Abstract
Background:Optimal outcomes for children who are deaf/hard-of-hearing (DHH) depend on access to high quality, specialized early intervention services. Tele-intervention (TI), the delivery of early intervention services via telehealth technology, has the potential to meet this need in a cost-effective manner.Method:Twenty-seven families of infants and toddlers with varying degrees of hearing loss participated in a randomized study, receiving their services primarily through TI or via traditional in-person home visits. Pre- and post-test measures of child outcomes, family and provider satisfaction, and costs were collected.Results:The TI group scored statistically significantly higher on the expressive language measure than the in-person group (p =.03). A measure of home visit quality revealed that the TI group scored statistically significantly better on the Parent Engagement subscale of the Home Visit Rating Scales-Adapted & Extended (HOVRS-A+; Roggman et al., 2012). Cost savings associated with providing services via TI increased as the intensity of service delivery increased. Although most providers and families were positive about TI, there was great variability in their perceptions.Conclusions:Tele-intervention is a promising cost-effective method for delivering high quality early intervention services to families of children who are DHH.
Highlights
Optimal outcomes for children who are deaf/hard-of-hearing (DHH) depend on access to high quality, specialized early intervention services
Differences in favor of the TI group were statistically significant for expressive language (p =.03, standardized mean difference effect size, or standardized mean difference effect sizes (SMDES) = .40), but not for receptive language (p = .22, SMDES = .23)
Time spent preparing for visits and documentation/record keeping was almost identical. This randomized controlled study contributes to our current knowledge about the costs and effects of TI when compared to in-person home visits
Summary
Optimal outcomes for children who are deaf/hard-of-hearing (DHH) depend on access to high quality, specialized early intervention services. A letter to all early intervention state programs from the US Departments of Education and Health and Human Services noted a “growing national crisis in the provision of essential early intervention and health care services for infants and toddlers with hearing loss” (Hager & Giannini, personal communication, July 21, 2006) The primary reasons such inadequate services occur include the following (CDC, 2013; White, 2007):. A survey of Early Hearing Detection and Intervention (EHDI) systems conducted by the National Center for Hearing Assessment and Management (NCHAM, 2010) found that of 48 US states and territories, 42% had telehealth or telepractice efforts under way or planned, primarily for early intervention and communication-related therapies To advance this effort, the American Speech-Language-Hearing Association (ASHA, 2005a; 2005b) issued the statement, “telepractice is an appropriate model of service delivery for the profession of speech-language pathology.
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