Running Head: A Pilot Study Comparing Tele-Therapy and In-Person Therapy: Perspectives from Parent- Mediated Intervention for Children with Autism Spectrum Disorders

Abstract

Conclusions about the efficacy of tele-therapy for parent-mediated intervention for children with Autism Spectrum Disorders (ASD) are limited, due to the shortage of direct comparisons between tele-therapy and traditional face-to-face therapy. In this study, we implemented a parent training program, which targeted on language facilitating intervention strategies. Fifteen parents of children with ASD participated in person, and 15 participated via online video conferencing. We measured parents' intervention fidelity and children's initiations, responses, lexical diversity and morphosyntactic complexity. Results indicated significant improvements in parents' fidelity and children's lexical diversity and morphosyntactic complexity. No significant differences were detected between the two therapy delivery groups on any outcome measures. Finally, children's progress on morphosyntactic complexity was significantly correlated with parents' improvement on fidelity. 3

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Journal of Autism and Developmental Disorders (2021) 51:129–143
https://doi.org/10.1007/s10803-020-04439-x
ORIGINAL PAPER
A Pilot Study Comparing Tele‑therapy andIn‑Person Therapy:
Perspectives fromParent‑Mediated Intervention forChildren
withAutism Spectrum Disorders
YingHao1,2· JessicaH.Franco2· MadhuSundarrajan2,3· YaoChen2
Published online: 6 May 2020
© This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2020
Abstract
Conclusions about the efficacy of tele-therapy for parent-mediated intervention for children with Autism Spectrum Disorders
(ASD) are limited, due to the shortage of direct comparisons between tele-therapy and traditional face-to-face therapy. In
this study, we implemented a parent training program, which targeted on language facilitating intervention strategies. Fif-
teen parents of children with ASD participated in person, and 15 participated via online video conferencing. We measured
parents’ intervention fidelity and children’s initiations, responses, lexical diversity and morphosyntactic complexity. Results
indicated significant improvements in parents’ fidelity and children’s lexical diversity and morphosyntactic complexity. No
significant differences were detected between the two therapy delivery groups on any outcome measures. Finally, children’s
progress on morphosyntactic complexity was significantly correlated with parents’ improvement on fidelity.
Keywords Tele-health· In-person therapy· Parent training· Children with ASD
Introduction
Parent training has been found to yield improved linguistic
skills in children with Autism Spectrum Disorders (ASD)
(e.g., Gengoux etal. 2015). However, barriers like the geo-
graphical distance between specialists and patients restrict
service delivery to many families that are in need of help
(Boisvert etal. 2010). Tele-therapy takes advantage of com-
puter and Internet-based technologies, and potentially over-
comes the barriers (Pickard etal. 2016). Previous studies
have demonstrated the initial efficacy of tele-therapy (e.g.,
Ingersoll etal. 2016). However, as there is a shortage of
direct comparisons between tele-therapy and traditional
onsite therapy for parent training in children with ASD,
conclusions about the efficacy of tele-therapy in this area
are limited (Boisvert etal. 2010; Boisvert and Hall 2014).
To address the gap, in this study, we compared the efficacy
of parent training for children with ASD that were delivered
in clinic and via Internet. In the following, we firstly con-
sidered significant areas of deficits in children with ASD to
specify focuses in our comparisons. We then reviewed the
extant literature of parent training and preliminary findings
of tele-therapy for parent-mediated intervention for children
with ASD before discussing the gap and raising our research
questions.
Significant Areas ofDeficit
Language remains a major deficit for an overwhelming
majority of children with ASD (Kasari etal. 2008), even
though it has been removed from the defining criteria for
the diagnosis of ASD (American Psychiatric Association
2013). Children with ASD demonstrate reduced language
usage, which is associated with reduced social interactions
(Deitchman etal. 2010). Early language development has
been widely found to predict future social functioning, and
inversely relate to atypical behaviors among children with
ASD (Barokova and Tager-Flusberg 2018; Howlin etal.
2004; Lord etal. 2004). Therefore, language is still a major
* Ying Hao
yinghao@olemiss.edu
1 Department ofCommunication Sciences andDisorders,
School ofApplied Sciences, University ofMississippi, 2301
South Lamar, NE, Suite 1200, Oxford, MS38655, USA
2 Department ofCommunication Sciences andDisorders,
University ofTexas atAustin, Austin, USA
3 Department ofSpeech-Language Pathology, University
ofthePacific, Stockton, USA
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