# Assessing the Feasibility of the Hybrid Ecological Therapeutic Intervention (HEI) for Preschoolers with ASD

## TL;DR

This study evaluates a new hybrid therapy model for preschoolers with autism, combining in-person and remote sessions to improve accessibility and outcomes.

## Contribution

The novel hybrid ecological intervention (HEI) model is proposed and tested for preschoolers with ASD in rural areas.

## Key findings

- The HEI model showed improvements in play, communication, and social abilities.
- Quantitative and qualitative data were found to be complementary and effective in evaluating the HEI model.
- The HEI model was associated with reduced autism severity in preschoolers.

## Abstract

Background: Autism Spectrum Disorder (ASD) necessitates enhanced therapeutic support, especially in rural areas. Individual therapeutic sessions are costly, presenting an economic burden on the family of the child with ASD, as well as on healthcare and educational systems. Therefore, the current investigation aimed to assess the feasibility of a new hybrid therapeutic model involving a combination of remote and in situ interventions, ecologically implemented. Methods: The following outcome measures were used to assess the program’s feasibility and preliminary outcomes. The Preschool Language Scales 5th Edition (PLS-5), the Test of Playfulness 4th edition (TOP-4), and individually tailored goals evaluated using the Goal Attainment Scale (GAS) and the Autism Spectrum Rating Scale (ASRS). The evaluated children with ASD (N = 25), age range of 39–76 months (Mean: 53.1 ± 11.9), were treated with the novel Hybrid Ecological Intervention (HEI) method, where each child received bimonthly frontal therapeutic sessions and bi-weekly remote therapeutic sessions by a health care professional (OT or ST), supported by four weekly frontal sessions by a technological support person supervised by healthcare professionals. Results: All qualitative scales presented were associated with improvements in all evaluated areas. Qualitative data mostly supported the HEI and ways to overcome existing challenges, supporting the use of both evaluation methods. Conclusions: The use of quantitative and qualitative data was found to be efficient and complementary to one another. The scales used (ASRS, GAS) were found to be useful tools for this method and for these participants. The HEI model was found to be associated with improvement in play, communication, social abilities, as well as autism severity.