Abstract/Summary

Background: Evidence on the effectiveness of telemedicine in coaching parents of autistic children on naturalistic developmental early interventions (EI) is limited and conducted in Western countries. In the Saudi context, little is known about EI services and the feasibility of telemedicine in coaching parents. Aims: 1) Examine the literature on the effectiveness of telemedicine in coaching parents to implement naturalistic developmental EI on child's social communication; 2) Investigate parents' and speech and language therapists' (SLTs) perceptions of EI and describe community-based practice with the aim of enhancing it, and 3) Investigate the feasibility of telemedicine to deliver community-based practice in coaching parents. Methods: A rapid review evaluated intervention characteristics, outcomes, and research quality in nine studies. Action research employed semi-structured interviews with six parents' and four SLTs' investigated the second aim. A sample of 47 parents completed the survey investigating telemedicine acceptability and intention to use. Finally, eleven parent-child dyads participated in a pre-post feasibility study investigating telemedicine's implementation, usability, and acceptability. Results: Review findings suggest insufficient evidence for the effectiveness of telemedicine on child's social communication. Action research showed that SLTs' EI practice was one-toone, therapist-implemented or hybrid, with no consistent parent training. SLTs' reported engaging parents in EI was challenging. Findings showed parents have mixed views about the service. Parents reported raising autistic children was effortful, and parents wanted more support. The surveys revealed high telemedicine acceptability, usability, and intention to use. In the feasibility study, parents showed low-moderate fidelity scores for full achievement and scored moderate-high for partial achievement of strategies. No significant treatment difference was observed in children's social communication. Conclusions: More high-quality research is required to examine the effectiveness of telemedicine applications on child's social communication in community-based settings to support access and continuity of therapy in EI services.