In some areas of the united states, especially in rural states or counties, there is a shortage of behavior analysts who can provide applied behavior analysis services. Telemedicine is a service that would allow for more children with autism spectrum disorder to obtain intervention and support. Telemedicine, also known as telehealth, would allow children with autism spectrum disorder to access the medically-necessary ABA services they need to provide the best opportunity for growth and development and to prevent further decline or stagnation in development.
Traveling to a center is also prohibitive for some beneficiaries due to transportation difficulties as well as living in a rural community which is associated with limited resources related to ABA services and transportation. Supervision may be provided via telemedicine services for children and families who are in need of home-based services and are not able to attend a clinic setting. Additionally, an distance supervisor could provide telemedicine to assist with providing services to children who may not otherwise be able to access services in a timely fashion and who may not be eligible for services outside the county in which they reside.
Telemedicine would offer immediate services to children in immediate medical need for services. Research supports that the earlier ABA intervention is obtained, the higher likelihood of greater outcomes for the child.
Along with telemedicine services, in-person contact with the children and their families by a professional program manager and/or a local supervisor could be a way of providing in-person check-ins but without requiring a board certified behavior analyst be physically present. This is a way of providing hands on support as an additional service without requiring the service of the BCBA as there are often limited BCBA’s in rural areas.
According to Dr. Lindgren (N.D.), telehealth services can greatly expand the geographic area that receives ABA services, a medically necessary treatment for children with autism spectrum disorder. This is especially relevant in rural communities. Due to the shortage of BCBA’s (Lindgren, N.D.), telehealth services can help children with autism receive ABA services in a more timely fashion and with lower cost, as well. And, more importantly, telemedicine can result in positive health outcomes for individuals and families receiving the service.
Linden, Acker, et.al. (2016) completed a study which resulted in finding that the use of telehealth can greatly reduce the cost of ABA services when telemedicine is used to train parents in ABA procedures. Telemedicine could be a way to decrease state funding needed for ABA services in general. In the Linden (2016) study, telehealth was found effective for both home-based and clinic-based services. Telehealth also resulted in reduction of problem behaviors displayed by the children in the treatment.
In summary, telemedicine is a necessary service for children with autism spectrum disorder in rural counties to ensure effective and quality ABA services. Clinic-based services are prohibitive for some beneficiaries which limits access to ABA service monitoring. Additionally, travel to available ABA supervisors is prohibitive due to location and often ineligibility of going beyond the county of residence for services in order to receive funding from certain insurance sources.
ABA services are medically necessary for children with autism spectrum disorder. Research strongly suggests that ABA services be provided as soon as possible as early intervention results in better outcomes for the child. Due to the lack of qualified professionals to provide ABA services locally, services may be unavailable or not be provided in a timely manner. Telemedicine is a solution to these issues specifically facing rural counties.
Lindgren, S. Ph.D., ND. Increasing Access to Applied Behavior Analysis through Telehealth. University of Iowa Children’s Hospital.
Lindgren, S., Wacker, D., Suess, A., Schieltz, K., Pelzel, K., Kopelman, T., … Waldron, D. (2016). Telehealth and Autism: Treating Challenging Behavior at Lower Cost. Pediatrics, 137(Suppl 2), S167–S175. http://doi.org/10.1542/peds.2015-2851O
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