Pragmatic adaptations of telehealth-delivered caregiver coaching for children with autism in the context of COVID-19: Perspectives from the United States and South Africa.
Lauren Franz, Jill Howard, Marisa Viljoen and 11 others
PMID 34098745WHAT IT FOUND
No child outcomes were reported.
Telehealth caregiver coaching for children with autism was adapted differently in two trials. The US added a 6-minute video and phone option; South Africa used WhatsApp, text materials, and extra coach training.
Key findings
01At Duke, an asynchronous phone-based coaching version was created for families without high-speed internet, using a 6-minute home video, a self-reflection checklist, emailed materials, and a phone session.
02In South Africa, coaching was changed to an asynchronous format, materials were shared through WhatsApp, and text and visual content replaced streamed videos because data costs were high.
03Non-specialist coaches in South Africa received additional training of 2-hour sessions over 4 days, covering new materials, technology, and two practice coaching sessions.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The report gives no child outcome data because both trials were ongoing. No participant numbers are given for either trial. Adaptation decisions were made by investigators and intervention team members, not community stakeholders. The report covers only a US trial and a South African trial, and it does not test whether these adaptations work outside those settings. The report says fidelity and core elements were retained, but it does not present outcome, engagement, or implementation data to support that claim.
Declared interests
The paper reports NIH extramural support. Dawson is on scientific advisory boards for Janssen Research and Development, Akili Interactive, LabCorp, Roche, and Tris Pharma; consults for Apple, Gerson Lehrman Group, Guidepoint, Axial Ventures, and Teva Pharmaceutical; is CEO of DASIO; and has book royalties from Guilford Press, Oxford University Press, and Springer Nature. Howard reports personal fees from Roche.
The easy way to misread this
Do not read this as evidence that telehealth caregiver coaching improves outcomes for children with autism. The trials were ongoing and the report only describes adaptations, so it shows what the teams changed, not what happened to the children.