Providing and Accessing Support During the COVID-19 Pandemic: Experiences of Mental Health Professionals, Community and Vocational Support Providers, and Adults with ASD
Tiffany Thang, Alice Liang, Yechan Choi, Adrian Parrales, Sara H. Kuang, Sri Kurniawan, Heather Perez · 2021 · Proceedings of the 23rd International ACM SIGACCESS Conference on Computers and Accessibility (ASSETS) · doi:10.1145/3441852.3476470
Summary
This experience report examines how the COVID-19 pandemic affected the provision and receipt of essential services for adults with autism spectrum disorder (ASD) at Hope Services, a community center for adults with developmental disabilities in California. The researchers interviewed 10 essential service providers — 5 mental health professionals and 5 community and vocational support providers — along with 4 clients of Hope Services. Interviews were conducted approximately one year after the pandemic began, as vaccines were becoming available. The study addresses a gap in research on telehealth for adults with ASD specifically, as prior work had focused primarily on children with ASD and their caregivers. Providers included job coaches, program coordinators, community support facilitators, mental health clinicians, licensed marriage and family therapists, and clinical social workers. Their clients ranged from their early 20s to 60s and 70s, were predominantly male (roughly 70%), and came from diverse ethnic backgrounds. Hope Services distributed tablets to clients to enable remote access through Zoom.
Key findings
The transition to telehealth produced significant changes in service delivery patterns. Mental health professionals working in-person saw session times increase from 30 minutes to 1 hour and 15 minutes, while those working remotely increased session frequency from once to 2-3 times per week. Community and vocational support providers shifted to shorter distance learning classes over Zoom and saw reduced client participation at job sites due to COVID fears. Technical challenges were pervasive: unreliable internet connectivity on both provider and client ends disrupted sessions regularly, with some providers resorting to conducting phone sessions from their cars while driving to find cell service. California wildfire evacuations compounded connectivity problems. Providers reported high stress from lacking adequate telehealth training and tools, with current platforms missing specialized features needed for this population. Clients expressed a strong preference for in-person interaction but appreciated technology for maintaining social connections during isolation — some reported actually increasing their social contact through social media and video calls during the pandemic compared to pre-pandemic levels of seeing friends only on special occasions. Both providers and clients highlighted that the loss of non-verbal visual cues, particularly with masks during in-person meetings, made it harder to assess client well-being.
Relevance
This report highlights critical gaps in telehealth accessibility for adults with developmental disabilities. The finding that existing telehealth platforms lack specialized tools and features for ASD populations points to a need for more inclusive design of virtual service delivery technologies. The digital divide is starkly illustrated: even when devices were provided, unreliable internet in suburban and rural areas remained a fundamental barrier. For accessibility practitioners, this underscores that device access alone is insufficient — reliable infrastructure is equally essential. The unexpected finding that some clients increased their social connections through technology during the pandemic suggests potential for virtual platforms to supplement (not replace) in-person services. The study is limited by its small sample size and single-organization focus, and interviews were conducted during a specific pandemic period that may not reflect longer-term patterns.
Tags: autism spectrum disorder · telehealth · COVID-19 · mental health · developmental disability · digital divide · virtual conferencing · community services