How do we reach rural America?

Rural aras make up nearly a quarter of counties in the United States (22%; Ratcliffe, Burd, Holder & Fields, 2016), with plenty of children and adults with disabilities caught in resource-low regions. Numerous struggles arise for families impacted, specifically by autism, in both urban and rural areas. Struggles include locating and accessing services, the best course for treatment (long term versus short term), how to finance services, and more.


Although access to services can be difficult in urban areas (e.g., long waiting lists), geographic location makes service access even more challenging when the closest option is hours away. Some families may log miles making round trip drives to service centers. Or families may contemplate moving to more urbanized areas for the sake of securing services, despite the unpredictable nature of waiting lists and provider availability.


Advancements in telehealth-based services are helping bridge the gap between family location and service location, through the rising use of telehealth-based parent training programs. Although distance based treatment services are limited in scope (e.g., no direct services provided), telehealth appears to be making its way into the forefront of service delivery.


One particular program gaining ground for parent training is the Online and Applied System for Intervention Skills (OASIS;, an online parent training that uses both online learning tutorials and live coaching sessions via video chat. Preliminary research on OASIS indicated huge mileage savings for families using the program, eliminating round trip drive time for one family from their home to the treatment site (3,834 miles total over 18 sessions) in favor of round trip drive time to a local telemedicine site (36 miles total over 18 sessions; Heitzman-Powell, Buzhardt, Rusinko, & Miller, 2014). With the advances in privacy-law compliant video chat programs, parents now don’t even have to leave their home to receive training.


Families and practitioners should keep an eye out for policies related to delivering services via telehealth, as more and more insurance companies have determined it’s a viable option for reimbursement of services.

Paige Boydston