Predictors of Satisfaction with Autism Treatment Services During COVID-19.
Emily F Ferguson, Maria Jimenez-Muñoz, Harrison Feerst and 1 others
PMID 34448995WHAT IT FOUND
Caregivers of autistic children reported lower satisfaction with speech, occupational, and behavioral therapy when delivered via telehealth compared to in-person.
However, higher caregiver stress predicted higher satisfaction with psychotherapy and occupational therapy. These are associations from a survey, not proof of cause.
Key findings
01Satisfaction with speech/language, occupational, and ABA/behavioral therapy was significantly lower when services were delivered via telehealth compared to in-person.
02Higher caregiver stress predicted higher satisfaction with psychotherapy and occupational therapy services.
03Higher child dysphoria predicted lower satisfaction with ABA/behavioral therapy, but not with speech, occupational, or psychotherapy services.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs
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What it does not show
The study is cross-sectional, so it can only show associations, not cause and effect. For example, it cannot prove that telehealth caused lower satisfaction; dissatisfied families may have chosen telehealth for other reasons. The sample was recruited via social media and mailing lists, requiring internet access and likely excluding lower socioeconomic families and those without digital access. The sample was predominantly White (79.0%), limiting generalizability to racially and ethnically diverse populations. Satisfaction was measured with a single adapted question per service, which may not capture the complexity of caregiver opinions. The study did not measure the quality of the services provided, only the caregivers' reported satisfaction.
Declared interests
The authors declare no conflicts of interest. The study was not funded by a commercial entity.
The easy way to misread this
Do not interpret the lower satisfaction scores for telehealth as proof that telehealth is clinically inferior. This is a survey of caregiver perceptions, not an outcome study of child progress. Families may have rated telehealth lower because it required more caregiver effort or lacked the social connection of in-person visits, even if the child made similar gains.