Tele-treatments
Traumatic brain injury
Evidence reviewed as of before 20-05-2021
Author(s): Ogourtsova, T. (PhD OT), Osman, G. (MSc OT student), & Dunn, T. (MSc student)
Introduction
For traumatic brain injuries (TBI), we found 14 studies on tele-treatments. Seven of them are high quality randomized clinical trials (RCTs), 3 are a fair quality RCTs, and 4 are non-RCTs.These tele-treatments were provided by psychologists, a multidisciplinary team of professionals, a and paraprofessional coach, while 2 studies did not have any rehabilitation specialist. Most tele-treatments (78.6% of studies) targeted to improve both, parent- and child-related outcomes. For example, interventions focused on parent’s skills, participation, family functioning, psychological distress, and self-management, as well as child’s gross motor capacity, performance, and executive functions. Interventions were mainly provided through videoconferencing (in 71.4%% of studies) and clinicians were mainly actively involved in all sessions (78.6% of studies).
Thirty-one (n=31) different outcomes were studied, and 58% of them emerged from RCTs. Telerehabilitation was found to be more effective (vs. no treatment) in improving 14.3% of outcomes; and more effective (vs. another intervention) in improving 36.3% of outcomes.
Proceed to the Clinician information section to find out more.
Clinician information
In this section, you will find a list of outcomes that were examined in the selected studies; whether telerehabilitation was more or as effective (for RCTs) or effective/not effective (for non-RCTs); the comparison intervention (e.g., usual care, if present); and the level of evidence. Find out more about the levels of evidence here.Health education
Results Table For traumatic brain injuries (TBI), two studies focused on tele-interventions without involving a clinician in delivering the treatments. Both studies were non-RCTs. The focus of these tele-interventions was to improve child’s self-management, education, and skill training.Four (n=4) different outcomes were studied, and all of them emerge from non-RCTs.
Expand on the outcomes below to find out more.
Functional disabilityEffective5
Two non-RCT studies from 1 project (Babcock et al., 2017; Kurowski et al., 2016) investigated the effect of telerehabilitation on functional disability among families of youth with TBI. These non-RCT studies assigned participants (youth alone) to receive telerehabilitation (Self-Management Activity Restriction and Relaxation Training [SMART] targeting self-management, education, and skill training with daily login sessions of approximately 30 minutes over a period of 4 weeks). Functional disability was measured by the youth and parent-reported Functional Disability Inventory (FDI: Adolescent-reported; Parent-reported) at post-treatment (4 weeks). A significant improvement was found in the parent-reported measure.
Conclusion: There is insufficient evidence (Level 5) regarding the effect of telerehabilitation (SMART targeting self-management, education, and skill training) on functional disability among youth with TBI. However, one non-RCT study found improvements following telerehabilitation in the parent-reported measure.
Conclusion: There is insufficient evidence (Level 5) regarding the effect of telerehabilitation (SMART targeting self-management, education, and skill training) on functional disability among youth with TBI. However, one non-RCT study found improvements following telerehabilitation in the parent-reported measure.
Symptom burdenEffective5
Two non-RCT studies from 1 project (Babcock et al., 2017; Kurowski et al., 2016) investigated the effect of telerehabilitation on symptom burden among youth with TBI. These non-RCT studies assigned participants (youth alone) to receive telerehabilitation (Self-Management Activity Restriction and Relaxation Training [SMART] targeting self-management, education, and skill training with daily login sessions of approximately 30 minutes over a period of 4 weeks). Symptom burden was measured by the youth and parent-reported Health and Behavior Inventory (HBI: Adolescent-reported; Parent-reported) at post-treatment (4 weeks). Significant improvements were found in both measures.
Conclusion: There is insufficient evidence (Level 5) regarding the effect of telerehabilitation (SMART targeting self-management, education, and skill training) on symptom burden among youth with TBI. However, one non-RCT study found improvements following telerehabilitation.
Conclusion: There is insufficient evidence (Level 5) regarding the effect of telerehabilitation (SMART targeting self-management, education, and skill training) on symptom burden among youth with TBI. However, one non-RCT study found improvements following telerehabilitation.
Behavioral challengesNot effective5
Two non-RCT studies from 1 project (Babcock et al., 2017; Kurowski et al., 2016) investigated the effect of telerehabilitation on behavioural challenges among youth with TBI. These non-RCT studies assigned participants (youth alone) to receive telerehabilitation (Self-Management Activity Restriction and Relaxation Training [SMART] targeting self-management, education, and skill training with daily login sessions of approximately 30 minutes over a period of 4 weeks). Behavioural challenges were measured by the Child Behavioural Checklist and Youth Self-Report at post-treatment (4 weeks). No significant improvements were found.
Conclusion: There is insufficient evidence (Level 5) regarding the effect of telerehabilitation (SMART targeting self-management, education, and skill training) on behavioural challenges among youth with TBI.
Conclusion: There is insufficient evidence (Level 5) regarding the effect of telerehabilitation (SMART targeting self-management, education, and skill training) on behavioural challenges among youth with TBI.
Concussion knowledgeNot effective5
Two non-RCT studies from 1 project (Babcock et al., 2017; Kurowski et al., 2016) investigated the effect of telerehabilitation on concussion knowledge among youth with TBI. These non-RCT studies assigned participants (youth alone) to receive telerehabilitation (Self-Management Activity Restriction and Relaxation Training [SMART] targeting self-management, education, and skill training with daily login sessions of approximately 30 minutes over a period of 4 weeks). Concussion knowledge was measured by the parent and adolescent-reported Centre for Disease Control and Prevention Head’s Up concussion quiz at post-treatment (4 weeks). No significant improvement was found.
Conclusion: There is insufficient evidence (Level 5) regarding the effect of telerehabilitation (SMART targeting self-management, education, and skill training) on concussion knowledge among youth with TBI.
Conclusion: There is insufficient evidence (Level 5) regarding the effect of telerehabilitation (SMART targeting self-management, education, and skill training) on concussion knowledge among youth with TBI.
Multidisciplinary team
Results TableFor traumatic brain injuries (TBI), we found 2 studies on tele-treatments provided by a multidisciplinary team. Both studies were high quality RCTs.
The focus of the tele-interventions provided by the multidisciplinary team was to improve child’s gross motor capacity, performance, and executive functions.
Sixteen (n=16) different outcomes were studied, and 75% of them emerge from RCTs.
Expand on the outcomes below to find out more.
