The impact of Telehealth Access on Parent Satisfaction of Services for Children With Special Health Care Needs

Full Description:

Introduction:
The COVID-19 pandemic has disrupted in-person therapies (e.g., occupational therapy, physical therapy). Parents of children with special healthcare needs (SHCN) have reported benefits and drawbacks of telehealth as a replacement for in-person services. However, little is known about how parents view telehealth service delivery for specific types of therapy. This study examined parent perspectives about telehealth technology’s abilities to deliver different therapies for parents, youth, and therapists.

Methods:
207 parents of 276 children with SHCN completed a REDCap survey assessing parent perspectives and satisfaction of each type of disability-related therapy during the pandemic. Parents reported the delivery method for each service, including telehealth, in-person, sending materials home, giving assignments to parents, or not receiving services. Telehealth access was measured as a binary variable (Yes/No). Wilcoxon Rank Sum Tests examined whether parents’ satisfaction significantly differed according to whether their child had telehealth access for eight services: Psychological Service, Physical Therapy, Occupational Therapy, Social Work Services, Speech Therapy, Feeding Therapy, Behavioral Therapy, and Developmental Therapy.

Results:
For six of the eight types of services examined (Feeding Therapy and Behavior Therapy excluded), parents whose children accessed services via telehealth reported significantly higher satisfaction compared to parents of children without telehealth access (p <.05 for each service). Telehealth had the largest impact on parents’ satisfaction for Developmental Therapy (Access to Telehealth: M=3.65/5, SE = 1.22, “Satisfied” average rating; No Telehealth: M=1.81/5, SE = 1.17, “Somewhat Dissatisfied” average rating), followed by psychological service (Access to Telehealth: M=3.98/5, SE = 1.20, “Satisfied” average rating; No Telehealth: M=2.53/5, SE = 1.47, “Neutral” average rating) and Physical Therapy (Access to Telehealth: M=3.51/5, SE = 1.35, “Satisfied” average rating; No Telehealth: M=2.33/5, SE = 1.46, “Somewhat Dissatisfied” average rating).

Discussion:
This study found that parents expressed higher satisfaction with multiple services when children had telehealth access, as compared to not having telehealth access, suggesting telehealth may be acceptable during in-person service disruption. However, parents reported no significant differences in satisfaction with or without telehealth access in two services – Feeding Therapy and Behavior Therapy. One possible explanation is that parents may already receive adequate training to assist with Feeding Therapy and Behavior Therapy effectively at home. Future research could examine parent training needs to better utilize both synchronous and asynchronous methods. Our findings can help policymakers identify service delivery resource allocation during future service disruptions, ultimately leading to optimized therapy outcomes for children with SHCN.

Abbreviated Description: Telehealth replaced many in-person services for children with special healthcare needs (SHCN) during the COVID-19 pandemic. Our study examined parent satisfaction about telehealth technology’s abilities to deliver eight types of services for their children with SHCN. Our findings showed that parents expressed significantly higher satisfaction with six types of services when children had access to telehealth, compared to when children did not. These results can help policymakers identify service delivery resource allocation during later periods of service disruption, which could improve equity and access to services for children with SHCN. Future research could examine parent training needs to better utilize various modalities of service delivery to maximize health outcomes.