754882

research-article2018
RSQXXX10.1177/8756870518754882Rural Special Education QuarterlyBuchter and Riggleman

Article
Rural Special Education Quarterly

Using Teleconferencing to Meet

2018, Vol. 37(3) 176­–182
© Hammill Institute on Disabilities 2018
Article reuse guidelines:
the Needs of Children, 0 to 3 Years Old, sagepub.com/journals-permissions
DOI: 10.1177/8756870518754882
https://doi.org/10.1177/8756870518754882

With Disabilities in Rural Areas journals.sagepub.com/home/rsq

Jennifer Buchter, MEd, MSW, LSW1 and Samantha Riggleman, PhD, BCBA2

Abstract
Serving families who live in rural communities can be a challenge for early intervention programs. Factors, such as travel,
family needs, and limited program and community resources, have been identified as ongoing barriers for this population.
Technology, specifically teleconferencing, can be a solution to provide equitable services compliant with Part C of
Individuals With Disabilities Education Act (IDEA; 2004) mandates and professional practices. This article will discuss how
to determine whether teleconference technology is a good fit and how to individualize, plan, and implement technology to
support families in rural communities. It will also discuss legal and practical considerations that must be taken into account
when using teleconferencing to discuss service delivery.

Keywords
rural areas, technology, collaboration, barriers, teleconference, early intervention, service delivery

