Caring for the Most Vulnerable: A Model for Managing Maladaptive Behavior in Children with Mental Special Needs During the COVID-19 Pandemic.

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Dursun O., Turan B., Gulsen M., Karayagmurlu A., Tugce M., Kutlu A., ...More

Telemedicine journal and e-health : the official journal of the American Telemedicine Association, 2020 (Journal Indexed in SCI Expanded) identifier

  • Publication Type: Article / Article
  • Volume:
  • Publication Date: 2020
  • Doi Number: 10.1089/tmj.2020.0380
  • Title of Journal : Telemedicine journal and e-health : the official journal of the American Telemedicine Association


Background: This article presents the results of a comprehensive

national model developed for managing maladaptive

behaviors (MBs) in children with mental special needs

(CMSNs) during the coronavirus disease 2019 (COVID-19)

pandemic that combines telehealth-based Applied Behavioral

Analyses, psychiatric interventions, and support from local

psychosocial teams. This study aims to determine the effectiveness

of a system that combined telehealth applications

with local psychosocial support teams, allowing services from

video calls to emergency interventions.

Materials and Methods: The system combines the telehealth

applications with the services from local psychosocial intervention

teams. In addition to system records covering sociodemographic sociodemographic

variables and initial complaints, a telephone

survey questioning the effectiveness and satisfaction of the

system was used as the main outcome.

Results: In total, 347 individuals used the system with mothers

constituting the majority of applicants (88.7%, n = 332).

The overall satisfaction of the system was 8.8/10. In terms

of effectiveness, 63.3% (n = 237) of caregivers reported an

improvement in the reason of application. Counselors decided

on a need for follow-up visits for 36.6% (n = 137) of applications.

A referral to a psychiatrist was asked for 40 patients


Discussion: To our best knowledge, this is the first study

presenting a model for managing MBs of CMSNs during the

COVID-19 outbreak. In general, therefore, it seems that there

is a need for unique systems to handle behavioral problems of


Conclusions: The findings of this study suggest that it is

possible to establish an integrative multistep multidisciplinary

telehealth-based approach in a short while.

Keywords: behavioral health, COVID-19 pandemic, children

with special needs