Functional strengthMore effective vs. Waitlist1b
One high quality RCT (Baque et al., 2017) investigated the effect of telerehabilitation on functional strength among children with acquired brain injury. This high quality RCT randomized participants (child/youth alone) to receive telerehabilitation (Move It To Improve It [Mitii] targeting gross motor capacity, performance and executive functions for a total of 60 hours; 30 minutes per day, 6 days a week for 20 weeks) vs. waitlist. Functional strength was measured by sit-to-stands, lateral step-ups, half-kneel to stand (30 second repetitions maximum) at post-treatment (20 weeks). A significant between-group difference was found on two out of three measures, favouring Mitii vs. waitlist.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCT that telerehabilitation (Mitii targeting gross motor capacity, performance and executive functions) is more effective than the comparison intervention (waitlist) in improving functional strength among children with acquired brain injury.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCT that telerehabilitation (Mitii targeting gross motor capacity, performance and executive functions) is more effective than the comparison intervention (waitlist) in improving functional strength among children with acquired brain injury.
AttentionAs effective vs. Waitlist1b
One high quality RCT (Piovesana et al., 2017) investigated the effect of telerehabilitation on attention among children with acquired brain injury. This high quality RCT randomized participants (child/youth alone) to receive telerehabilitation (Move It To Improve It [Mitii] targeting gross motor capacity, performance, and executive functions for a total of 60 hours; 30 minutes a day, 6 days a week for 20 weeks) vs. waitlist. Attention was measured by the Test of Everyday Attention for Children at post-treatment (20 weeks). No significant between-group difference was found.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCT that telerehabilitation (Mitii targeting gross motor capacity, performance, and executive functions) is as effective as the comparison intervention (waitlist) in improving attention among children with acquired brain injury.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCT that telerehabilitation (Mitii targeting gross motor capacity, performance, and executive functions) is as effective as the comparison intervention (waitlist) in improving attention among children with acquired brain injury.
Executive functionsAs effective vs. Waitlist1b
One high quality RCT (Piovesana et al., 2017) investigated the effect of telerehabilitation on executive functioning among children with acquired brain injury. This high quality RCT randomized participants (child/youth alone) to receive telerehabilitation (Move It To Improve It [Mitii] targeting gross motor capacity, performance, and executive functions for a total of 60 hours; 30 minutes a day, 6 days a week for 20 weeks) vs. waitlist. Executive functioning was measured by the parent-reported Delis-Kaplan Executive Functioning System, Tower of London Test, Comprehensive Trail Making Test, and the Behavior Rating Inventory of Executive Function (BRIEF) at post-treatment (20 weeks). No significant between-group difference was found.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCT that telerehabilitation (Mitii targeting gross motor capacity, performance, and executive functions) is as effective as the comparison intervention (waitlist) in improving executive functioning among children with acquired brain injury.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCT that telerehabilitation (Mitii targeting gross motor capacity, performance, and executive functions) is as effective as the comparison intervention (waitlist) in improving executive functioning among children with acquired brain injury.
Intellectual abilitiesAs effective vs. Waitlist1b
One high quality RCT (Piovesana et al., 2017) investigated the effect of telerehabilitation on intellectual ability among children with acquired brain injury. This high quality RCT randomized participants (child/youth alone) to receive telerehabilitation (Move It To Improve It [Mitii] targeting gross motor capacity, performance, and executive functions for a total of 60 hours; 30 minutes a day, 6 days a week for 20 weeks) vs. waitlist. Intellectual ability was measured by the Wechsler Intelligence Scale for Children (WISC) at post-treatment (20 weeks). No significant between-group difference was found.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCT that telerehabilitation (Mitii targeting gross motor capacity, performance, and executive functions) is as effective as the comparison intervention (waitlist) in improving intellectual ability among children with acquired brain injury.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCT that telerehabilitation (Mitii targeting gross motor capacity, performance, and executive functions) is as effective as the comparison intervention (waitlist) in improving intellectual ability among children with acquired brain injury.
MobilityAs effective vs. Waitlist1b
One high quality RCT (Baque et al., 2017) investigated the effect of telerehabilitation on mobility among children with acquired brain injury. This high quality RCT randomized participants (child/youth alone) to receive telerehabilitation (Move It To Improve It [Mitii] targeting gross motor capacity, performance, and executive functions for a total of 60 hours; 30 minutes a day, 6 days a week for 20 weeks) vs. waitlist. Mobility was measured by the parent-reported High-Level Mobility Assessment Tool, Timed-up and Go Test, and 28-item Mobility Questionnaire at post-treatment (20 weeks). No significant between-group difference was found.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCT that telerehabilitation (Mitii targeting gross motor capacity, performance, and executive functions) is as effective as the comparison intervention (waitlist) in improving mobility among children with acquired brain injury.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCT that telerehabilitation (Mitii targeting gross motor capacity, performance, and executive functions) is as effective as the comparison intervention (waitlist) in improving mobility among children with acquired brain injury.
Physical activityAs effective vs. Waitlist1b
One high quality RCT (Baque et al., 2017) investigated the effect of telerehabilitation on physical activity in children with acquired brain injury. This high quality RCT randomized participants (child/youth alone) to receive telerehabilitation (Move It To Improve It [Mitii] targeting gross motor capacity, performance, and executive functions for a total of 60 hours; 30 minutes a day, 6 days a week for 20 weeks) vs. waitlist. Physical activity was measured by ActiGraph GT3X triaxial accelerometer measurements of step counts and vertical accelerations at post-treatment (20 weeks). No significant between-group differences were found.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCT that telerehabilitation (Mitii targeting gross motor capacity, performance, and executive functions) is as effective as the comparison intervention (waitlist) in improving physical activity among children with acquired brain injury.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCT that telerehabilitation (Mitii targeting gross motor capacity, performance, and executive functions) is as effective as the comparison intervention (waitlist) in improving physical activity among children with acquired brain injury.
Walking enduranceAs effective vs. Waitlist1b
One high quality RCT (Baque et al., 2017) investigated the effect of telerehabilitation on walking endurance among children with acquired brain injury. This high quality RCT randomized participants (child/youth alone) to receive telerehabilitation (Move It To Improve It [Mitii] targeting gross motor capacity, performance, and executive functions for a total of 60 hours; 30 minutes a day, 6 days a week for 20 weeks) vs. waitlist. Walking endurance was measured by the 6-minute-walk test at post-treatment (20 weeks). No significant between-group difference was found.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCT that telerehabilitation (Mitii targeting gross motor capacity, performance, and executive functions) is as effective as the comparison intervention (waitlist) in improving walking endurance among children with acquired brain injury.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCT that telerehabilitation (Mitii targeting gross motor capacity, performance, and executive functions) is as effective as the comparison intervention (waitlist) in improving walking endurance among children with acquired brain injury.
