or hereafter known under a Creative Commons Attribution 4.0 International License or its equivalent, which, for the avoidance of doubt, allows others to copy, distribute, and transmit the Work under the following conditions:
- Attribution—other users must attribute the Work in the manner specified by the author as indicated on the journal Web site;
- The Author is able to enter into separate, additional contractual arrangements for the nonexclusive distribution of the journal's published version of the Work (e.g., post it to an institutional repository or publish it in a book), as long as there is provided in the document an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post online a prepublication manuscript (but not the Publisher’s final formatted PDF version of the Work) in institutional repositories or on their Websites prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work. Any such posting made before acceptance and publication of the Work shall be updated upon publication to include a reference to the Publisher-assigned DOI (Digital Object Identifier) and a link to the online abstract for the final published Work in the Journal.
- Upon Publisher’s request, the Author agrees to furnish promptly to Publisher, at the Author’s own expense, written evidence of the permissions, licenses, and consents for use of third-party material included within the Work, except as determined by Publisher to be covered by the principles of Fair Use.
- The Author represents and warrants that:
- the Work is the Author’s original work;
- the Author has not transferred, and will not transfer, exclusive rights in the Work to any third party;
- the Work is not pending review or under consideration by another publisher;
- the Work has not previously been published;
- the Work contains no misrepresentation or infringement of the Work or property of other authors or third parties; and
- the Work contains no libel, invasion of privacy, or other unlawful matter.
- The Author agrees to indemnify and hold Publisher harmless from Author’s breach of the representations and warranties contained in Paragraph 6 above, as well as any claim or proceeding relating to Publisher’s use and publication of any content contained in the Work, including third-party content.
Revised 7/16/2018. Revision Description: Removed outdated link.