Electronic Thesis and Dissertation Repository

Thesis Format

Monograph

Degree

Master of Arts

Program

Education

Supervisor

Neil, Nicole

Abstract

Accessibility to autism services could be challenging for families in rural areas. Telehealth has become a popular tool for autism services after the pandemic. The current study examined service providers’ and service users’ perspectives on telehealth to determine what factors predict its future use. Participants (n=67) including (n=24) autism services providers, (n=37) caregivers, and (n=8) autistic persons completed a mixed-method online survey adopted from the Telehealth Satisfaction Questionnaire. Qualitative responses were analyzed using provisional coding based on a feasibility theoretical framework. Results suggest that the practicality and acceptability of telehealth predict its future use. Qualitative results indicate that telehealth presents some barriers: (a) implementation barriers including technological difficulties and client profile challenges, (b) acceptability barriers related to rapport, (c) adaptation barriers related to modifications of material, (d) integration barriers related to training and caregiver capacity. This study provides implications for strategic planning to eliminate organizational and subjective barriers to telehealth autism services, ensuring equitable access to evidence-based services.

Summary for Lay Audience

Telehealth autism services use technology and video conferencing to deliver clinical services such as speech and language, occupational therapy, behaviour therapy, and mental health. Telehealth autism services increase access to clinical services for families who live in remote areas where autism services are scarce. In Ontario, there is limited research on the feasibility of telehealth autism services. This study engaged autism service providers, caregivers of autistic persons, and autistic people who used telehealth by enquiring about their perspectives on the feasibility of telehealth services. The study used mixed methods through online surveys adopted from the Telehealth Satisfaction Questionnaire (Villalobos et al., 2021). Quantitative and qualitative data were collected from 67 participants including 24 autism service providers, 37 caregivers of autistic persons, and 8 autistic persons. The goal of this project was to understand what factors impact the future use of telehealth for autism services in a post-pandemic context. This project was based on Bowen et al.’s (2009) feasibility theoretical framework examining the following indicators: (a) acceptability, (b) demand, (c) implementation, (d) practicality, (e) integration, (f) adaptation, (g) expansion, and (h) efficacy. Open ended survey questions were analyzed using provisional coding (Saldana, 2021). The main Themes were based on Bowen’s feasibility indicators. Providers and users perceived the acceptability and the practicality of telehealth as important predictors for its future use. The results also indicate that telehealth presents some barriers : (a) implementation barriers which include (1) technological difficulties such as connectivity and proficiency in using the online platform, (2) client profile challenges such as attending skills, engaging in interfering behaviours, level of communication, (b) acceptability barriers mainly related to lack of rapport, (c) adaptation barriers related to accommodations and modifications of program material, (d) integration barriers related to training and caregiver capacity. Participants also reported that training and access to digital program resources improved the acceptability of telehealth over time, and client profile was sometimes perceived as a facilitator to receiving telehealth services when clients have advanced technological skills. This study contributes to the development of strategic planning tools for autism service providers to expand their services using telehealth ensuring equitable access to evidence-based autism services.

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