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Examining clinicians’ concerns delivering telemental health interventions directly to autistic individuals during COVID-19

Research output: Contribution to journalArticlepeer-review

Lucy Adams, Nicoletta Adamo, Matthew Hollocks, Lucia Valmaggia, Aylana Brewster, Jennifer Watson, Maisie Krisson, Emily Simonoff

Original languageEnglish
Article number101956
JournalResearch in Autism Spectrum Disorders
Volume94
Issue number101956
Early online date29 Mar 2022
DOIs
Accepted/In press20 Mar 2022
E-pub ahead of print29 Mar 2022
PublishedJun 2022

Bibliographical note

Funding Information: The authors would like to acknowledge the clinicians who participated and helped to distribute the survey, members of the networks that helped to distribute the survey, and the funding bodies that provided financial support. Of the clinicians that helped, the authors would like to especially thank principal clinical psychologist Dr Kevin Tierney who also helped with conceptualisation and resources. LA was funded by a PhD studentship from the Psychiatry Research Trust (PRT, UK, Grant reference: 0c Valmaggia). ES, MH and LV acknowledge financial support from the National Institute for Health Research (NIHR) Biomedical Research Centre for Mental Health at South London and Maudsley NHS Foundation Trust and King’s College London (UK). The views expressed are those of the author(s) and not necessarily those of the PRT, NHS, the NIHR or the Department of Health. The authors can confirm that the funding bodies had no other role in the report. Funding Information: The authors would like to acknowledge the clinicians who participated and helped to distribute the survey, members of the networks that helped to distribute the survey, and the funding bodies that provided financial support. Of the clinicians that helped, the authors would like to especially thank principal clinical psychologist Dr Kevin Tierney who also helped with conceptualisation and resources. LA was funded by a PhD studentship from the Psychiatry Research Trust (PRT, UK, Grant reference: 0c Valmaggia). ES, MH and LV acknowledge financial support from the National Institute for Health Research (NIHR) Biomedical Research Centre for Mental Health at South London and Maudsley NHS Foundation Trust and King's College London (UK). The views expressed are those of the author(s) and not necessarily those of the PRT, NHS, the NIHR or the Department of Health. The authors can confirm that the funding bodies had no other role in the report. The study received ethical approval from King's College London (KCL; MRSP-19/20?20653) and underwent KCL's Data Protection Registration to ensure compliance with the United Kingdom (UK) and European Union (EU) Data Protection laws including GDPR and the UK Data Protection Act 2018. Informed e-consent for participation and the publication of anonymous data was obtained from all included participants. Research data is not available because this involved minimal risk ethical approval. Publisher Copyright: © 2022 Elsevier Ltd

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Abstract

Background
The COVID-19 pandemic necessitated the adoption of telemental health (TMH). Pre-pandemic, clinicians had voiced many TMH concerns, but these had not been investigated with respect to autism spectrum disorder (ASD) even with it being known that there are distinct ASD-associated challenges for in-person mental health interventions.

Method
A convenience sample of (n = 55) clinicians completed an online survey regarding their perspectives of adopting TMH interventions in ASD, with closed- and open-answered questions. Quantitative and qualitative data were analysed descriptively/inferentially and via Content Analysis, respectively.

Results
Multiple clinicians endorsed each TMH challenges/barrier previously identified as concerns in the non-ASD literature. However, overall levels of concern over challenges/barriers were low, and challenges were more likely to be predicted than experienced and considered to be case/presentation specific. Challenges that were considered ASD-specific included the exacerbation of those associated with in-person delivery in ASD, alongside difficulties with trust and appropriate remote social behaviour. On average, clinicians indicated a preference for 50% TMH interventions post-pandemic. Clinicians’ perceived technological competence and extent of professional experience with ASD were not significantly associated with levels of concern, nor number of experienced challenges, with TMH interventions in ASD.

Conclusion
In support of the existing TMH literature, challenges/barriers were more likely to be predicted than experienced and were considered to be case/presentation-specific, though this may be more variable in ASD owing to the well-established marked heterogeneity in this population. Remote provision of interventions exacerbated in-person ASD-associated challenges, as predicted, but clinician-level factors appeared not to impact TMH perceptions.

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