Young children with disabilities and their families continue
to face challenges in accessing high quality, equitable ser-
vices based on the recurring issues of (a) lack of funding,
(b) lack of professionally qualified personnel, (c) lack of
policies that support flexible service delivery, and (d) lack
of individualizing services to meet the needs of families
(McLaren & Rutland, 2013; Moffatt & Eley, 2010; Olsen,
Fiechtl, & Rule, 2012; Votava & Chiasson, 2015). Chronic
shortages of early intervention providers nationwide affect
all children, especially those in rural areas (Cason, Behl, &
Ringwalt, 2012; Hebbeler, Spiker, & Kahn, 2012; Houston,
Munoz, & Bradham, 2011; Houston & Perigoe, 2010).
These barriers to special education services for young chil-
dren with disabilities in rural communities identified nearly
20 years ago continue to exist today (Rural Early Childhood
Special Education Task Force, 2010; Shaddock & Batchler,
1986). Technology, specifically teleconference technology,
is an option that can be used to address these challenges
(Hinton, Sheffield, Sanders, & Sofronoff, 2017; Houston &
Stredler-Brown, 2012; Meadan, Meyer, Snodgrass, & Halle,
2013; Moffatt & Eley, 2010). Technology is continually
improving, including affordability, ease of use, and access
to devices and high-speed Internet. Early intervention pro-
viders can use teleconference technology to address the
unique barriers that families living in rural areas may be
experiencing.
Providing services to children and families in rural areas
is associated with higher costs due to travel time, distance
between families, and a lack of providers (Moffatt & Eley,
2010; Olsen et al., 2012; Rural Early Childhood Special
Education Task Force, 2010; Shaddock & Batchler, 1986).
These costs should not influence service delivery; however,
research suggests they often do (Olsen et al., 2012; Rural
Early Childhood Special Education Task Force, 2010). In
addition, these barriers affect the development of the
Individualized Family Service Plan (IFSP), which can neg-
atively affect outcomes for children and their families
(Votava & Chiasson, 2015). Rushed and inadequate family
assessments have been found to occur more frequently with
families in rural communities due to the 45-day timelines,
limited assessment, and lack of access to families for fol-
low-up (Votava & Chiasson, 2015). Legal mandates of the
Individuals With Disabilities Education Act (IDEA; 2004)
and recommended practices (Bruder, 2010; Division of
Early Childhood [DEC], 2014) dictate that services should
be based on the needs of the child and family, rather than
what is available or affordable to providers. Too often, chil-
dren and families living in rural communities do not receive
the early intervention services they require, and these ser-
vices are not comparable with their peers’ in urban areas
(Olsen et al., 2012; Votava & Chiasson, 2015). These
1
University of Nevada, Las Vegas, USA
2
Grand Valley State University, Allendale, MI, USA
Corresponding Author:
Jennifer Buchter, University of Nevada, Las Vegas, 4505 S. Maryland
Pkwy., Las Vegas, NV 89154, USA.
Email: buchterj@unlv.nevada.edu
Buchter and Riggleman 177
barriers negatively affect child and family outcomes (Olsen
et al., 2012).
This article examines the research on teleconference
technology related to providing services to young children
and families. Barriers and challenges are discussed. A plan-
ning form is provided to assist practitioners and agencies in
developing, implementing, or improving teleconference
supports for families in rural areas.
Benefits of Rural Education
Although there may be challenges in accessing educational
services in rural communities, there are many benefits.
Educational benefits of rural areas include smaller class and
caseload size and greater parent involvement (Berry &
Gravelle, 2013). Teachers in rural communities report a
positive relationship with their students and families, a high
quality of life, fewer behavioral issues, and support from
students’ families (Davis, 2002). These benefits are associ-
ated with teacher retention, a family-like atmosphere, col-
laboration, and a cohesiveness with the community
(Huysman, 2008; Malloy & Allen, 2007). Characteristics of
small communities have been associated with increasing
the inclusion of students with disabilities in the general edu-
cation classroom (Downing & Peckham-Hardin, 2007).