Executive functionsAs effective vs. Internet resource2a
One fair quality RCT (Aguilar et al., 2019) investigated the effect of telerehabilitation on executive functions among children with TBI. This fair quality RCT randomized participants (parent alone) to receive telerehabilitation (Internet-Based Interacting Together Everyday: Recovery After Childhood TBI [I-InTERACT] targeting parental skills in 40–60-minute sessions, 1 session a week or bi-weekly for 10-14 sessions, with 4 optional sessions), express I-InTERACT (7 sessions), or internet resources. Executive functions were measured by the Behaviour Rating Inventory of Executive Function (BRIEF) or BRIEF pre-school at follow-up (6 months). A significant between-group difference was found, favouring express I-InTERACT vs. I-InTERACT.
Conclusion: There is limited evidence (Level 2a) from one fair quality RCT that telerehabilitation (I-InTERACT targeting parental skills) is as effective as the comparison intervention (internet resources) in improving executive functions among children with TBI. However, the express version of the intervention was found to be more effective than the regular full version.
Conclusion: There is limited evidence (Level 2a) from one fair quality RCT that telerehabilitation (I-InTERACT targeting parental skills) is as effective as the comparison intervention (internet resources) in improving executive functions among children with TBI. However, the express version of the intervention was found to be more effective than the regular full version.
Family cohesionMore effective vs. Internet resource2a
Two fair quality RCTs from one project (Narad et al., 2019; Wade et al., 2017) investigated the effect of telerehabilitation on family cohesion among parents of children/adolescents with TBI. These fair quality RCTs randomized participants (child/youth and parent or child/youth alone) to receive telerehabilitation (Teen Online Problem-Solving with Family [TOPS-F] targeting family functioning using 1 in-person session, followed by 1 session a week or bi-weekly for 10-18 sessions, over a period of 6 months), TOPS-Teen only, or internet resources. Family cohesion was measured by Parent-Adolescent Relationship Questionnaire at follow-up (6 months). A significant between-group difference was found (only for 2-parent households), favouring TOPS-Teen only vs. internet resources.
Conclusion: There is limited evidence (Level 2a) from two fair quality RCTs from one project that telerehabilitation (TOPS-Teen only targeting family functioning) is more effective than the comparison intervention (internet resource) in improving family cohesion among parents of children/adolescents with TBI.
Conclusion: There is limited evidence (Level 2a) from two fair quality RCTs from one project that telerehabilitation (TOPS-Teen only targeting family functioning) is more effective than the comparison intervention (internet resource) in improving family cohesion among parents of children/adolescents with TBI.
Global family functioningAs effective vs. Internet resource2a
Two fair quality RCTs from one project (Narad et al., 2019; Wade et al., 2017) investigated the effect of telerehabilitation on global family functioning among families of children/adolescents with TBI. These fair quality RCTs randomized participants (child/youth and parent or child/youth alone) to receive telerehabilitation (Teen Online Problem-Solving with Family [TOPS-F] targeting family functioning using 1 in-person session, followed by 1 session a week or bi-weekly for 10-18 sessions, over a period of 6 months), TOPS-Teen only, or internet resources. . Global family functioning was measured by Family Assessment Device (FAD-GF) at follow-up (6 months). A significant between-group difference was found (FAD-GF, for 2-parent households only), favouring TOPS-F vs. TOPS-Teen only. No other significant between-group differences were found.
Conclusion: There is limited evidence (Level 2a) from two fair quality RCTs from one project that telerehabilitation (TOPS-F and TOPS-Teen only targeting family functioning) is as effective as the comparison intervention (internet resources) in improving global family functioning among families of children/adolescents with TBI. However, the family version of the intervention was more effective than the teen-only version.
Conclusion: There is limited evidence (Level 2a) from two fair quality RCTs from one project that telerehabilitation (TOPS-F and TOPS-Teen only targeting family functioning) is as effective as the comparison intervention (internet resources) in improving global family functioning among families of children/adolescents with TBI. However, the family version of the intervention was more effective than the teen-only version.
Internalizing behavioursAs effective vs. Internet resource2a
One fair quality RCT (Aguilar et al., 2019) investigated the effect of telerehabilitation on internalizing behaviours among children with TBI. This fair quality RCT randomized participants (parent alone) to receive telerehabilitation (Internet-Based Interacting Together Everyday: Recovery After Childhood TBI [I-InTERACT] targeting parental skills in 40–60-minute sessions, 1 session a week or bi-weekly for 10-14 sessions, with 4 optional sessions), express I-InTERACT (7 sessions), or internet resources. Internalizing behaviours were measured by Child Behaviour Checklist (CBCL: Internalizing behaviours subscale) at follow-up (6 months). No significant between-group difference was found.
Conclusion: There is limited evidence (Level 2a) from one fair quality RCT that telerehabilitation (I-InTERACT targeting parental skills) is as effective as the comparison intervention (internet resources) in improving internalizing behaviours among children with TBI.
Conclusion: There is limited evidence (Level 2a) from one fair quality RCT that telerehabilitation (I-InTERACT targeting parental skills) is as effective as the comparison intervention (internet resources) in improving internalizing behaviours among children with TBI.
Somatic complaints As effective vs. Internet resource2a
One fair quality RCT (Aguilar et al., 2019) investigated the effect of telerehabilitation on somatic complaints among children with TBI. This fair quality RCT randomized participants (parent alone) to receive telerehabilitation (Internet-Based Interacting Together Everyday: Recovery After Childhood TBI [I-InTERACT] targeting parental skills in 40–60-minute sessions, 1 session a week or bi-weekly for 10-14 sessions, with 4 optional sessions), express I-InTERACT (7 sessions), or internet resources. Somatic complaints were measured by the somatic complaints subscale Child Behaviour Checklist (CBCL) at follow-up (6 months). No significant between-group difference was found.
Conclusion: There is limited evidence (Level 2a) from one fair quality RCT that telerehabilitation (I-InTERACT targeting parental skills) is as effective as the comparison intervention (internet resources) in improving somatic complaints among children with TBI.
Conclusion: There is limited evidence (Level 2a) from one fair quality RCT that telerehabilitation (I-InTERACT targeting parental skills) is as effective as the comparison intervention (internet resources) in improving somatic complaints among children with TBI.
