maanantai 23. heinäkuuta 2012

Etäpuheterapia ja autistiset henkilöt

Etäpuheterapian ja videovälitteisen menetelmän käyttöä autististen henkilöiden kanssa on tutkittu melko laajalti. Alla koonti muutamista alan tutkimuksista:

Telepractice allows for clinician-to-client, as well as clinician-to-clinician or clinician-to-physician interconnectivity, and can be used to provide direct speech-language intervention to an individual or group of individuals, or supervisory guidance to professionals through Active Consultation, a form of telepractice that uses video conferencing and Bluetooth technology to “teach the teacher” in real-time. Telepractice is a service delivery model that can bridge the research-to-practice gap by offering universal access to evidence-based services and world-wide interconnectivity to ensure that professionals learn and share the skills necessary to provide, implement, and support generalization of such services in home, school, or clinical settings.

(Baharav E., Reiser C., 2010)

There is a growing body of literature indicating that intense early intervention is current best practice for treating children with autism spectrum disorders (ASD). Several studies demonstrate the effectiveness of parents as agents of intervention in the child's home environment. However, this approach requires intense one-on-one supervision by highly trained professionals. Consequently, there is a significant gap between the intensive service requirements for children with ASD and the available resources to provide these services. In the current pilot study, the use of remote technology, telepractice, is evaluated as a tool for coaching parents of two children found to have ASD. Two clinical models of intervention are compared: a traditional model of twice-weekly speech and language therapy sessions (traditional clinical model) and a model where a once-a-week clinical session is followed by a home-based session administered by the parents and remotely supervised and coached by the clinician (clinic/telepractice model). Results suggest that gains obtained in traditional therapy can be maintained and even exceeded in a treatment model that uses telepractice. Parents reported that they perceived telepractice sessions to be as valuable as those delivered directly by the clinician, felt comfortable using the technology, and were willing to continue intervention with their children at home. These preliminary results suggest that use of telepractice holds promise for reducing the demands on available resources of service for this population. A study with a larger population is currently underway including cost-benefit analyses to examine the implications for such a treatment model to its users and to the healthcare system.

(Boisvert M., Lang R., Andrianopoulos M., & Boscardin ML.)

OBJECTIVE: Studies involving the use of telepractice in the delivery of services to individuals with autism spectrum disorders (ASD) were reviewed with the intent to inform practice and identify areas for future research. METHODS: Systematic searches of electronic databases, reference lists and journals identified eight studies that met pre-determined inclusion criteria. These studies were analysed and summarized in terms of the: (a) characteristics of the participants, (b) technology utilized, (c) services delivered via telepractice, (d) research methodology and (e) results of the study. RESULTS: Telepractice was used by university-based researchers, behaviour analysts, psychiatrists and psychologists to assist caretakers and educators in the delivery of services to 46 participants with ASD. The services delivered included behavioural and diagnostic assessments, educational consulting, guidance and supervision of behavioural interventions and coaching/training in the implementation of a comprehensive early intervention programme. CONCLUSIONS: Results suggests telepractice is a promising service delivery approach in the treatment of individuals with ASD that warrants additional research. Guidelines for practitioners and potential directions for future research are discussed.

(Lauren V. T. L., Hutchins P., Prelock A., 2012)

Purpose: There is a paucity of research examining the effectiveness of Comic Strip Conversations (CSCs) and the use of telepractice in family-centered practice to reach underserved populations. The purpose of this study was to examine the feasibility of a collaborative family- centered approach using a combination of face-to-face and telepractice service delivery models to train parents to implement CSCs successfully. Method: A case-study method was employed. The participants were 2 parents and their 8-year-old daughter with autistic disorder. The parents participated in a 6-week training and implementation procedure involving weekly feedback from a research team to support appropriate implementa- tion of the CSCs. Quantitative and qualitative data were collected via parent report to evaluate the process and outcomes. Results: The parents were successfully trained to implement intervention in the conventional and recommended way (Gray, 1994). The use of CSCs in the home was deemed feasible and effective for addressing a range of social, communicative, and behavioral challenges. In addition, the parents reported other benefits of CSCs not previously explored in the research base. Conclusion: The inferences that can be drawn from the case study are limited given the potential for threats to internal validity. However, this study offers tentative evi- dence for the feasibility of parent training to implement CSCs using a combination of face-to-face and telepractice techniques.

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