Technology-Facilitated Assessment, Monitoring, Treatment, and Intervention for Mental Health and Behavioral Issues Among Individuals With Special Needs

Introduction

Students’ psychological well-being plays a critical role in their academic and social outcomes and successful transition into adulthood, yet there has been a rising trend of school age children’ anxiety, depression, and other mental health and behavior issues in recent years (Office of Special Education and Rehabilitative Services, 2020). Children and youth with disabilities are at an even higher risk of developing mental health disorders compared to their peers without disabilities (Inkelas et al., 2007; Cooper et al., 2007; Deb et al., 2001). While those diagnosed as emotionally disturbed may receive special education services, many continue to have poor life outcomes due to functional limitations in important cognitive, social, and communication domains, comorbidity with other debilitating disabilities, and additional challenges brought on by socio-economic stressors associated with disadvantageous family background and difficulties in obtaining adequate support (Wagner et al., 2005). The unrecognized, unmet mental health needs among students with special needs have been noted not only by the researchers but also by the policy makers, “mental health problems are often overlooked and therefore untreated in people with learning disabilities” (National Guideline Alliance, 2016, p. 33). The purpose of this study is to describe the status of current research on technology-based solutions to address mental health challenges among individuals with special needs and to discuss implications for future research.

With the rapid development and wide availability of mobile technologies, there is increasing acceptance of telemental health (TMH), i.e., “provision of behavioral and/or mental health care services using technological modalities in lieu of, or in addition to, traditional face-to-face methods (e.g., provision of therapy using the phone, diagnostic interviewing via videoteleconferencing, use of applications to track mood states, consultations via email)” (https://www.apa.org/pi/disability/resources/publications/telepsychology). Orsolini et al. (2021) argued that TMH has the potential to substitute in-person mental health care with enhanced equity access and comparable effectiveness. The authors conducted a thorough review of 56 recent studies of TMH application focusing on youth anxiety, depression, and obsessive-compulsive disorder. While the studies varied in the content, length, frequency and modality of their TMH application, the findings consistently supported the efficacy of TMH care for improving mental health symptoms compared to in-person care.

Researchers and practitioners have strongly advocated the use of TMH for individuals with special needs and their family. According to Waldman et al. (2018), TMH allows convenient and timely provision of assessment and intervention with no geographic restrictions, flexible scheduling, and reduced costs. As such, it can be particularly helpful for those with physical and mobility impairments, in episodic or chronic conditions, or with limited access to needed services. By reducing the number of office visits to medical professionals and supporting home-based real-time assessment and monitoring of the symptoms, TMH may also reduce the stress and worry among caregivers of those with special needs AND behavioral or mental health issues. We want to add that it does not hurt that children and youth with special needs also happen to belong to the digital native generations who enjoy unprecedented familiarity with and competency for using mobile technologies. Although it remains a valid concern that TMH may add to the burden of caregivers who may be or feel incompetent for implementing home-based interventions, the COVID -19 pandemic has led to rapid transition to TMH and there is evidence that parents with children of Autism Spectrum Disorder (ASD) are capable of effectively adapting available materials and environment and follow instructional practices to implement behavioral interventions with their children at home when adequate support is provided (Orum Çattik et al., 2021). In a systematic review of 55 single-case and group experimental research studies, Neely et al. (2021) found empirical support of the use of telehealth for behavioral assessment and reinforcement of positive behaviors among the ASD population, while noting that more research is needed to investigate under what conditions telehealth is effective.