Teleassistance and telerehabilitation: COVID-19, other epidemic situations and future prospects

ABSTRACT

Persons with intellectual disability (PwID) and/or and autism spectrum disorder with high support needs (ASD-HSN) have resulted to be among the most vulnerable populations to COVID-19 and distress factors associated to the measures for containing its spread. Telemedicine, particularly teleassistance (TA) and telerehabilitation (TR), was used to manage several health, rehabilitation, and assistance needs, in respect to both the prevention and treatment of the epidemic illness and the continuity of care necessary for the condition of developmental disability and co-occurrent physical or mental disorders. TA and TR can be operated through direct or indirect interaction with the PwID/ASD, in the latter way, intermediation on the local side is provided by a family member, a habitual caregiver or a technician. The present chapter reviews the most frequent TA and TR activities, their prerequisites, ways of use, and objectives, which must be aligned with the more general aim of every individualized therapeutic and rehabilitation plan, which is to promote and favor PwID/ASD's quality of life. Studies on TA and TR efficacy for PwID/ASD are limited, especially concerning adulthood. The few available findings show effectiveness in maintenance or slight improvement of cognitive, adaptive, and occupational skills. Family members and other caregivers reported empowerment of their educational and relational skills with the PwID/ASD, including the management of ordinary and extraordinary activities and critical episodes. In comparison with traditional face-to-face services, main advantages have been identified in higher availability and accessibility, and shorter physical and psychological distance. Main limits are represented by the lack of all aspects of the therapeutic relationship related to physical interaction, possible poor ability to use technology, availability of the technology itself, privacy issue, and distracting factors associated to the home environment. Although feasibility and effectiveness are shown so far, it is unlikely that telemedicine will be able to replace traditional practices, at least in the near future. However, it could represent a valid supplement, integration, or temporary alternative. Future research should provide insights on indications, efficacy assessment, contextual implementation, and operational stability over time of specific TA and TR activities as well as on the use of artificial intelligence, machine learning, and interactive avatars. (PsycInfo Database Record (c) 2022 APA, all rights reserved)