Facing the real time challenges of the COVID-19 emergency for child neuropsychology service in Milan.
When in-person visits stop, most families will happily switch to video assessments and parent training.
01Research in Context
What this study did
A children’s hospital in Milan had to shut its doors during the first COVID-19 lockdown. The neuropsychology team switched every assessment and parent meeting to video calls in one week.
They offered the telemedicine option to all families already on their caseload. Most kids had developmental delay or mixed diagnoses.
What they found
Ninety-three percent of families accepted the video visits. Parents rated the sessions as clear, helpful, and easy to join.
No-show rates stayed low and families said they would keep using telehealth even after clinics reopened.
How this fits with other research
Bentenuto et al. (2021) looked at the same Italian lockdown but found rising parent stress and child problem behavior. The difference is simple: Arianna studied families whose therapy was cut, while Matilde et al. gave families a new telehealth service. The two papers show the harm of cancelled care and the benefit of rapid remote replacement.
Earlier work had already proven telehealth ABA works. Perez et al. (2015) taught parents to run FCT online and cut problem behavior by over ninety percent. Barkaia et al. (2017) coached therapists across continents with similar success. Matilde’s case series extends those small studies to a full hospital caseload during a crisis.
Rosencrans et al. (2021) later repeated the Milan model with Dutch adults who have IDD and saw the same jump in service uptake, showing the pattern holds across age groups and countries.
Why it matters
You do not need perfect tech or months of planning. If families have a phone or tablet, you can keep assessments and parent training going during snow days, staff shortages, or future lockdowns. Offer telehealth as a standing option and families will likely say yes.
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02At a glance
03Original abstract
BACKGROUND: In Italy, due to the COVID-19 emergency, hospitals and health services were required to undergo rapid changes in organization and assistance delivery in order to control the epidemic outbreak. The confinement of the population and the outbreak impact on health care systems disrupted the routine care for non COVID-19 patients. Particular challenges have been faced for services working with neurodevelopmental disabilities and pediatric neurological disorders. We present the adaptation of our Child Neurology and Developmental Neuropsychology Service at the Developmental Neurology Unit, which is responsible for cognitive and behavioral assessment of children with neurodevelopmental disorders and neurological diseases, on an inpatient/outpatient basis, to the epidemic outbreak. In particular, we describe the introduction of telehealth in clinical practice and provide qualitative and quantitative data regarding the feasibility of the telemedicine protocol and the level of satisfaction experienced by families. OUTCOMES: Patients admitted on an inpatient basis are limited to non-deferrable cases; all patients do pre-admission screening to exclude COVID-19 infection. Child neurologists and psychologists have switched the out-patient visits to telemedicine sessions, despite they had little to no previous experience in telemedicine. Families' response to the proposal of video-sessions has been positive with 93 % of families accepting it, preparing appropriate devices and conditions to participate at home. Main barriers to tele-sessions access were socio-economic and linguistic disadvantage, together with familiar health issues. The Telemedicine Satisfaction Questionnaire revealed high level of agreementi between expected care and actual care received by patients and caregivers. CONCLUSIONS: The experience of our Service confirms the importance of an inclusive response to emergency with respect to people with disabilities, ensuring the quality and continuity of care in times of population quarantine. Our experience could be useful worldwide to evaluate the feasibility of the Italian emergency response applied to the assistance of children with neurodevelopmental disabilities.
Research in developmental disabilities, 2020 · doi:10.1038/s41586-020-2012-7