Maximizing Virtual Visits to Maintain Essential Touchpoints in Autism Care

The Coronavirus Pandemic brings much uncertainty to our lives but one constant remains: access to your medical teams. While it is critical to socially distance and stay healthy and safe, medical teams around the world are adapting and meeting the challenge to care for people through telemedicine.

Kristin Sohl, MD, FAAP

Kristin Sohl, MD, FAAP

Telemedicine has been utilized for several decades in its more traditional sense with patients going to their local clinic and the specialist virtually seeing from a distant location. Now, with COVID-19, policies have been adjusted to allow physicians and practitioners to see patients directly in their home. This allows the clinician and the patient to receive care for their concern and limit their risk for infection.

Virtual visits are being done through many ways, called platforms. One of the most common options is Zoom but there are many others. Phone (audio only) visits are also a form of virtual visit being used to connect right now. I would like to provide some important tips to maximize your virtual visits.

First, let’s talk about the professional and what they need to do to be ready for the visit. All professionals using telemedicine need to get comfortable with the technology and practice the key elements like connecting, muting and unmuting audio, turning on and video and sharing their screen. Professionals also need to know how to handle common problems like converting a video visit to an audio only or phone visit if the connection is lost, helping the patient connect and working with non-English speaking patients.

The professionalism and caring demeanor used in person should be used in virtual visits. Be sure to introduce yourself, obtain consent for the virtual visit by explaining the benefits and risks of a virtual visit compared to in person and engage with the patient as you normally would in person. One important addition with a virtual visit is to check for understanding with the patient since they won’t have the same “check-out” paperwork they usually receive when seen in person.

Now, let’s talk about the patient or client and what they need to do to prepare for the visit. It is important to determine what device you will use to connect with your provider. You can use a smart phone, webcam on your computer, or tablet. These are the ideal devices for connecting with video and audio and make for the best visits with your clinical team. If you don’t have access to one of these, audio only options can work like a telephone or traditional cell phone. Once you know which device you will use, look at the instructions your provider gave you for connecting. This may be in your email. Call the clinic or office if you need help. You may need to download (install) a program on your device to be able to connect for the visit. Once this is complete, practice. Practice turning on and off your video (camera) and connecting to audio (sound). Check the lighting in the room where you will do the visit to make sure it is not too bright or too dark. Test to make sure you can see your full head and shoulders in the camera image.  Set a reminder for the day and time of your visit so you can be ready. Write down your questions for the doctor so you will be ready. Have a list of medicines that you take with you.

When it’s time for the appointment, connect to the visit using the instructions from your provider’s office (clinic). Here are some more tips for a successful visit. If you are seeing the provider with your child, let them be with you. Make sure they are awake and ready to participate like they would if they were going to the provider’s office. If your child doesn’t want to sit on camera, that’s okay, have some toys or preferred items nearby so they can be comfortable while you talk with the provider. It will be important for the provider to visually see your child when possible. It is also helpful to have your child’s most recent weight in case the provider is monitoring specific things for your child.

Individuals with autism and their family members as well as the professionals who support and serve them are navigating unchartered waters together.  Innovations like rapid adoption of virtual technology for longitudinal medical follow-up care, initial evaluations, parent trainings, support groups, therapies, early interventions, special education and more are stretching our collective ingenuity to meet critical needs.

Professionals and people with autism alike are finding that virtual visits are a unique and refreshing way to connect that seem to reduce the perceived demands of traditional social communication and open up channels for novel opportunities to support the therapeutic relationship. It is likely we will look back on our traditional, in-person visit methods and wonder what we could have applied with 2020 hindsight.

Kristin Sohl, MD, FAAP is Associate Professor, Department of Child Health, University of Missouri School of Medicine, and Executive Director, ECHO Autism.

Dr, Sohl is a pediatrician with extensive experience in medical diagnosis, evaluation and treatment of children with a concern of autism and other neurodevelopmental disorders. Dr. Sohl is regarded as an expert in quality and process improvement particularly for comprehensive autism diagnostic and longitudinal services. She is the founder of ECHO Autism, an innovative framework to increase community capacity to care for children with autism and other developmental/behavioral concerns. The ECHO Autism program is viewed as a national model in expanding autism diagnosis and treatment to underserved and rural populations-those currently faced with the longest wait times. In partnership with Autism Speaks – Autism Treatment Network and Autism Intervention Research for Physical Health Network, The ECHO Autism team has established partnerships with other children’s hospitals and autism centers in more than 30 locations in the United States and 10 international locations. Since 2015, ECHO Autism has expanded to mentor many types of professionals through its unique blend of professional development and case-based learning to become Autism Ready ™ so that people with autism and their families can be supported in their local communities.  

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