Lessons Learned in Telehealth Services: Tips for Professionals and Families By Alana Ianello, MAT, BCBA & Louise Southern, M.Ed., BCBA
The world seems vastly different than it was in 2019. As we try to adjust to wearing facial coverings, staying at home, working from home, meeting virtually, and online schooling, many must also explore the world of telehealth. Telehealth services typically involve live, two-way video interaction between a professional and the client (the individual, and their caregivers). Almost overnight, many caregivers had to learn how to navigate new online and telehealth technologies to support their child. For some individuals with autism and their families, this period has been supremely challenging for many reasons. Some individuals with autism respond effectively and independently to well-structured telehealth services. They interact with the professional, learn from the virtually delivered content, and enjoy those virtual sessions. However, other individuals with autism struggle to access and respond to telehealth without ongoing, direct facilitation or mediation by a caregiver. In these situations, the caregiver becomes the instructor, and the professional is there through telehealth to coach and support the caregiver as they work with the individual.
Telehealth Strategies and Guidelines In any case, there are strategies and guidelines to consider when providing telehealth services to support individuals with autism, and below are just a few of these: • Assure that everyone is very comfortable with technology and the telehealth platform. Build in time to support individuals with autism and caregivers in accessing and using the technology. • For some individuals with autism, it is most effective and appropriate to start with short telehealth sessions (5 or 10 minutes) and build up from there as they begin to understand and engage with this new format. • It may be necessary to adjust goals during this unique and challenging time. Prioritize and focus on skills valued most by the individual and their family. • For some caregivers/parents who are providing parentmediated telehealth services, it may be most effective to start with shorter sessions and build up from there. Again, it needs to work for the family. • Discuss a plan with the caregiver to establish their needs for upcoming sessions. If a caregiver will be facilitating the session, identify the natural family routines and activities in which skills could be targeted. Prep the family with any materials needed for the session. 4 • The Spectrum, Summer 2020
• Be sure to choose a time for telehealth sessions that aligns well with the caregiver’s schedule. It needs to work for the family. • Structure the sessions for success. Use familiar visual supports (e.g., schedule, agenda, activities plan) to clarify what will happen and in what order for the individual with autism. There are a wide range of telehealth platforms, tools, and online resources that enable screen sharing, dynamic interactions, and varied response forms. • While many individuals with autism may gravitate toward technology, some are not accustomed to interfacing with technology in this way. It is likely that the professional will need to take things slowly, and keep things relaxed and “work-free” at first. For instance, use preferred videos, music, and online interactive games. Build in breaks. Continual interaction in a virtual platform can be overwhelming and exhausting for some. • Continue to provide choices! We all need choices, especially in a time when it seems that our choices are incredibly limited for where we can go and what we can do. Provide