Behavioural challengesMore effective vs. Internet resource2b
One quasi-experimental study (Mast et al., 2014) investigated the effect of telerehabilitation on behavioural challenges in children with brain injury. This quasi-experimental study assigned participants (parent alone) to receive telerehabilitation (Internet-based Interacting Together Everyday: Recovery After Childhood TBI [I-InTERACT] targeting positive parenting skills and child behaviour in 40–60-minute sessions, 1 session a week or bi-weekly for 10-14 sessions, with 4 optional sessions) vs. internet resources. Behavioural challenges were measured by Eyberg Child Behaviour Inventory (ECBI: Total Intensity; Total Problems) at follow-up (6 months). A significant between-group difference was found (ECBI: Total Intensity), favouring telerehabilitation vs. internet resources.
Conclusion: There is limited evidence (Level 2b) from one quasi-experimental study that telerehabilitation (I-InTERACT targeting positive parenting skills and child behaviour) is more effective than the comparison intervention (internet resources) in improving behavioural challenges in children with brain injury.
Conclusion: There is limited evidence (Level 2b) from one quasi-experimental study that telerehabilitation (I-InTERACT targeting positive parenting skills and child behaviour) is more effective than the comparison intervention (internet resources) in improving behavioural challenges in children with brain injury.
Behavioural and emotional functioningAs effective vs. Internet resource2b
One quasi-experimental study (Mast et al., 2014) investigated the effect of telerehabilitation on behavioural and emotional functioning in children with brain injury. This quasi-experimental study assigned participants (parent alone) to receive telerehabilitation (Internet-based Interacting Together Everyday: Recovery After Childhood TBI [I-InTERACT] targeting positive parenting skills and child behaviour in 40–60-minute sessions, 1 session a week or bi-weekly for 10-14 sessions, with 4 optional sessions) vs. internet resources. Behavioural and emotional functioning were measured by Child Behaviour Checklist (CBCL: Internalizing scale, Externalizing scale, and Total problems scale) at follow-up (6 months). No significant between-group difference was found.
Conclusion: There is limited evidence (Level 2b) from one quasi-experimental study that telerehabilitation (I-InTERACT targeting positive parenting skills and child behaviour) is as effective as the comparison intervention (internet resources) in improving behavioural and emotional functioning among children with brain injury.
Conclusion: There is limited evidence (Level 2b) from one quasi-experimental study that telerehabilitation (I-InTERACT targeting positive parenting skills and child behaviour) is as effective as the comparison intervention (internet resources) in improving behavioural and emotional functioning among children with brain injury.
Satisfaction with telerehabilitationEffective5
One non-RCT study (Woods et al., 2012) investigated the effect of telerehabilitation on satisfaction with telerehabilitation among caregivers of children with acquired brain injury (ABI). This non-RCT study assigned participants (parent alone) to receive telerehabilitation (Signpost telephone-support targeting parenting skills and management of challenging behaviours with 3 telephone meetings of 2.5 hours over 6 weeks) vs. face-to-face. Satisfaction with telerehabilitation was measured through qualitative reports, where parents rated Signposts useful, helpful and feasible at post-treatment (5 months).
Conclusion: There is insufficient evidence (Level 5) regarding the effect of telerehabilitation (Signpost telephone-support targeting parenting skills and management of challenging behaviours) on satisfaction with telerehabilitation among caregivers of children with ABI. However, one non-RCT study found high rates of satisfaction following telerehabilitation.
Conclusion: There is insufficient evidence (Level 5) regarding the effect of telerehabilitation (Signpost telephone-support targeting parenting skills and management of challenging behaviours) on satisfaction with telerehabilitation among caregivers of children with ABI. However, one non-RCT study found high rates of satisfaction following telerehabilitation.
Social competenceNot effective5
One non-RCT study (Wade et al., 2018) investigated the effectiveness of a telerehabilitation intervention on social competence in adolescents with TBI or brain tumor. This non-RCT pre-post study assigned participants (parents and children) to receive telerehabilitation (Social Participation and Navigation [SPAN] targeting developmental and implementation of social participation goals for 30–60-minute sessions, 1 session a week for 10 weeks). Social competence was measured by the youth and parent-reported Youth Self Report (YSR: Social competence) and the Child Behaviour Checklist (CBCL: Social competence) at post-treatment (10 weeks). No significant improvements were found.
Conclusion: There is insufficient evidence (Level 5) regarding the effect of telerehabilitation (SPAN targeting developmental and implementation of social participation goals) on social competence in adolescents with TBI or brain tumor.
Conclusion: There is insufficient evidence (Level 5) regarding the effect of telerehabilitation (SPAN targeting developmental and implementation of social participation goals) on social competence in adolescents with TBI or brain tumor.
Paraprofessional coach
Results Table For children with traumatic brain injury (TBI), we found 1 study on tele-treatments provided by a paraprofessional coach. This study was a non-RCT. The focus of the tele-interventions provided by the paraprofessional coach was to improve social participation.Four (n=4) different outcomes were studied, and all of them emerge from non-RCTs.
Expand on the outcomes below to find out more.
Participation frequency and satisfactionEffective5
One non-RCT study (Wade et al., 2018) investigated the effectiveness of a telerehabilitation intervention on participation frequency and satisfaction in adolescents with TBI or brain tumor. This non-RCT study assigned participants (parents and children) to receive telerehabilitation (Social Participation and Navigation [SPAN] targeting developmental and implementation of social participation goals for 30–60-minute sessions, 1 session a week for 10 weeks). Participation frequency and satisfaction were measured by the parent and youth-reported 30-item Social Participation Scale at post-treatment (10 weeks). A significant improvement was found only in one parent-reported measure (Participation frequency).
Conclusion: There is insufficient evidence (Level 5) regarding the effect of telerehabilitation (SPAN targeting developmental and implementation of social participation goals) on participation frequency and satisfaction in adolescents with TBI or brain tumor. However, one non-RCT study found improvements following telerehabilitation.
Conclusion: There is insufficient evidence (Level 5) regarding the effect of telerehabilitation (SPAN targeting developmental and implementation of social participation goals) on participation frequency and satisfaction in adolescents with TBI or brain tumor. However, one non-RCT study found improvements following telerehabilitation.
Participation problemsEffective5
One non-RCT study (Wade et al., 2018) investigated the effectiveness of a telerehabilitation intervention on participation problems (in adolescents with TBI or brain tumor. This non-RCT study assigned participants (parents and children) to receive telerehabilitation (Social Participation and Navigation [SPAN] targeting developmental and implementation of social participation goals for 30–60-minute sessions, 1 session a week for 10 weeks). Participation problems were measured by youth self-report (YSR: Total problems; Internalizing problems; Externalizing problems; Social problems) and parent-reported Child Behavior Checklist (CBC: Total problems; Internalizing problems; Externalizing problems; Social problems) at post-treatment (10 weeks). Significant improvements were found only in parent-reported measures.
