Acceptance of Telehealth Therapy to Replace In-Person Therapy for Autism Treatment During COVID-19 Pandemic: An Assessment of Patient Variables.

During COVID-19, many autism therapy providers switched to online sessions when face-to-face therapy wasn't safe. This study looked at why some families chose online therapy while others didn't. They compared 200 families and found that things like income, age, or language didn't predict who would accept online therapy. However, about 40% of families said no to online therapy, meaning their children missed out on important treatment during the pandemic.

This study examined factors influencing caregiver acceptance of telehealth ABA therapy during COVID-19 among children with autism. Researchers compared 100 families who accepted telehealth with 100 who declined, analyzing demographic variables (socioeconomic status, gender, age, ethnicity, language, household size) and clinical measures (treatment dosage, adaptive behavior scores, verbal behavior assessments). Results showed no statistically significant demographic differences between groups, though moderate differences in treatment dosage were observed. Approximately 40% of families initially declined telehealth services, creating concerning treatment gaps during the pandemic when in-person services were unavailable due to health safety concerns.

High telehealth declination rates highlight need for better preparation and support systems for crisis-driven service delivery changes. Providers should focus on addressing non-demographic barriers to telehealth acceptance and develop strategies to maintain therapeutic engagement during service disruptions.

Non-experimental design limits causal inferences. Study focused only on initial pandemic response, not long-term outcomes. Limited to single organization in California, reducing generalizability. Clinical significance of treatment dosage differences unclear.

Children with autism achieve improved behavioral outcomes with applied behavior analytic (ABA) interventions. Typically, ABA is delivered in a participant's home or in a clinic setting. At the onset of COVID-19, treatment in these environments was not available due to health exposure concerns. A large social service organization in California rapidly pivoted to the delivery of ABA intervention through telehealth.

Access disparity for telehealth has been a historical concern in health care delivery, particularly for disenfranchised populations within the autistic participant population.This study evaluated the demographic and behavioral variables associated with the acceptance or declination of telehealth by the pediatric participants' caregivers at the onset of the pandemic.A non-experimental design was used, and archival data were compared for a random sample of 100 participants with autism who accepted telehealth interventions with 100 participants who declined it.Socioeconomic data, gender, age, ethnicity, language, and household size were compared. Clinical data were compared for treatment dosage, standardized Vineland Adaptive Behavior Scales scores, and Verbal Behavior Milestones Assessment and Placement Program scores.None of the demographic variables were statistically significant in a participant's acceptance or declination of telehealth, but there were moderate differences in treatment dosage across the groups.It is concerning that a large portion of participants initially declined intervention via telehealth, resulting in these participants experiencing a gap in intervention during the pandemic. As intervention is imperative for pediatric autism participants, it is untenable that ∼40% of the population initially declined telehealth at the start of the pandemic.