Rural communities sometimes lack the resources for sepa-
rate education environments; however, the close connection
to community members and the availability of natural sup-
ports help students be successfully included in the general
education setting (Downing & Peckham-Hardin, 2007).
Using Teleconference Technology to
Overcome Barriers
Teleconference technology can be an option to overcome
some of the challenges faced by providing services in rural
settings (Houston & Stredler-Brown, 2012; Meadan et al.,
2013; Moffatt & Eley, 2010). With the increase in availabil-
ity and improvements with technology, programs have
begun to utilize two-way communication technologies,
such as Skype, GoToMeeting, and FaceTime, to provide
services to families in rural areas (Hinton et al., 2017; Olsen
et al., 2012). While research does not clearly support tele-
conference technology in the education field, initial research
suggests positive outcomes in providing coaching services
consistent with professional practices (DEC, 2014) and
increasing equity in services and outcomes (Clark, 1986;
Houston & Stredler-Brown, 2012; Moffatt & Eley, 2010;
Olsen et al., 2012; Suppo & Mayton, 2014).
Teleconference technology has the potential to reduce or
eliminate barriers for families of young children with dis-
abilities living in rural communities; however, early inter-
vention Part C programs must be aware of ethical issues and
limitations in implementing a universal, one-size-fits-all
approach to teleconference technology (Brennan et al.,
2010; Hinton et al., 2017; Houston & Stredler-Brown,
2012; Meadan et al., 2013; Moffatt & Eley, 2010). Research
suggests that integrating technology should be individual-
ized and determined through objective measures (Houston
& Stredler-Brown, 2012; Olsen et al., 2012). Planning with
families and developing agency policies that support tele-
conference technology can eliminate some of these ethical
issues and prevent frustration and miscommunication.
Another ethical issue that requires explicit attention and
planning is parents’ rights and potential issues related to use
of technology. Parents need to be informed of how telecon-
ferencing fits within their educational rights under IDEA
and the risks associated with privacy and confidential per-
sonal information being shared. Teleconference technology
should not be used to replace a visit or used to justify a
reduction in services but rather should be used to supple-
ment services and support the family and child in meeting
their educational outcomes.
What Is Teleconference Technology?
Teleconferencing is defined as audio or audiovisual meet-
ings between geographically separated parties using tele-
communications networks, such as telephones or Internet.
Teleconferencing has also been referred to as telepractice,
teleintervention, and telerehabilitation (American Speech-
Language-Hearing Association [ASHA], 2010; Brennan
et al., 2010). Examples of free or low-cost teleconference
technology are Skype, GoToMeeting, and FaceTime. These
allow for all collaborative members to be involved in a home
visit or meeting without being in the same room. Many tele-
conference technologies are free to use and can be accessed
on a smartphone, mobile device, tablet, or computer.
Teleconferencing increases efficiency and results in a
more effective use of limited resources, improved access to
services, and improvements in quality of services
(Brookman-Frazee, 2004; Dixon, Verenikina, Costley, &
Pryor, 2015; Gouseti, 2013; Lajoie & Lu, 2012; Moffatt &
Eley, 2010; Nagykaldi et al., 2008). It is a very personal
medium when face-to-face communications are necessary.
It is also an effective alternative to travel, as traveling to
rural areas for multiple home visits can be difficult to coor-
dinate with multiple stakeholders. Table 1 can be used as a
planning tool to determine whether using teleconferencing
is an appropriate mode to meet the needs of children and
families in rural areas and assist in individualizing the plan.
The planning form also addresses whether the family and
team members all have access to technology and whether
anyone, including parents, needs training on the use of tech-
nology to access the teleconferencing medium selected. If
teleconference technology is a viable option to increase ser-
vice time or added collaboration, special consideration
should be given to the questions within the planning form
178 Rural Special Education Quarterly 37(3)