Conclusion: There is insufficient evidence (Level 5) regarding the effect of telerehabilitation (SPAN targeting developmental and implementation of social participation goals) on problems (total, internalizing, externalizing, social, and social competence) in adolescents with TBI or brain tumor. However, one non-RCT study found improvements following telerehabilitation on parent-reported measures.
Conclusion: There is insufficient evidence (Level 5) regarding the effect of telerehabilitation (SPAN targeting developmental and implementation of social participation goals) on problems (total, internalizing, externalizing, social, and social competence) in adolescents with TBI or brain tumor. However, one non-RCT study found improvements following telerehabilitation on parent-reported measures.
Confidence in participation self-efficacyEffective5
One non-RCT study (Wade et al., 2018) investigated the effectiveness of a telerehabilitation intervention on confidence in participation self-efficacy in adolescents with TBI or brain tumor. This non-RCT study assigned participants (parents and children) to receive telerehabilitation (Social Participation and Navigation [SPAN] targeting developmental and implementation of social participation goals for 30–60-minute sessions, 1 session a week for 10 weeks). Confidence in participation self-efficacy was measured by the parent and youth-reported 20-item Self-Efficacy Scale at post-treatment (10 weeks). A significant improvement was found in the youth-reported measure.
Conclusion: There is insufficient evidence (Level 5) regarding the effect of telerehabilitation (SPAN targeting developmental and implementation of social participation goals) on confidence in participation self-efficacy in adolescents with TBI or brain tumor. However, one non-RCT study found improvements following telerehabilitation in a youth-reported measure.
Conclusion: There is insufficient evidence (Level 5) regarding the effect of telerehabilitation (SPAN targeting developmental and implementation of social participation goals) on confidence in participation self-efficacy in adolescents with TBI or brain tumor. However, one non-RCT study found improvements following telerehabilitation in a youth-reported measure.
Confidence in emotion self-efficacyNot effective5
One non-RCT study (Wade et al., 2018) investigated the effectiveness of a telerehabilitation intervention on confidence in emotion self-efficacy in adolescents with TBI or brain tumor. This non-RCT study assigned participants (parents and children) to receive telerehabilitation (Social Participation and Navigation [SPAN] targeting developmental and implementation of social participation goals for 30–60-minute sessions, 1 session a week for 10 weeks). Confidence in emotion self-efficacy was measured by the parent and youth-reported 20-item Self-Efficacy Scale at post-treatment (10 weeks). No significant improvements were found.
Conclusion: There is insufficient evidence (Level 5) regarding the effect of telerehabilitation (SPAN targeting developmental and implementation of social participation goals) on confidence in emotion self-efficacy in adolescents with TBI or brain tumor.
Conclusion: There is insufficient evidence (Level 5) regarding the effect of telerehabilitation (SPAN targeting developmental and implementation of social participation goals) on confidence in emotion self-efficacy in adolescents with TBI or brain tumor.
Psychology
Results Table For traumatic brain injuries (TBI), we found 9 studies on tele-treatments provided by psychologists. Out of those studies, 4 are high quality randomized clinical trials (RCTs), 3 are fair quality RCTs, and 2 are non-RCTs.The focus of the tele-interventions provided by psychologists was to improve child’s behavior, positive parenting skills, family functioning, parent psychological distress.
Seven (n=7) different outcomes were studied, and all emerge from RCTs.
Expand on the outcomes below to find out more.
Effective communication More effective vs. Internet resource1b
Three high quality RCTs from one project (Narad et al., 2015; Petranovich et al., 2015; Wade et al., 2014) investigated the effect of telerehabilitation on effective communication among families of adolescents with traumatic brain injury (TBI). These high quality RCTs randomized participants (youth and parents) to receive telerehabilitation (Counselor-Assisted Problem-Solving [CAPS] targeting family functioning, problem solving, communication skills, self-regulation, and anger management with one in-person 90-minute session, followed by 7-11 video-conference sessions of 30-45 minutes over a 6 month period) vs. internet resources. Effective communication was measured by the parent and teen-reported Iowa Family Interaction Rating Scale (IFIRS) at follow-up (6, 12, and 18 months). A significant between-group difference was found at 6 months (parent-reported IFIRS), favouring CAPS vs. internet resources.
Conclusion: There is moderate evidence (Level 1b) from three high quality RCTs from one project that telerehabilitation (CAPS targeting family functioning) is more effective than the comparison intervention (internet resources) in improving effective communication among families of adolescents with TBI.
Conclusion: There is moderate evidence (Level 1b) from three high quality RCTs from one project that telerehabilitation (CAPS targeting family functioning) is more effective than the comparison intervention (internet resources) in improving effective communication among families of adolescents with TBI.
Parental mental health More effective vs. Internet resource1b
Three high quality RCTs from one project (Narad et al., 2015; Petranovich et al., 2015; Wade et al., 2014) investigated the effect of telerehabilitation on parental mental health among parents of adolescents with traumatic brain injury (TBI).
The first three high quality RCTs from one project (Narad et al., 2015; Petranovich et al., 2015; Wade et al., 2014) randomized participants (youth and parents) to receive telerehabilitation (Counsellor-Assisted Problem-Solving [CAPS] targeting family functioning, problem-solving, communication skills, self-regulation, and anger management with one in-person 90-minute session, followed by 7-11 video-conference sessions of 30-45 minutes over a period of 6 months) vs. internet resources. Parental mental health (global psychiatric symptoms and distress) were measured by the Symptom Checklist-90R: Global Severity Index (SCL-90-GSI) and the Center for Epidemiological Studies Depression Scale (CES-D) at follow-up (6, 12, and 18 months). A significant between-group difference was found on one measure (SCL-90-GSI, for low-income families only) at all 3 timepoints, favouring CAPS vs. internet resources.
The second high quality RCT (Raj et al., 2015) randomized participants (parent alone) to receive telerehabilitation (Internet-based Interacting Together Everyday: Recovery After Childhood TBI [I-InTERACT] targeting parent psychological distress using 40–60-minute sessions, 1 session a week or bi-weekly for 10-14 sessions with 4 optional sessions) vs. internet resources. Parental mental health (psychological distress) was measured by the SCL-90-GSI and CES-D at follow-up (6 months). A significant improvement was found in one measure (SCL-90-GSI, for families with low income only), favoring InTERACT vs. internet resources.
