The Effectiveness of Telehealth-Based Family-Centered Early Intervention

The Effectiveness of Telehealth-Based Family-Centered Early Intervention: Enhancing Sensory Inputs Activities on Vision and Posture-Movement Performance

Background: Children with developmental delays or sensory processing disorders (SPD) face challenges in processing and integrating sensory information from their environment, which can lead to behavioral, learning, and social issues. Visual-vestibular stimulation activities target fundamental abilities such as balance, coordination, and sensory processing, which are crucial for many developmental areas. Past literature supports the use of digital media as a medium to provide ongoing home-based occupational therapy interventions for children who are unable to receive in-person treatment, with opportunities for caregiver-guided interventions. Therefore, this project is designed based on the "1001 Children's Therapy Activities" model as the foundation for behavioral intervention, combining parent and child participation in play to establish effective home activities and execution, aiming to enhance children's visual perception and posture-movement performance, thereby improving learning outcomes.

Objective: To investigate the impact of a "Telehealth Visual and Vestibular Home Program" that integrates parent and child activity participation on children's visual perceptual performance and posture-movement effects.

Method: Caregivers of children attending early intervention clinics at a teaching hospital in northern Taiwan are recruited and randomly assigned to either a remote group (N=30) or a waitlist group (N=30). The remote group receives a 6-week visual and vestibular home course; the waitlist group will participate after a 6-week. Assessments using the Developmental Test of Visual Perception (DTVP-2), the Movement Assessment Battery for Children, Second Edition (MABC-2), and a course satisfaction questionnaire are conducted before and after the intervention.

Data Analysis: Basic data are presented using descriptive statistics, and t tests are used to compare pre- and post-training assessment mean values. Statistical analysis is performed using SPSS 26.0, with a significance level set at Alpha<0.05.

Past literature supports that digital media can be used as a medium to provide continuous interventional home-based occupational therapy for children who cannot receive physical therapy, and has the opportunity to guide the intervention through caregivers (Marino et al., 2020), using different visual and vestibular senses. For intervention factors, a home-based teaching model is designed to meet the needs of high-frequency supervision and feedback established by habits. It can respond appropriately and immediately to difficulties and adjust settings. In addition to providing timely assistance, individual consultations can also be provided on the online platform. , based on the capabilities of individual families or caregivers, as well as the child's own temperament and abilities, we provide exclusive technical advice to minimize difficulties and make the use of strategies more successful to help establish good home activities. Through the remote home teaching model, children's execution can be increased, including action planning, bilateral coordination, vestibular processing, visual perception, visual-motor integration and eye movement, thereby increasing the improvement of children's visual perception, posture and movement ( Božanić Urbančič et al., 2023; Wiener-Vacher et al., 2013; Yılmaz & Önal, 2021). For children who receive early treatment, caregivers often fail to provide ideal guidance despite intentional guidance. They are unable to provide appropriate home therapy activities according to the children's abilities and needs, and they also deviate from the games that children should participate in during their development. Therefore, through professional and standardized intervention models, subtle changes and learning in daily life are established in this way, promoting the quality of their visual movements and increasing learning performance.

In the clinical practice of early childhood education in our hospital, there is a lack of home treatment programs for early childhood education. This study intends to use the specific model of "1001 Children's Treatment Activities" as the basis for intervention in behavior change, combined with the participation of parents and children in games, to establish the basis for children's effective treatment. Good home activities and execution can improve children's visual perception, posture and movements, thereby improving learning performance.

Inclusion Criteria:

• (1) Children currently receiving early treatment; (2) Children with caregivers who need to establish a home treatment plan; (3) Children who can cooperate with the trial process and complete homework at home, and have completed at least 5/6 of the training; (4) There is an Internet connection;

Exclusion Criteria:

• (1) Children's medical records show a diagnosis of central nervous system injury (such as cerebral palsy, brain trauma, epilepsy, cortical blindness), rare disease diagnosis (such as William's disease, Down syndrome); (2) Children under 3 years old , 7 years old and above; (3) The caregiver cannot communicate in Chinese.