Telehealth treatment effective in managing developmental delay

Telehealth treatment is a potential method of providing intervention to children with developmental delay (DD), according to a recent study published in JAMA Pediatrics.

DD leads to early behavior problems in children which can be prevalent and impairing, and there is little data on the efficacy of telehealth intervention in treating children with DD. To evaluate the impact of telehealth on parenting intervention for behavioral problems in children with DD, investigators conducted a randomized clinical trial.

The trial took place from March 17, 2017, to December 15, 2020. Children present with DD and early behavior problems were recruited from early intervention. There was a telehealth parenting intervention group and a control group in the study. Children were randomly assigned to 1 of these 2 groups, then analyzed through a 12-month follow-up.

Intervention included internet-delivered parent-child interaction therapy (iPCIT), providing guidance on interactions between caregivers and children through video conferencing. There were 20 weeks of iPCIT given to families. Many of these families were low wealth, with over half of children in extreme poverty or low income-need ratio categories.

Behaviors and caregiving stress between child and caregiver were analyzed at preintervention, midtreatment, postintervention, and during 6-month and 12-month follow-ups. There were 150 children in the sample, 74% of which were male. Children were assigned to one of the groups randomly with their caregivers.

In families receiving iPCIT, the rate of externalizing problems was significantly lower than families in the control group, which received referrals as usual. Post treatment, children in the iPCIT group were also significantly more likely to follow caregiver directions.

A clinically significant change was seen in 74% of the iPCIT group analyzed postintervention, compared to 42% of the control group. Positive parenting skills were also more often seen in caregivers from the iPCIT group, along with a decrease in controlling or critical behaviors.

These results indicated positive outcomes from telehealth treatment in maintaining improvements for young children with DD and their caregivers. Investigators hypothesized telehealth could expand the scope and reach of care for low-income families.

Reference

Bagner DM, Berkovits MD, Coxe S, Frech N, Garcia D, Golik A, et al. Telehealth treatment of behavior problems in young children with developmental delay: arandomized clinical trial. JAMA Pediatr. 2023.doi:10.1001/jamapediatrics.2022.5204