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Early Intervention for Children With Developmental Disabilities and Their Families via Telehealth: Systematic Review
Yoomi Shin1, Eun Ju Park2, Anna Lee2,3,4
1College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul, Republic of Korea.
Insights
Telehealth offers a viable alternative for early intervention in young children with developmental disabilities, improving access and family-centered care. Further research is needed to address cognitive outcomes and technological challenges.
Area of Science:
- Pediatrics
- Developmental Psychology
- Health Services Research
Background:
- Early intervention is critical for children aged 0-3 with developmental disabilities.
- Geographical distance and resource limits hinder access to essential early intervention services.
- Telehealth presents a potential solution to overcome these access barriers.
Purpose of the Study:
- To systematically review the effectiveness and implementation of telehealth interventions for infants and toddlers (0-3 years) at risk for or diagnosed with developmental disabilities.
- To compare telehealth interventions with traditional in-person services regarding child developmental outcomes and family well-being.
Main Methods:
- A systematic search of 4 databases (PubMed, Embase, CINAHL, Web of Science) was conducted for studies from 2010-2024.
- Included studies involved telehealth for children aged 0-3 with developmental disabilities and active provider-family interaction.
- Study quality was assessed using the mixed methods appraisal tool, with data analyzed via narrative synthesis.
Main Results:
- Eighteen studies (12 single-case, 4 RCTs, 2 non-equivalent control) met inclusion criteria.
- Telehealth, primarily via synchronous videoconferencing, targeted communication, physical, social-emotional, and adaptive behaviors.
- Two studies found telehealth comparable or superior to in-person interventions, but research gaps in cognitive development were noted.
Conclusions:
- Telehealth is a feasible option for early intervention, enhancing accessibility and family-centered care.
- Challenges include technological literacy and a lack of research on cognitive outcomes.
- Future research should focus on comprehensive, multidisciplinary telehealth interventions and expanded family outcomes.
Background:
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.
Objective:
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.
Methods:
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.
Results:
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.
Conclusions:
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.
Trial Registration:
PROSPERO CRD42024551286; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=551286.