Two fair quality RCTs from one project (Narad et al., 2019; Wade et al., 2017) randomized participants (child/youth and parent or child/youth alone) to receive telerehabilitation (Teen Online Problem-Solving with Family [TOPS-F] targeting family functioning using 1 in-person session, followed by 1 session a week or bi-weekly for 10-18 sessions, over a period of 6 months), TOPS-Teen only, or internet resources. Parental mental health (depression; psychological distress) was measured by SCL-90-GSI and the CES-D at follow-up (6 months). Significant between-group differences were found, favouring TOPS-F vs. TOPS-Teen only (CES-D, for 2-parent households only), and favouring TOPS-F vs. internet resources (CES-D, for 2-parent households only).
Conclusion: There is strong evidence (Level 1a) from two high quality RCTs projects and 1 fair-quality RCT project that telerehabilitation (CAPS targeting family functioning; I-InTERACT targeting parent psychological distress; TOPS-F) is more effective than the comparison intervention (internet resources) in improving mental health among parents of adolescents with TBI.
The first three high quality RCTs from one project (Narad et al., 2015; Petranovich et al., 2015; Wade et al., 2014) randomized participants (youth and parents) to receive telerehabilitation (Counsellor-Assisted Problem-Solving [CAPS] targeting family functioning, problem-solving, communication skills, self-regulation, and anger management with one in-person 90-minute session, followed by 7-11 video-conference sessions of 30-45 minutes over a period of 6 months) vs. internet resources. Parental mental health (global psychiatric symptoms and distress) were measured by the Symptom Checklist-90R: Global Severity Index (SCL-90-GSI) and the Center for Epidemiological Studies Depression Scale (CES-D) at follow-up (6, 12, and 18 months). A significant between-group difference was found on one measure (SCL-90-GSI, for low-income families only) at all 3 timepoints, favouring CAPS vs. internet resources.
The second high quality RCT (Raj et al., 2015) randomized participants (parent alone) to receive telerehabilitation (Internet-based Interacting Together Everyday: Recovery After Childhood TBI [I-InTERACT] targeting parent psychological distress using 40–60-minute sessions, 1 session a week or bi-weekly for 10-14 sessions with 4 optional sessions) vs. internet resources. Parental mental health (psychological distress) was measured by the SCL-90-GSI and CES-D at follow-up (6 months). A significant improvement was found in one measure (SCL-90-GSI, for families with low income only), favoring InTERACT vs. internet resources.
Two fair quality RCTs from one project (Narad et al., 2019; Wade et al., 2017) randomized participants (child/youth and parent or child/youth alone) to receive telerehabilitation (Teen Online Problem-Solving with Family [TOPS-F] targeting family functioning using 1 in-person session, followed by 1 session a week or bi-weekly for 10-18 sessions, over a period of 6 months), TOPS-Teen only, or internet resources. Parental mental health (depression; psychological distress) was measured by SCL-90-GSI and the CES-D at follow-up (6 months). Significant between-group differences were found, favouring TOPS-F vs. TOPS-Teen only (CES-D, for 2-parent households only), and favouring TOPS-F vs. internet resources (CES-D, for 2-parent households only).
Conclusion: There is strong evidence (Level 1a) from two high quality RCTs projects and 1 fair-quality RCT project that telerehabilitation (CAPS targeting family functioning; I-InTERACT targeting parent psychological distress; TOPS-F) is more effective than the comparison intervention (internet resources) in improving mental health among parents of adolescents with TBI.
Parental stressAs effective vs. Internet resource1b
One high quality RCT (Raj et al., 2015) investigated the effects of telerehabilitation o parental stress among parents of children with traumatic brain injury (TBI). randomized participants (parent alone) to receive telerehabilitation (Internet-based Interacting Together Everyday: Recovery After Childhood TBI [I-InTERACT] targeting parent psychological distress using 40–60-minute sessions, 1 session a week or bi-weekly for 10-14 sessions with 4 optional sessions) vs. internet resources. Parental stress was measured by the Parent Stress Index at follow-up (6 months). No significant between-group difference was found.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCT that telerehabilitation (I-InTERACT targeting parent psychological distress) is as effective as the comparison intervention (internet resources) in improving stress among parents of children with TBI.
Conclusion: There is moderate evidence (Level 1b) from one high quality RCT that telerehabilitation (I-InTERACT targeting parent psychological distress) is as effective as the comparison intervention (internet resources) in improving stress among parents of children with TBI.
Parent-teen conflictAs effective vs. Internet resource1b
Three high quality RCTs from one project (Narad et al., 2015; Petranovich et al., 2015; Wade et al., 2014) and two fair quality RCTs from one project (Narad et al., 2019; Wade et al., 2017) investigated the effect of telerehabilitation on parent-teen conflict among families of adolescents with traumatic brain injury (TBI).
The high quality RCTs from one project (Narad et al., 2015; Petranovich et al., 2015; Wade et al., 2014) randomized participants (youth and parents) to receive telerehabilitation (Counselor-Assisted Problem-Solving [CAPS] targeting family functioning, problem solving, communication skills, self-regulation, and anger management with one in-person 90-minute session, followed by 7-11 video-conference sessions of 30-45 minutes over a 6 month period) vs. internet resources. Parent-teen conflict was measured by the parent and teen-reported Problem-Solving Discussion Rating Scale at follow-up (6, 12, and 18 months). No significant between-group differences were found.
The fair quality RCTs from one project (Narad et al., 2019; Wade et al., 2017) randomized participants (child/youth and parent or child/youth alone) to receive telerehabilitation (Teen Online Problem-Solving with Family [TOPS-F] targeting family functioning using 1 in-person session, followed by 1 session a week or bi-weekly for 10-18 sessions, over a period of 6 months), TOPS-Teen only, or internet resources. Parent-teen conflict was measured by Interaction Behavior Questionnaire-Short Form at follow-up (6 months). No significant between-group difference was found.
Conclusion: There is strong evidence (Level 1b) from three high quality RCTs from one project and two fair quality RCTs from another project that telerehabilitation (CAPS targeting family functioning; TOPS targeting family functioning) is as effective as the comparison intervention (internet resources) in improving parent-adolescent conflict among families of adolescents with TBI.
The high quality RCTs from one project (Narad et al., 2015; Petranovich et al., 2015; Wade et al., 2014) randomized participants (youth and parents) to receive telerehabilitation (Counselor-Assisted Problem-Solving [CAPS] targeting family functioning, problem solving, communication skills, self-regulation, and anger management with one in-person 90-minute session, followed by 7-11 video-conference sessions of 30-45 minutes over a 6 month period) vs. internet resources. Parent-teen conflict was measured by the parent and teen-reported Problem-Solving Discussion Rating Scale at follow-up (6, 12, and 18 months). No significant between-group differences were found.
