When the COVID-19 pandemic triggered a massive shift to telehealth last year, Angela Dahiya-Singh, a fourth-year clinical science doctoral student in the College of Science, was already interested in how technology-based strategies could reduce barriers to assessment and treatment for families affected by autism spectrum disorder (ASD). With funding from a Cross Destination Area Institute grant, she worked with a tech company to develop a behavior consultation app that’s now being trialed by parents in rural communities in Southwest Virginia. Prior to the pandemic, she was traveling once a week with the Mobile Autism Clinic (MAC) to offer assessments and therapy. Her work is supported in part by the Doctoral Scholars program from the Institute for Critical Technology and Applied Science.

Interview has been condensed and edited for clarity. 

What brought you to Virginia Tech?
I was drawn by the clinical training opportunities in the psychology department and by my advisor, Professor Angela Scarpa. She’s the director of the Virginia Tech Autism Clinic and  Center for Autism Research, and she had this big plan to develop a mobile autism clinic. Right when I applied she had purchased this RV that was going to be transformed into a traveling clinic. I caught her at the right time and I was like, 'Oh my God I want to work with you, can I talk to you for a little bit about the clinic?' That was really exciting to me. A primary research and clinical interest of mine is being able to provide more accessible care to families in remote and underserved communities. There are a lot of families in rural areas who aren’t able to come into the clinic, pandemic or not. 

How is the experience of a family coping with autism different in small Appalachian towns like the ones the mobile clinic visits than it might be in Blacksburg or a bigger city?
Resources are the biggest difference. A family might get a diagnosis for their child or be told by a provider ‘I think your child has ASD,’ but often there isn’t much follow-up information about what to do next. Some providers also don’t have the resources to get specialized  training in ASD-specific treatments or assessments. Financial resources and geographic isolation can be barriers, too. With the MAC, we’re driving one-and-a-half hours each way; a lot of families don’t have the resources to do that. 

How can technology help lower some of those barriers?
Some behavioral interventions for families might involve coming in once a week for 12 to 16 weeks. The mobile consultation app I’m focusing on in my dissertation condenses the information into one month. Having it in the palm of your hand makes it easier to access resources without having to wait a week to see the therapist, try out the strategies, come back and say, ‘this worked’ or ‘this didn't work,’ and troubleshoot. I think it just makes it more accessible and ideally, feasible.

Do you think we’re going to see greater acceptance of telehealth post-pandemic?
I definitely think so. When we switched to telehealth we were able to provide services to families over HIPAA-compliant Zoom from areas like Galax, Virginia, or even farther. It would normally take an hour-and-a-half or more for them to drive to our clinic. Same thing with assessments. A lot of our diagnostic assessments in the clinic are several hours and they sometimes require multiple sessions. If we're able to condense some of the things that don't need to be done in person, I’m hoping that can continue moving forward. I also hope that everyone continues to be open to telehealth and just knows that it's an option. I had been very interested in telehealth since the start of my graduate school career, but when COVID hit, it suddenly became necessary around the country. Policies that had made telehealth difficult before the pandemic were broken down, and it helped me feel like my ideas were a little bit more accepted and normal because I was like, ‘okay this is something that can actually work.’

What’s the biggest motivation for your work? 
For me, it is seeing a family from start to finish — like seeing how a child will start treatment without certain skills, such as not being able to say any words or a full word, to, at the end of those 12 or so weeks, being able to actually ask their parent for help or request a snack. I get so excited watching the family’s progress and seeing the result of treatment. I’ve always loved working with kids and families. I’m the oldest in my family, so I’ve always been around kids, and that’s always been a population that I’ve wanted to work with. 

The ICTAS Doctoral Scholars program helps attract exceptional students to Virginia Tech and increase the educational and experiential diversity of research by offering a competitive graduate fellowship and professional development opportunities to top students pursuing transdisciplinary research. The program is led by ICTAS and supported by significant contributions from the Graduate School and each scholar’s college and department. Faculty members interested in nominating an incoming graduate student for the program should contact their college’s associate dean or graduate director; more information is available on the ICTAS website

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