Early Intervention for Children With Developmental Disabilities and Their Families via Telehealth: Systematic Review.

Early Intervention for Children With Developmental Disabilities and Their Families via Telehealth: Systematic Review.

Publication date: Jan 17, 2025

Early intervention during the first 3 years of life is crucial for children with developmental disabilities to optimize developmental outcomes. However, access to such services is often limited by geographical distance and resource constraints. Telehealth can be part of a solution for overcoming these barriers, enabling the delivery of early intervention services. However, a comprehensive understanding of the efficacy and implementation of telehealth in early interventions remains elusive, particularly for children aged 0-3 years. This systematic review aims to synthesize existing research on the effectiveness and implementation of telehealth interventions in infants and toddlers (aged 0-3 years) who are at risk of or diagnosed with developmental disabilities. The primary objective of the study is to evaluate the ways that telehealth compares to conventional in-person interventions in improving developmental outcomes for children and supporting family well-being. A systematic search was conducted of 4 electronic databases (PubMed, Embase, CINAHL, and Web of Science), focusing on studies published between 2010 and 2024. The inclusion criteria were studies involving telehealth interventions for children aged 0-3 years who were at high risk or had developmental disabilities, which involved active interactions between the providers and the families. Study quality was assessed using the mixed methods appraisal tool, and a narrative synthesis was used to analyze the data. Eighteen studies met the inclusion criteria: 12 single-case designs, 4 randomized controlled trials, and 2 nonequivalent control group designs. All studies involved caregiver-child dyads, with child ages ranging from 5 to 37 months and having or at risk of autistic spectrum disorder (n=10, 56%), cerebral palsy (n=4, 22%), and other conditions (n=4, 22%). Synchronous videoconferencing was the primary modality for caregiver training and coaching (n=17, 94%) while 1 intervention used an Internet of Things system. Outcomes were identified in child communication (n=9, 50%), physical (n=6, 33%), social or emotional (n=6, 33%), and adaptive behavior (n=4, 22%), as well as caregiver implementation (n=12, 66%). Telehealth demonstrated comparable or superior effectiveness to traditional in-person methods in 2 studies. However, the focus on specific conditions and limited research on cognitive development were notable gaps. Telehealth can be a viable alternative to traditional in-person early interventions for young children who have developmental disabilities and their families. It enhances accessibility and interactions between families and providers at a distance while promoting family-centered care. Challenges exist, including those of technological literacy, and the lack of research on cognitive outcomes must be addressed. Future work should explore more comprehensive interventions, including multidisciplinary approaches and expanded family outcomes, to solidify the role that telehealth plays in early intervention. PROSPERO CRD42024551286; https://www. crd. york. ac. uk/prospero/display_record. php?RecordID=551286.

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Concepts Keywords
Coaching autistic spectrum disorder
Crd42024551286 cerebral palsy
Toddlers Child, Preschool
Videoconferencing developmental delay
Developmental Disabilities
developmental disabilities
digital intervention
early intervention
Family
family-centered care
Female
Humans
Infant
Infant, Newborn
Male
multidisciplinary care
systematic review
telehealth
Telemedicine

Semantics

Type Source Name
disease MESH Developmental Disabilities
drug DRUGBANK Methionine
disease MESH autistic spectrum disorder
disease MESH cerebral palsy
disease MESH syndrome
disease MESH attention deficit hyperactivity disorder
disease MESH learning disabilities
disease MESH COVID 19 pandemic
disease MESH infections
drug DRUGBANK Spinosad
disease MESH visual impairment
disease MESH hearing impairment
disease MESH chronic conditions
disease MESH intellectual disability
disease MESH neurodevelopmental disorder
disease MESH autism
disease MESH preterm infants
disease MESH Deafness
disease MESH cognitive impairment
disease MESH developmental coordination disorder
drug DRUGBANK Etoperidone
disease MESH Caregiver burden
drug DRUGBANK Trestolone
drug DRUGBANK Pirenzepine
pathway REACTOME Reproduction

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