Table 1.  Planning Form.

Questions to ask Yes No Follow-up/notes

1. Does the agency have written policies regarding technology? Does the family agree with these policies?  
2. Does the family have access to high-speed Internet and technology?  
3. Is the technology compatible within team members? (iPhone, Droid, Kindle, etc.)  
4. Will the family be reimbursed for use of their equipment?  
5. Will the agency pay or provide for technology such as Internet access?  
6. Will the agency pay or provide (loan) technology such as devices?  
7. Does the team have the technology skills?  
8. Who will need assistance and training to implement the technology?  
9. The team will review plan by _______ (insert date).  

found in Table 1. It should also be determined if the partici-
pating agency has a written policy statement regarding the
use of technology for receiving services. If there is policy,
the policy should be followed to ensure compliance of each
agency involved in service delivery.
Benefits of Teleconferencing
A literature review by Cason (2011) found that teleconfer-
ence technology can support eight of the 14 indicators that
Part C coordinators report to the Office of Special Education
Programs (OSEP), including (a) timely receipt of services,
(b) service in the natural environment, (c) child outcomes,
(d) family outcomes, (e) two indicators for Child Find
including children ages birth to 1 year and 1 to 3 years with
IFSPs at the state and national level, (f) increasing public
outreach and referrals, (g) meeting of the 45-day time line,
and (h) support for the transition from Part C to Part B ser-
vices. In addition to support of these indicators, the authors
found that telepractice supported the parent-coaching model
and implementation of strategies in everyday routines and
activities in the natural environment (Cason, 2011; Houston
& Behl, 2012; Shaddock & Edwards, 1984).
Shaddock and Edwards (1984) and Houston and Behl
(2012) provided two examples of research at the state level
examining the implementation of a teleconference technol-
ogy program with families of young children with disabili-
ties in rural areas. They examined the issues related to
having children and families commute from their homes to
early childhood programs. The advantages of the telecon-
ference programs were a decrease in the disruption to the
family; an increase in families implementing the interven-
tion throughout the day, thus increasing the amount of
opportunities for practice; and an increase in access to
highly qualified professionals, and opportunities to prac-
tice in authentic settings. Challenges included helping par-
ents feel comfortable with technology, selecting providers
comfortable with technology, having access to information
technology (IT) support, and having limited access to high-
speed Internet.
A recent randomized-controlled study examined a parent
education intervention in managing the behavior of children
with disabilities through a telehealth parenting intervention
in rural Australia (Hinton et al., 2017). The intervention used
an evidenced-based parenting curriculum to examine the
effectiveness of adapting the curriculum to online modules
and weekly telephone or email support with a provider.
The four measures used to evaluate effectiveness were
the Developmental Behavior Checklist–Primary Care
Version, the Child Adjustment and Parent Efficacy Scale–
Developmental Disability, the Parenting and Family
Adjustment Scales, and a Client Satisfaction Questionnaire
(Hinton et al., 2017). These were all completed by the care-
giver of the child in the intervention both before and after the
intervention had taken place. Parents reported a high level of
satisfaction, as well as a high module completion rate.
Results of the study include a positive change in children’s
behavior, and these positive changes could be observed 3
months post intervention.
Legal and Ethical Considerations When Using
Teleconferencing
While technology is pushing ahead at a rapid pace, educa-
tion laws have not yet caught up in developing regulations
on its use. There is some evidence that such uses of technol-
ogy produce the same effects and outcomes as compared
with face-to-face consultations; however, certain consider-
ations must be made (McCarty & Clancy, 2002). It is imper-
ative to protect personal information of children with
disabilities and their families and maintain a high standard
for privacy and confidentiality, as outlined in the Family
Educational Rights and Privacy Act (FERPA). The U.S.
Department of Education has several initiatives to provide
technical assistance to schools and private entities to protect
the privacy rights of children with disabilities. One initia-
tive is the privacy tool kit that includes a list of frequently
asked questions, FERPA guidance, a library of commonly
cited resources related to confidentiality and security, and
checklists of important items to include in data security
Buchter and Riggleman 179
plans. The privacy tool kit, along with technical assistance,
training materials, and a help desk, can be found online at
http://nces.ed.gov/programs/ptac through the Privacy
Technical Assistance Center. This resource can be used to
assist states and programs in developing teleconferencing
supports.
A legal issue to be considered in the expansion of tele-
conferencing in special education is the right of children
with disabilities and their families to protection of confi-
dential and identifying information (Cason, 2011). This is
an issue at the state, agency, and individual level. Solutions
include ensuring that all providers have a secure Internet
connection when using teleconferencing, not using personal
devices that may result in accidental sharing of information,
using password protected devices, and not using devices or
conducting meetings in a public space (Menzano, Goodwin,
Rockett, & Morris, 2011). For example, if a speech thera-
pist is providing a session using teleconferencing with a
family in a rural location, the speech therapist needs to be in
a location that maintains privacy, such as an office with a
door and not a busy coffee shop where others could hear
and see the computer screen. Another issue that can arise is
training for all parties involved in teleconferencing. It is
strongly recommended that, if families and providers find
that this method can alleviate some of the barriers of pro-
viding services to rural areas, all parties must be comfort-
