Autism Spectrum Disorders
As the preferred term implies, Autism Spectrum Disorders (ASD) represents a spectrum of abilities and needs. Characteristics that are common in ASD include:
- Difficulties interacting with the environment. This can result in sensitivity to different sensory information, (like sight, sound, touch, etc.), restricted and predictable routines, repetitive body movements and intense focus on objects and actions.
- Challenges taking the perspective of others and reading social cues. Therefore, individuals with ASD may have difficulty interpreting non-verbal communication, sharing attention and enjoyment of joint activities with others, and responding in ways that are deemed socially appropriate.
- Language-learning needs. This is one of the areas with most variability. Some people with ASD have strong language skills and fluent speech; others have limited language or use repeated forms.
Because of the variety of needs that students with ASD present, speech-language pathologists must use different treatment methods with these clients. There are 27 evidence-based interventions for ASD described by the National Professional Development Center. The interventions range from offering physical assistance, changing the student’s environment, or targeting subtle skills like interpreting tone of voice or eye gaze. The remote nature of telepractice and the “hands-on” approach to many interventions can create some unique challenges. SLPs must evaluate the needs of each client with ASD, problem-solve ways to modify telepractice treatment, and sometimes consider whether other settings are better-suited for a student.
However, telepractice may offer students with ASD some unique opportunities. Digital, high interest activities are simple to present. The telepractice environment may minimize sensory effects, which can help the SLP isolate and target specific skills. Techniques like social narratives, technology-aided instruction and video modeling may be employed with little modification. Peer-mediated instruction, parent-implemented intervention and pivotal response training are indirect approaches. SLPs can make these accessible through “tele-coaching” others.
Although the body of research for telepractice in ASD is only emerging, there is evidence that direct and indirect strategies can be successful. Boisvert et al. found positive results for two students with ASD. One client received “active consult,” in which a student clinician was coached and monitored remotely by a supervising clinician. The other client received direct telepractice services. This student responded more positively to telepractice intervention than he did to onsite services. Baharav et al. compared the effectiveness of a hybrid onsite/telecoaching model with traditional onsite therapy. Their study found that the gains made onsite could be maintained as well or better through telepractice support.
Although there is still a lot to learn about telepractice and Autism Spectrum Disorders, the early evidence is promising that services may be modified effectively and our ASD students can be well-served through this medium.
- Evidence-based practices. Retrieved November 14, 2016, from http://autismpdc.fpg.unc.edu/evidence-based-practices
- Baharav, E., Reiser, C. Using telepractice in parent training in early autism. Telemedicine Journal and E-Health 2010 Jul-Aug;16(6):727-31
- Boisvert, M., Hall, N., Andrianopoulos, M., Chaclas, J. The Multi-faceted Implementation of Telepractice to Service Individuals with Autism. International Journal of Telerehabilitation, [S.l.], Dec. 2012.