How telehealth can improve access to neurodiversity support services

• Globally, there are limited or no services available to support neurodiverse people, including those with autism, ADHD and anxiety.Finding ways to provide increased service access is thereby essential, and telehealth can play a key role in making support more accessible.And it’s not just families who benefit – telehealth services can also help organizations and individual staff optimize their limited resources.

Throughout much of the world, there are limited or no services available to help support neurodiverse populations, including those diagnosed with autism, attention deficit and hyperactivity disorder (ADHD) and anxiety – and those limited services are often only available if a family can access and afford them. “In most world regions, autism awareness has advanced substantially but has not always led to a significant increase in available services,” observed a 2022 study. Consider the immense logistical challenges of supporting the travel to and from in-person therapy sessions for neurodivergent children and the hours per week of social, communication, motor and behavioural therapies delivered by a variety of professionals.In areas with great need but few clinicians – 54% of US counties do not have a single board certified behaviour analyst – waiting lists for services can span years which can have a negative impact on outcomes for autistic children in particular. In a 2021 report, the United States’ National Institutes of Health suggested that “research shows that early diagnosis of and interventions for autism are more likely to have major long-term positive effects on symptoms and later skills”. Finding ways to provide increased service access is essential. Some families have even taken the extreme step of moving to different locations where services are more readily accessible, but that isn’t an option for everyone.

Telehealth increasingly the norm post-COVID

Telehealth services – which enable practitioners to continue their work with patients without being physically located in the same place – made their way into the public consciousness during the COVID-19 pandemic, when many clinics were closed for in-person services. As many clients and families grew comfortable with video or chat-enabled therapy sessions, telehealth as a mode of delivering services has continued to grow. Even as the world has reopened, telehealth remains a vital option for providing access to more individuals, especially those in rural and underserved communities. Floreo, a virtual reality platform designed to teach social, communication behavioural, and life skills, started working on telehealth capability well before the COVID-19 pandemic brought telehealth to light for many. This functionality was used by schools and clinics when many services were brought to a halt, and schools were shut down. It was a lifeline for many individuals and families who could not leave their homes for regular special education or therapy programmes.Floreo’s Founder and CEO, Vijay Ravindran, recalls the product decision he made in 2019: “The need to enable remote therapy services in the autism community was evident before COVID-19 due to staffing shortages at clinics and school districts combined with parent fatigue commuting to and from therapy clinic locations.“Meanwhile, it was evident to all that video conferencing alone could not convey all the therapy and training of in-person therapy. That’s where virtual reality and Floreo have been able to step in.”

Floreo has also seen success working with state Medicaid programmes to bring technology into families’ homes. Under the Children’s Long-Term Support Waiver in Wisconsin, families can access a subscription and needed equipment for Floreo and optional telehealth services from in-house Floreo clinicians located outside of the US state. Adding the virtual reality aspect to a teletherapy session, as Floreo does, allows for practice with virtual peer characters in social situations, navigating environments like a supermarket or street crossing, and difficult-to-replicate situations like interacting with police officers, all from the comfort and convenience of the family home.For some families, this has been a game changer. One participant’s mother was thrilled to have access to an alternative option to in-person therapy for her son: “When I would take [my son] to social skills class, he would have a meltdown, and I couldn’t even get him out of the house to even go to social skills class. “When he was there, he didn’t like it because it was more classroom-driven and his focus wasn’t there (even though I knew he was benefiting from it). It became too much of a struggle to get him to go, so I ended up taking him out of the class.”

Telehealth also has benefits for practitioners

And it is not just families who can benefit from the convenience of telehealth and more accessible services. Large autism therapy companies like the Center for Social Dynamics are using telehealth to help manage staff time more efficiently. In some traditional therapy situations, therapists may need to travel from house to house to visit clients for home-based services, contributing to staff burnout and turnover.

By incorporating telehealth into their business model, clinics can more easily manage travel demands on staff time, allowing their organizations to optimize their staff resources. Staff can spend their work hours actively providing and billing for services, instead of commuting to each client’s location. Clinicians can reach and positively impact more clients during critical early intervention years, preventing those long waitlists. In areas around the world with little to no services, individuals can benefit from telehealth experts and clinicians outside of their local areas, key new