able in using the technology (Cason, 2011; Cason et al.,
2012; Finkelstein et al., 2004). This may require that the
family or provider receives some training in the desired
teleconferencing medium to prevent inadvertently sharing
confidential information.
According to the Health and Human Services (HHS)
Office for Civil Rights, the division charged with enforcing
the Health Insurance Portability and Accountability Act of
1996 (HIPAA), covered entities may communicate with cli-
ents and families so long as reasonable safeguards are used
when doing so (Baker & Bufka, 2011). Examples of safe-
guards may include securing locations and equipment and
implementing technical solutions to mitigate risks, along
with providing training in the use of the technologies.
Teleconferencing is an exciting area where future
research is needed, especially in the legal issues that may
arise in using technology. Special considerations must be
made when a team decides to use teleconferencing to best
meet the needs of families of children with disabilities in
rural areas. Successful implementation of teleconferencing
requires awareness and compliance with federal require-
ments of privacy and protection of confidential informa-
tion. Obtaining competent training in the appropriate use of
teleconferencing for providers and families will help avoid
major risks and pitfalls in this novel area. In this emerging
area of practice, programs and providers must be proactive
about ensuring privacy and confidentiality. Every organiza-
tion engaged in teleconferencing should have clear written
policies on confidentiality and security and make certain all
employees are trained in these policies (Blaire, Bambas, &
Stone, 1998). Also, consent forms signed by families and
clients should document their awareness that there is a
chance of unauthorized access during transmission, storage,
and retrieval of information (McCarty & Clancy, 2002).
Implications for Practice
Practitioners need to be sensitive to the needs and prefer-
ence of families living in rural areas. Although teleconfer-
ence technology should be introduced as a way to
supplement face-to-face meetings and home visits, it should
in no way replace them. Service providers can use the plan-
ning form (see Table 1) to determine whether using telecon-
ferencing may be a way to alleviate any barriers to providing
services. This form provides recommendations for individ-
ualizing the planning process, clarifying communication,
and reviewing the implementation of the plan; however,
there are also financial considerations to consider along
with training all members on the agreed upon teleconfer-
ence technology and what implementation will look like.
Flexible Policies That Support Teleconferencing
In using the planning form found in Table 1, service provid-
ers should start with the first question that addresses whether
the agency has written policies regarding technology and
whether the family agrees with those policies. Before dis-
cussing and implementing teleconference supports with
families, providers should consult with their respective
agencies to establish whether there is a policy in place on
using technology with families. If there is a policy, it should
be reviewed to ensure that teleconference technology can
be used. Agency policies may need to be updated or clari-
fied before implementing. If there is not a policy statement
on using technology to enhance service delivery, practitio-
ners should seek guidance and support in developing an
agency policy. When developing an agency policy, the other
questions on this form can be used. It is recommended that
the policies be flexible enough to be individualized to meet
the needs of families.
Agency policies should also include deciding when to
use teleconferencing. The nature of the visit and the needs
of the child and family should be taken into consideration.
A home visit may be more effective or preferred for families
working with challenging behaviors or children who are
considered medically fragile.
Teleconference technology can be used as needed and
appropriate to support the provision of services. Part of the
individualized planning process can include deciding which
visits are a good fit for a teleconference visit and which are
best for an in-person visit. Teleconference technology also
can be used to support families and communication with
180 Rural Special Education Quarterly 37(3)
team members outside of scheduled visits and to support
families as issues or concerns arise (Baharav & Reiser, 2010;
Brookman-Frazee, 2004; Vismara, Young, & Rogers, 2012).
Financial Considerations
Issues, such as access to technology (e.g., laptops, smart-
phones, tablets, high-speed Internet), payment or reim-
bursement for use of families’ equipment and Internet,
lending programs for families who may not have equip-
ment, and policies and procedures for what will happen to
damaged equipment, must be decided upon ahead of time
and discussed to determine whether teleconferencing is a
good fit for families. Once agency policies have been
reviewed or written, it is important to determine financial
responsibilities. An important component is whether the
family has access to the technology and Internet. On the
planning form in Table 1, Questions 2, 4, 5, and 6 assist in
planning and clarifying whether the family has access to
high-speed Internet and devices and whether the loaning of
devices is available. If the family does not have high-speed
Internet access, will and how will they be reimbursed for
gaining access? Reimbursement issues and up-front costs
can be reduced through direct billing to the agency through
an agreement with an Internet provider in the community. If
the family has Internet access, will any portion of their
expenses be reimbursed? These issues should be deter-
mined prior to implementation, so families are not left with
unexpected expenses or misunderstandings about the
requirements and time line for reimbursement. Additional
questions that should be addressed are which documents the
family will be required to provide for reimbursement along
with the time line for reimbursement.
These same issues arise in the reimbursement of cell
phones and the associated costs. If a family will be using
their cell phones and data plans, will they be reimbursed
any portion of the monthly plan costs? If they have to
upgrade to a smartphone, will the agency cover the
expenses? If the family does not have access to technology,
