Potentials of Telerehabilitation for Families of Children With Special Health Care Needs During the Coronavirus Disease 2019 Emergency | JAMA Pediatrics | JAMA Network
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Comment & Response
August 24, 2020

Potentials of Telerehabilitation for Families of Children With Special Health Care Needs During the Coronavirus Disease 2019 Emergency

Author Affiliations
  • 1Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
  • 2Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
JAMA Pediatr. 2021;175(1):105. doi:10.1001/jamapediatrics.2020.2351

To the Editor We recently read the article from Thompson and Rasmussen,1 and we appreciate the focus that JAMA Pediatrics is dedicating to the effects of the coronavirus disease 2019 (COVID-19)2 emergency on children with special health care needs and their families. We wholeheartedly agree with the authors about the urgent necessity of taking care of families of at-risk children by quickly acknowledging and adequately responding to this epidemic. Here, we would like to highlight that the necessary mitigation strategies adopted by many countries to limit the virus spread include the reduction or the complete closing of rehabilitation units and centers, with the consequent suspension of rehabilitation programs. As a consequence, fragile individuals with severe neurodevelopmental conditions, especially children and their parents, are exposed to the risk of being left alone and without supervised rehabilitation support.1

As such, among the actions needed to cope with this worldwide rapid spread of COVID-19, we would like to highlight the opportunity to invest in telerehabilitation solutions for the most fragile children and their families.3 Telecommunication devices are now possible for many families, and they support remote connections with relatives, even for those individuals living far from big cities and who have partial access to central rehabilitation resources. We argue that health care professionals can rely on telerehabilitation approaches to grant continuity of care and adequate support to children and their families. By adopting and improving telerehabilitation solutions, we can at least partially reduce the risk of hopelessness and loneliness as well as anxious and depressive feelings related to the COVID-19 emergency. These technological solutions may take different shapes: engaging in remote consultations, sharing interactive materials, promoting joint parent-professional observations, granting active listening to parents’ daily hassles, and caregiving needs. In general, the provision of video feedback support to parents has been widely documented and represents a valid alternative to face-to-face visits that can significantly improve child development and parental well-being.4

From this point of view, the COVID-19 pandemic represents a unique opportunity to promote psychological closeness despite physical constraints and to promote shared compassion and empathy between families and professionals. We believe that the efforts directed in promoting and improving telerehabilitation services and programs may still be beneficial even after the end of the COVID-19 pandemic emergency. In other words, by taking advantage of the present critical situation, the investment in telerehabilitation solutions holds the potential to reduce disparities in the access to child and family health care and to promote smarter and inclusive rehabilitation communities worldwide.

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Article Information

Corresponding Author: Livio Provenzi, PhD, Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, via Mondino 2, 27100 Pavia, Italy (livio.provenzi@mondino.it).

Published Online: August 24, 2020. doi:10.1001/jamapediatrics.2020.2351

Conflict of Interest Disclosures: None reported.

Thompson  LA, Rasmussen  SA.  What does the coronavirus disease 2019 (COVID-19) mean for families?   JAMA Pediatr. 2020. doi:10.1001/jamapediatrics.2020.0828PubMedGoogle Scholar
Parodi  SM, Liu  VX.  From containment to mitigation of COVID-19 in the US.   JAMA. 2020. Published online March 13, 2020. doi:10.1001/jama.2020.3882PubMedGoogle Scholar
Zhai  Yunkai,,  et al “From Isolation to Coordination: How Can Telemedicine Help Combat the COVID-19 Outbreak?.” medRxiv. Published online February 23, 2020. doi:10.1101/2020.02.20.20025957
Fukkink  RG. Video feedback in widescreen: a meta-analysis of family programs. Clin Psychol Rev. 2008:28(6); 904-916. doi:10.1016/j.cpr.2008.01.003.