Study highlights barriers, facilitators to telehealth occupational therapy for autistic children during the pandemic
January 17, 2023

By Mike McNulty

Telehealth became an essential way for occupational therapists to work with clients during the Covid-19 pandemic. Now, nearly three years after the March 2020 stay-at-home orders, researchers from USC Chan’s Disparity Reduction and Equity in Autism Services (DREAmS) lab published an article in OTJR: Occupational Therapy Journal of Research exploring perceived barriers and facilitators to telehealth occupational therapy for autistic children during the pandemic.

“We found that effective telehealth occupational therapy relies on a number of intersecting factors, and its success involves not only the individual clinician and client, but hinges upon the family’s involvement and the clinical infrastructure too,” said Assistant Professor Amber Angell PhD ’16.

Angell is the article’s first and senior author, and directs the DREAmS lab, which focuses on understudied and underserved groups of individuals on the autism spectrum, including Latinx children, girls and women and adults. Its overarching purpose is to reduce disparities in autism diagnosis and services among underserved groups.

Utilizing a narrative-based approach, Angell and colleagues conducted semi-structured interviews with 13 participants — three clinical administrators, six occupational therapists and four caregivers of children with autism — each lasting from 45 to 90 minutes. More than 13 total hours of interviews were transcribed, coded, analyzed, reviewed and, ultimately, confirmed.

The researchers identified four overarching themes: challenges to conducting telehealth OT; facilitators to conducting telehealth OT; negative outcomes of conducting telehealth OT; and positive outcomes of conducting telehealth OT.

“Our findings raise a number of pertinent issues — the extent to which therapeutic models can be translated to telehealth, clinicians’ needs for high-quality training in telehealth best practices, how parents may interpret or misinterpret a therapist’s coaching and how OTs can capitalize on opportunities that exist within a child’s natural environment,” Angell said.

The study was supported by the USC Chan Division’s Lisa A. Test Endowed Research Award. Co-authors include USC Chan students Elaine Carreon MA ’21, OTD ’22, Joana Akrofi MA ’21, OTD ’22, Marshae Franklin OTD ’21, PhD ’26 and Elinor Taylor PhD ’25, as well as Assistant Clinical Professor Catherine Crowley OTD ’06.

“This article contributes to the growing body of literature for best practices to support the experiences of autistic children, their family members and other partners,” Angell said. “By better understanding the perspectives of pediatric OTs, clinic administrators and caregivers of autistic children, we can sustain and improve the future of telehealth OT.”

“Challenges and Facilitators to Telehealth Occupational Therapy for Autistic Children During COVID-19” is available at doi.org/10.1177/15394492221142597.

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