Background & Aims

Estimates suggest that one in 59 children receive a diagnosis of autism and that early intervention can be effective if applied consistently and intensively. Parent implemented intervention can increase intervention consistency and intensity however, availability of providers, geographical factors, time constraints, and parental stress levels can all act as barriers to service access. Limitations in understanding elements that support family engagement can also impact participation in intervention. Telepractice can increase availability of intervention services and decrease the time and costs associated with face-to-face delivery. Research focused on children with autism has shown that telepractice is acceptable to parents. Despite positive findings for telepractice services with individual clients, limited research has been conducted on telepractice services for parent groups; parent perceptions and preferences regarding intervention; and service delivery methods. This research aimed to investigate parent perceptions of a group intervention programme for autism; the telepractice approach; parent and child outcomes; and parental stress. The purpose of the investigation was to build an understanding of parent's intervention preferences to inform future service offerings, increase choice, and support participation.

Methods

Eleven parents of preschool children with autism participated in a telepractice delivered group training programme called Hanen More Than Words (HMTW). The intervention is traditionally delivered face to face and teaches strategies to facilitate social-communication development in young children.

Quantitative and qualitative measures were used to evaluate parent perceptions of the telepractice HMTW intervention. Data were collected via the Parenting Stress Index, HMTW programme evaluation forms, and online parent survey.

Quantitative data was analysed using descriptive statistics. Pre- and post-intervention comparisons of parenting stress were conducted using paired T-Tests. Open comment field responses were analysed qualitatively using a directed content analysis.

Results

Parents reported high levels of satisfaction with telepractice delivered HMTW across intervention and post programme evaluations. Interactive learning opportunities, group participation, video coaching, individualisation of service, and programme facilitation were identified as key supports to learning.

Parents perceived increased insight into the interaction, learning, and behaviour of themselves and their children. They reported positive changes in strategy implementation and confidence. Parents also perceived improvements in their children's communication, responsiveness, interaction, and play following intervention. Parental stress measurements from pre- to post intervention, were not significantly different.

Conclusions

Telepractice may reduce service barriers and improve access, particularly with the efficiency of a group delivery approach. Utilising technology to deliver group intervention was acceptable to parents and perceived to have positive outcomes for both parent and child. Further investigation into parent perceptions of intervention types and delivery approaches, could facilitate a broader understanding of family needs with respect to service access and engagement.

Implications

Expansion of telepractice offerings can increase efficiencies and service choice for families and providers. Limitations in service availability and barriers to service access and engagement, confirm the importance of pursuing ongoing service improvements and evaluating the preferences of service users. Development of standardised tools to measure and compare parent perceptions across intervention types and service delivery approaches would be beneficial.

中文翻译：

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家长对自闭症团体远程医疗沟通干预的看法

背景与目标

据估计，每 59 名儿童中就有 1 名被诊断为自闭症，如果持续和深入地进行早期干预，早期干预是有效的。父母实施的干预可以提高干预的一致性和强度，但是，提供者的可用性、地理因素、时间限制和父母的压力水平都可能成为获得服务的障碍。在理解支持家庭参与的要素方面的局限性也会影响干预的参与。远程医疗可以增加干预服务的可用性，并减少与面对面交付相关的时间和成本。针对自闭症儿童的研究表明，家长可以接受远程治疗。尽管对个人客户的远程医疗服务有积极的发现，对家长团体的远程医疗服务进行了有限的研究；家长对干预的看法和偏好；和服务提供方式。这项研究旨在调查家长对自闭症团体干预计划的看法；远程诊疗方法；父母和孩子的结果；和父母的压力。调查的目的是了解家长的干预偏好，以便为未来的服务产品、增加选择和支持参与提供信息。

方法

11 名患有自闭症的学龄前儿童的父母参加了一项名为 Hanen More Than Words (HMTW) 的远程医疗小组培训计划。干预传统上是面对面进行的，并教授促进幼儿社交沟通发展的策略。

定量和定性措施用于评估家长对远程医疗 HMTW 干预的看法。数据是通过育儿压力指数、HMTW 计划评估表和在线家长调查收集的。

使用描述性统计分析定量数据。使用配对 T 检验对育儿压力进行干预前后比较。使用定向内容分析对开放评论字段的响应进行定性分析。

结果

家长们对远程医疗在干预和项目后评估中提供的 HMTW 表示高度满意。交互式学习机会、小组参与、视频指导、个性化服务和项目便利化被确定为学习的关键支持。

家长们对自己和孩子的互动、学习和行为有了更深入的了解。他们报告了战略实施和信心方面的积极变化。父母还认为，干预后孩子的沟通、反应能力、互动和游戏有所改善。从干预前到干预后的父母压力测量值没有显着差异。

结论

远程执业可以减少服务障碍并改善访问，特别是通过小组交付方法的效率。利用技术进行小组干预是父母可以接受的，并且被认为对父母和孩子都有积极的结果。进一步调查家长对干预类型和提供方法的看法，可以促进更广泛地了解家庭在服务获取和参与方面的需求。

启示

远程医疗产品的扩展可以提高家庭和提供者的效率和服务选择。服务可用性的限制以及服务访问和参与的障碍证实了追求持续服务改进和评估服务用户偏好的重要性。开发标准化工具来衡量和比较家长对干预类型和服务提供方法的看法将是有益的。