The coronavirus disease (COVID-19) pandemic is proving to have far-reaching, detrimental implications on education and rehabilitation for persons with disabilities around the world. As countries recover, however, new opportunities to think and work outside the box may present themselves. How will this crisis change the dynamics of providing services for persons with disabilities?
Prior to the pandemic, such services were provided within designated centers or clinics, often at a high cost due to several factors — the intervention of experienced professionals, the location, transportation to and from the clinic and the tools used in treatment. As the world adapts after COVID-19, however, many of these services will be provided remotely, thus reducing their costs.
There will likely be a shift from physical rehabilitation centers to virtual ones. In the era of digital transformation, families are able to receive virtual support anywhere in the world via the internet and smart devices, which facilitate access on a wider and more sustainable scale. Nowadays, specialists can support a larger number of beneficiaries remotely.
Access to rehabilitation was commonly limited to those who lived close enough to a center that provided such services. Even if a provider was nearby, however, families may not have been able to receive help because of long waiting lists — some lasting months or even years.
Family involvement in the planning and implementation of treatment for their children with disabilities was often seen as nonessential, and it was commonly held that families should defer to the decisions of providers. Yet, after COVID-19, families will have a major role in decision-making. Family support is essential because not everyone with a disability needs all services to be provided through a specialist. There are currently more persons with disabilities than experienced professionals, and this disparity may be more pronounced in some countries than others.
This change in the service delivery model is in line with what the World Health Organization (WHO) ... has recommended. It was addressed in 2008 when the First Global Conference on Task Shifting called for the “transfer of tasks or delegation of tasks” in providing less complicated health care services to other individuals whose training does not require significant time and high cost. This approach was based on statistics that indicated a global deficiency in more than 57 countries in the number of professionals in the health care field. According to the WHO recommendations, task-shifting is the best solution to deliver services to the largest number of individuals and reduce the cost of providing these services through specialists.
Designing treatment plans for persons with disabilities traditionally involved several stages, starting with the specialist interviewing the family to gain a comprehensive understanding of the case, then observing, reviewing records, conducting tests, interpreting and analyzing data (which is time consuming and tends to be subjective) and finally making appropriate clinical decisions.
The current situation has created an inevitable shift to technology. What was formerly considered a hindrance may be the most viable, time effective and least expensive path to treatment. By analyzing data online, a service provider is able to relay immediate and automated support to the family. For example, if a family experiences difficulty in getting their child to respond properly, they can request immediate counseling remotely.
For some time, specialists faced obstacles in providing differentiated rehabilitation in group settings, as they had to navigate multiple individual rehabilitation treatment plans simultaneously.
This approach has been shifted to adaptive therapies based on necessity and capacity, where the family’s needs are prioritized as the main considerations. In this way, the family has the option to apply a therapeutic program that does not conflict with their daily routines.
As professionals in the field of helping persons with disabilities, we hope that this crisis will serve as a wake-up call. Changes we are currently experiencing could improve our ability to provide better services to those who need them. A silver lining in this pandemic could be a better standard of living for persons with disabilities by optimizing all available resources to expand access to improved services.
Faisal Al-Nemary is COO at the Autism Center of Excellence. He is also an adviser to the vice minister of Human Resources and Social Development on autism and disability-related issues. Faisal has over 15 years’ experience as a clinician and researcher in the field of autism spectrum disorder.