At the start of the COVID-19 pandemic, Kennedy Krieger Institute developed a streamlined and personalized telehealth system for our patients and families.
We expanded telehealth services to 80 Kennedy Krieger patient care programs to continue to provide care, even when patients and families could not always be seen in-person at Kennedy Krieger Institute.
We learned that:
• 94.3% of Kennedy Krieger patients reported that they were satisfied with the Institute’s telehealth services.
• 95.3% found telehealth easy to use.
• 96.1% felt that their information was kept private and confidential.
• 74.3% of parents would use telehealth again, even if an on-site appointment was an option.
• 84.2% of parents of adolescents would use telehealth again.
• 58.7% of parents of younger children would use telehealth again.
Telehealth may help reduce disparities by…
• Reducing parent burden through increased scheduling flexibility, resulting in decreased time that parents take off from work for their child’s appointments.
• Increasing the possibility of two parents or multiple caregivers participating in appointments.
• Increasing convenience by reducing the amount of travel and parking time required of patients and parents of patients.
• Increasing healthcare services for patients in geographic areas with limited specialty services for children with developmental, behavioral, and mental health disorders.
• Improving healthcare provider understanding of patient home-based resources and living environments
The Neuropsychology Department learned that when parents completed an online questionnaire prior to their child’s appointment, Kennedy Krieger could plan for a longer or shorter assessment day accordingly.
1. The Kennedy Krieger Neuropsychology Department developed a three-level model of care using telehealth in clinical assessment.
Level 1 involves a record review and telehealth interview to answer a diagnostic question. Level 2 adds targeted telehealth-based assessment to help answer more complicated diagnostic questions. Finally, Level 3 adds an additional on-site/in-person assessment for even more complicated diagnostic questions and disruptive behaviors.
Read more about the Neuropsychology model.
2. The Department of Behavioral Psychology has used telehealth to help patients with disruptive behaviors make and maintain behavioral gains during treatment. These services were initially offered to military families, and were vastly expanded during the COVID-19 pandemic. Several case examples of behavioral therapists using Applied Behavior Analysis (ABA) via telehealth are presented below:
- In this case example, the behavioral therapist of a 20-year-old used telehealth to help a parent implement ABA, resulting in a reduction in challenging behavior and an increase in functional communication.
- In this case example, a 27-year old patient’s self-injurious skin picking behaviors were reduced to near zero rates through an intensive outpatient admission. Once treated, her behavioral therapist was able to provide training and consultation to her caregivers via telehealth and maintain these treatment gains for the next five months.
3. The Center for Autism and Related Disorders has developed several telehealth-based approaches for evaluating if children meet criteria for Autism Spectrum Disorder (ASD)
Kennedy Krieger’s Neuropsychology faculty collaborated with neuropsychologists across the country to develop a model combining telehealth with on-site, in-person care to support the rehabilitation of children and teens with brain injuries.
- The Kennedy Krieger Neuropsychology Department compared tests results from onsite/in-person assessments to test results from telehealth assessments. The department found very few differences between the in-person and telehealth test results. Evidence shows that telehealth assessment can be validly used to evaluate intellectual and academic functioning.
- The Kennedy Krieger Neuropsychology Department found that, following psychological and neuropsychological telehealth assessments, parents had increased confident that they understood their child’s condition, knew how to help their child, and could advocate for their child. The noted improvements in parent confidence were similar to improvements seen by researchers at other hospitals following on-site/in-person neuropsychological evaluations. These findings provide evidence that telehealth-based assessments have the same level of family impact as on-site/in-person assessments.