The pandemic has forced all types of therapy online, including treatment for children with ASD.  Although the transition was driven by necessity during the pandemic, it has raised crucial questions about the future. Can technological platforms meet the needs of children with ASD? How can they be adapted? What advantages and disadvantages do they present? Professor Ofer Golan sat down with psychologist Dr. Gili Segall to hear her perspective after a year of working remotely. 

Gili Segall is a New York- and Israeli-licensed clinical psychologist, and a clinical assistant professor in the department of child and adolescent psychiatry at the NYU Grossman School of Medicine – NYU Langone Health, where she works with families as a clinical psychologist. She received her doctorate in Clinical Psychology from Bar-Ilan University in Israel, where her Ph.D. thesis analyzed how parents talk to their children and the relationship between certain aspects of the parent-child dialogue and childrens’ emerging beliefs and perceptions. 

Ofer Golan is a clinical psychologist, associate professor, and the head of the Autism Research Lab at Bar-Ilan University, Israel. His research focuses on socio-emotional functioning in autism, including social communication, emotion recognition, expression and regulation, and ways to develop them through evidence-based interventions. He is the founder and the clinical advisor of two Israeli clinical centers which provide evidence-based diagnosis and intervention services for children, adolescents, and adults with autism and their families, in addition to training clinicians and disseminating evidence-based interventions nationwide.

Segall moved most of her therapy sessions online at the onset of the pandemic, when the New York area was sheltering in place. The transition wasn’t easy and led to significant challenges. “There are children that I evaluated initially through telehealth, but when I went the extra mile and invited them to the office, I was able to see aspects of social interactions that I was not aware of online. Technology can mask some of the issues that we encounter when we meet face to face,” she explains. 

However, despite the challenges the online work has posed for some of her clients, for others, Segal was surprised to discover, it has actually been an advantage. “It’s more of like a focused stimulus, not necessarily having to absorb certain other sensory stimulations like sounds or smells or a more complex experience of sitting with someone in a room…when you’re more comfortable in a setting then you are often better able to get something out of the interaction in that setting.” 

Another key advantage is accessibility. Since the majority of children with ASD do not live in close proximity to a treatment center, before the pandemic, they could not take advantage of the expertise that a clinician like Segall offers. “If you had told me a year and a half ago that I would be working completely online, I would have probably said ‘no way. It’s something that I didn’t feel very comfortable with, and wasn’t familiar with,” says Segall. “But I can actually see that technology can be very effective and very helpful and make our interventions much more accessible. My office is in the center of Manhattan, but now I can work with people from all over New York, New Jersey, and Connecticut, and even Florida, which is amazing. These are individuals and families that may not have treatment options near them, but they can access the support through online platforms.”

One of the concerns professionals have about incorporating technology into treatment is that it may discourage, rather than encourage human interaction. Segal sees it differently—since parents are not trained in therapy techniques, supporting them through technology can actually be a way to increase their involvement in the therapeutic processes.  “I think that the work with parents is a very crucial aspect of working with children because you can definitely help the parent do this process, become more aware of their children’s experience, become a better social coach their children in their daily routines. There’s a very strong connection between how parents support and help their children and the children’s outcomes.” 

Not only is parental involvement beneficial for the children, but the parents benefit as well. “I was involved in a program called Peers for Peace that helped kids increase their ability to actually engage in play dates. We found that helping the parents become social coaches for their children decreased their parental stress, which, in turn, had a positive impact on the children’s mental states. It helped parents feel that they might understand their children and their emotional experience a bit better”.