The fair quality RCTs from one project (Narad et al., 2019; Wade et al., 2017) randomized participants (child/youth and parent or child/youth alone) to receive telerehabilitation (Teen Online Problem-Solving with Family [TOPS-F] targeting family functioning using 1 in-person session, followed by 1 session a week or bi-weekly for 10-18 sessions, over a period of 6 months), TOPS-Teen only, or internet resources. Parent-teen conflict was measured by Interaction Behavior Questionnaire-Short Form at follow-up (6 months). No significant between-group difference was found.
Conclusion: There is strong evidence (Level 1b) from three high quality RCTs from one project and two fair quality RCTs from another project that telerehabilitation (CAPS targeting family functioning; TOPS targeting family functioning) is as effective as the comparison intervention (internet resources) in improving parent-adolescent conflict among families of adolescents with TBI.
Problem-solvingAs effective vs. Internet resource1b
Three high quality RCTs from one project (Narad et al., 2015; Petranovich et al., 2015; Wade et al., 2014) investigated the effect of telerehabilitation on problem-solving among families of children/adolescents with traumatic brain injury (TBI). These high quality RCTs randomized participants (youth and parents) to receive telerehabilitation (Counselor-Assisted Problem-Solving [CAPS] targeting family functioning, problem solving, communication skills, self-regulation, and anger management with one in-person 90-minute session, followed by 7-11 video-conference sessions of 30-45 minutes over a 6-month period) vs. internet resources. Problem-solving was measured by the parent and teen-reported Family Assessment Device Problem-solving scale at follow-up (6, 12, and 18 months). No significant between-group differences were found.
Conclusion: There is moderate evidence (Level 1b) from three high quality RCTs from one project that telerehabilitation (CAPS targeting family functioning) is as effective as the comparison intervention (internet resources) in improving problem-solving among families of children/adolescents with TBI.
Conclusion: There is moderate evidence (Level 1b) from three high quality RCTs from one project that telerehabilitation (CAPS targeting family functioning) is as effective as the comparison intervention (internet resources) in improving problem-solving among families of children/adolescents with TBI.
Mental health (child) More effective vs. Internet resource2a
One fair quality RCT (Aguilar et al., 2019) investigated the effect of telerehabilitation on mental health among children with TBI. This fair quality RCT randomized participants (parent alone) to receive telerehabilitation (Internet-Based Interacting Together Everyday: Recovery After Childhood TBI [I-InTERACT] targeting parental skills in 40–60-minute sessions, 1 session a week or bi-weekly for 10-14 sessions, with 4 optional sessions), express I-InTERACT (7 sessions), or internet resources. Child’s mental health (anxiety, depression, withdrawal) was measured by the Child Behaviour Checklist (CBCL: Anxiety/Depression; Withdrawn/Depressed subscales) at follow-up (6 months). One significant between-group difference was found (CBCL: Withdrawn/Depressed), favouring express I-InTERACT vs. internet resources.
Conclusion: There is limited evidence (Level 2a) from one fair quality RCT that telerehabilitation (I-InTERACT targeting parental skills) is more effective than the comparison intervention (internet resources) in improving mental health among children with TBI.
Conclusion: There is limited evidence (Level 2a) from one fair quality RCT that telerehabilitation (I-InTERACT targeting parental skills) is more effective than the comparison intervention (internet resources) in improving mental health among children with TBI.
Parental self-efficacyConflicting4
Four high quality RCTs (three from one project: Narad et al., 2015; Petranovich et al., 2015; Wade et al., 2014; & Raj et al., 2019) investigated the effect of telerehabilitation on parental self-efficacy in caregivers of children with TBI.
The first set of 3 high quality RCTs from 1 project (Narad et al., 2015; Petranovich et al., 2015; Wade et al., 2014) randomized participants (youth and caregiver) to receive telerehabilitation (Counselor-Assisted Problem-Solving [CAPS] targeting family functioning after TBI with problem solving, communication skills, self-regulation, and anger management in 1 in-person initial session for 90 minutes, followed by 30–45-minute sessions, for 7-11 sessions) vs. internet resources. Parental self-efficacy was measured by the Caregiver Self-Efficacy Scale (CSES) at follow-up (6, 12, and 18 months). A significant between-group difference was found, favouring CAPS vs. internet resources at 6 months.
The second high quality RCT (Raj et al., 2015) randomized participants (parent alone) to receive telerehabilitation (Internet-based Interacting Together Everyday: Recovery After Childhood TBI [I-InTERACT] targeting parent psychological distress) vs. internet resources. Parental self-efficacy was measured by CSES at follow-up (6 months). No significant between-group difference was found.
Conclusion: There is conflicting evidence (Level 4) regarding the effect of telerehabilitation on parental self-efficacy. While one project of high quality RCTs found that telerehabilitation (CAPS, targeting family functioning) was more effective than internet resources, another high quality RCT found that telerehabilitation (I-IntERACT, targeting family functioning) was as effective as internet resources. Note: Sample size (n=132 vs. 37) and nature of interventions (parent & child vs. parent targeted only) could explain the difference in findings.
The first set of 3 high quality RCTs from 1 project (Narad et al., 2015; Petranovich et al., 2015; Wade et al., 2014) randomized participants (youth and caregiver) to receive telerehabilitation (Counselor-Assisted Problem-Solving [CAPS] targeting family functioning after TBI with problem solving, communication skills, self-regulation, and anger management in 1 in-person initial session for 90 minutes, followed by 30–45-minute sessions, for 7-11 sessions) vs. internet resources. Parental self-efficacy was measured by the Caregiver Self-Efficacy Scale (CSES) at follow-up (6, 12, and 18 months). A significant between-group difference was found, favouring CAPS vs. internet resources at 6 months.
The second high quality RCT (Raj et al., 2015) randomized participants (parent alone) to receive telerehabilitation (Internet-based Interacting Together Everyday: Recovery After Childhood TBI [I-InTERACT] targeting parent psychological distress) vs. internet resources. Parental self-efficacy was measured by CSES at follow-up (6 months). No significant between-group difference was found.
Conclusion: There is conflicting evidence (Level 4) regarding the effect of telerehabilitation on parental self-efficacy. While one project of high quality RCTs found that telerehabilitation (CAPS, targeting family functioning) was more effective than internet resources, another high quality RCT found that telerehabilitation (I-IntERACT, targeting family functioning) was as effective as internet resources. Note: Sample size (n=132 vs. 37) and nature of interventions (parent & child vs. parent targeted only) could explain the difference in findings.
References
Aguilar, J.M., et al., A Comparison of 2 Online Parent Skills Training Interventions for Early Childhood Brain Injury: Improvements in Internalizing and Executive Function Behaviors. Journal of Head Trauma Rehabilitation, 2019. 34(2): p. 65-76.Babcock, L., et al., Adolescents with Mild Traumatic Brain Injury Get SMART: An Analysis of a Novel Web-Based Intervention. Telemedicine Journal & E-Health, 2017. 23(7): p. 600-607.
Baque, E., et al., Randomized controlled trial of web-based multimodal therapy for children with acquired brain injury to improve gross motor capacity and performance. Clin Rehabil, 2017. 31(6): p. 722-732.
Kurowski, B.G., et al., Feasibility and Potential Benefits of a Web-Based Intervention Delivered Acutely After Mild Traumatic Brain Injury in Adolescents: A Pilot Study. Journal of Head Trauma Rehabilitation, 2016. 31(6): p. 369-378.
Mast, J.E., et al., Web-based parenting skills to reduce behavior problems following abusive head trauma: a pilot study. Child Abuse Negl, 2014. 38(9): p. 1487-95.
Narad, M.E., et al., Effects of a Web-Based Intervention on Family Functioning Following Pediatric Traumatic Brain Injury. Journal of developmental and behavioral pediatrics : JDBP, 2015. 36(9): p. 700-707.
Narad, M., et al., Randomized controlled trial of an online problem-solving intervention following adolescent traumatic brain injury: Family outcomes. Archives of Physical Medicine and Rehabilitation, 2019. 100(5): p. 811-20.
Petranovich, C.L., et al., Long-Term Caregiver Mental Health Outcomes Following a Predominately Online Intervention for Adolescents With Complicated Mild to Severe Traumatic Brain Injury. Journal of pediatric psychology, 2015. 40(7): p. 680-688.
Piovesana, A., et al., A randomised controlled trial of a web-based multi-modal therapy program to improve executive functioning in children and adolescents with acquired brain injury. Clinical Rehabilitation, 2017. 31(10): p. 1351-1363.
Raj, S.P., et al., Web-Based Parenting Skills Program for Pediatric Traumatic Brain Injury Reduces Psychological Distress Among Lower-Income Parents. J Head Trauma Rehabil, 2015. 30(5): p. 347-56.
Wade, S., et al., Counselor-assisted problem solving improves caregiver efficacy following adolescent brain injury. Rehabilitation Psychology, 2014. 59(1): p. 1-9.
Wade, S., et al., Teen online problem solving for teens with traumatic brain injury: Rationale, methods, and preliminary feasibility of a teen only intervention. Rehabilitation Psychology, 2017. 62(3): p. 290-9.
Wade, S., et al., Social Participation and Navigation (SPAN) program for adolescents with, acquired brain injury: Pilot findings. Rehabilitation Psychology, 2018. 63(3): p. 327-37.
Woods, D., et al., Feasibility and consumer satisfaction ratings following an intervention for families who have a child with acquired brain injury. Neurorehabilitation, 2012. 30(3): p. 189-98.
Patient and family information
Summary for Patients/FamiliesWhat research is available?
There are 14 studies on different available telerehab-treatments.
How strong is the research behind these treatments?
While there are 10 studies of high and moderate research quality, 4 studies are of low research quality.
Telerehabilitation is an emerging and a rapidly growing field. More high-quality research is on its way. We are dedicated to update the available information with the most recent findings.
Who provides these treatments?
These telerehab-treatments are provided by different specialists including:
- Psychologists
- Paraprofessional coaches
- Multidisciplinary teams of different professionals (e.g., occupational therapists, speech language pathologists).
What is the involvement of the clinician in these treatments?
Clinicians are mainly actively involved in these telerehab-treatments. In other words, they are present and engaged with you and/or the child in every therapy session.
How are these treatments provided?
In most cases, telerehab-treatments are provided through videoconferencing by using different platforms (e.g., Skype, Zoom, or other video calls options). Other ways included self-directed online learning and phone calls.
Who receives these treatments?
Telerehab-treatments are provided mostly directly to parents of children with TBI or the child alone. Fewer treatments engaged both the child and their parent together in their approach.
What are the goals of these treatments?
Most of these telerehab-treatments focus on improving both, child and parent-related outcomes including:
- Parent’s…
- Abilities and interaction skills with their child
- Positive parenting skills
- Family functioning after TBI
- Psychological distress
- Management of challenging behaviors
- Child’s…
- Gross motor capacity and performance (e.g., jumping)
- Executive functions (e.g. planning an activity and sequencing events)
- Child behavior
- Problem-solving
- Communications skills
- Self-regulation
- Anger management
- Self-management
- Education
- Social participation
Does it work?
Yes! Telerehab-treatments are shown to work for children and youth with TBI and their families.
For instance, telerehab delivered by psychologists, a multidisciplinary team, and paraprofessional coaches were shown to be more effective in improving numerous skills and abilities among parents and children than when family receives:
- No treatment
- Self-directed online learning (passive web)
Are there any side effects/risks?
If your medical and rehabilitation team have cleared you and/or your child to engage in telerehabilitation, there are no specific associated risks or side effects. Your rehabilitation professional will help you and your child to perform the therapy safely and effectively.
However, it is important to relay any concerns and/or questions to your rehabilitation professional because telerehabilitation is a relatively new approach and it is different from the traditional face-to-face method. For instance, sometimes, technical issues (e.g., access to suitable technology such as a computer or a smart phone, internet connection, the platform that is used) might come up. We encourage you to discuss these and other issues with your rehabilitation specialist to promote best results and optimize your therapy sessions.
How many treatments are necessary to make progress?
On average, improvements were noted following telerehab-treatments that were provided for 30-60 minutes, once per week or bi-weekly, for about 10-14 weeks.
However, every child’s needs and progress journeys, as well as parents’ resources, preferences, and availabilities are different.
In collaboration with your rehabilitation professional, you can determine the duration and frequency of tele-treatments that are most optimal and suitable for you and your child.
Is this appropriate for me and my child?
Telerehab could be a great option for certain interventions that are feasible to be delivered and received virtually.
Children with TBI aged anywhere from about 3 to 18 years old, and their families, can benefit from telerehab. However, every child’s needs, family’s resources, and progress journeys are different.
We encourage that you discuss the appropriateness of telerehabilitation with your health professional.
Where can I access more detailed information (e.g. that I can share with my child’s health provider)?