will tablets, smartphones, or laptops be available? It is
important for agencies that use teleconferencing to develop
and share policies surrounding the use of the equipment and
the financial expectations should equipment be damaged
while being used.
Access to Technology
Questions 2 and 3 on the planning form found in Table 1
address issues such as bandwidth and devices. Broadband
width can negatively affect teleconference technologies due
to the large amount of video data being streamed between
the users. The American Recovery and Reinvestment Act
(2009) increased access to broadband technology. By 2012,
98% of Americans had access to download speeds of 3
megabytes per second and approximately 78% had access
to broadband speeds of 25 megabytes per second, which is
necessary for videoconferencing (U.S. Department of
Commerce, 2013). Research using synchronous technolo-
gies in teacher training programs found that bandwidth was
associated with the quality of audio and video. Lack of
bandwidth was associated with calls freezing, videos being
pixelated, a mismatch or delay in audio, and dropped calls
(Schmidt, MacSuga Gage, Gage, Cox, & McLeskey, 2015).
For some technology platforms, early intervention pro-
viders and the family must use the same technology
(Question 3 on the planning form in Table 1). For instance,
if a parent uses Skype with the speech and language pathol-
ogist, the same platform of teleconferencing should be used
for all other service providers to ensure consistency of use.
An option to ensure families have access to technology
devices and compatible equipment, such as laptops, iPads,
and tablets, is to provide equipment through lending pro-
grams. Although this may take an initial investment from
agencies, ensuring access to compatible technology in
homes and among providers can reduce some of the barriers
of teleconferencing. Policies will need to be developed
regarding the use and storage of equipment and who will be
responsible if the equipment is damaged or broken due to
regular use or improper use. All parties must be in agree-
ment and understand these policies.
Training
If the team, or family, does not have experience using the
teleconference technology, a decision will need to be made
as to who will provide training and technical assistance to
the team (Questions 7 and 8 of the planning form found in
Table 1). Individualization and planning are critical for suc-
cess at both the program and individual level. Providers
must be qualified and comfortable using teleconference
technology and have access to technology support both in
office and for the family.
Larger agencies may have technology support available
that they can use to support providers and families. Providers
may be required to go through technology departments to
ensure practices and policies are congruent and meet
requirements. These departments can be instrumental in
assisting in the development and implementation of a tele-
conference program. In addition to training, they can help
problem-solve issues as they arise. If these resources are not
available, other options for training support include offering
leadership opportunities for providers that may have an
interest and background in technology or contracting with a
community provider, such as a local school district, state
agency, or other organization in the area. A benefit of tech-
nology is that it has become much more user friendly.
Families can be provided training in using equipment dur-
ing home visits before implementing teleconferencing.
Buchter and Riggleman 181
Implementation and Evaluation
Once the planning form in Table 1 has been completed and
a platform has been decided (e.g., Skype, GoToMeeting,
FaceTime), team members can plan a home visit to make
sure all individuals involved are familiar with the technol-
ogy and the platform being used. This is best done with all
team members present to ensure the app (if an app is being
used) has been downloaded and everyone has successfully
connected. Each platform will have its own method for con-
necting, such as email address, cell phone number, or
assigned group number. For example, Skype may be the
chosen platform. The family may use Skype on their smart-
phone while others may be using a tablet or laptop. Once
everyone has been added to the invite or notice, it is impor-
tant to test the connection. Individual contacts, as well as
group contacts, can be set up. There may be issues with the
chosen platform, and another platform may be more acces-
sible to all members. This is a good time to practice and
make sure everyone is trained and comfortable with the
technology. As mentioned previously, it is important that all
team members are aware of how to protect confidentiality,
such as checking to make sure they are connected to the
appropriate secure Wi-Fi connection.
Follow-up to review and ensure the plan has been imple-
mented effectively is critical. Question 9 in Table 1 sched-
ules a date for team members to meet and review the plan to
ensure all follow-up tasks have been completed, to reevalu-
ate, and to follow up with strengths and challenges among
families and team members. Documenting the specific task
in the follow-up column with the name of the person respon-
sible can help teams effectively implement the plan, reduce
frustration, and support success.
Conclusion
There are barriers in providing early intervention services
covered under Part C of IDEA (2004) to children and fami-
lies in rural areas. The use of teleconference technologies
(e.g., FaceTime, Skype, GoToMeeting) is one way to over-
come barriers in service implementation and collaboration.
These technologies can be used to provide additional sup-
ports to families in cases where face-to-face meetings or
home visits may occur once a month or less. Supplementing
face-to-face meetings or home visits with teleconference
technology can offer additional support; however, it may
not be appropriate for every family.
Before using teleconference supports, it is critical to plan
and review the plan to ensure its successful implementation.
This process may be ongoing. If teleconferencing is being
used, data-based decision making at the individual and pro-
gram level are critical as research is limited, especially in
the areas of early intervention and special education (Clark,
1986; Finkelstein et al., 2004; McConnochie et al., 2005;
Olsen et al., 2012). Future research is needed on the effi-
cacy of service implementation using such technologies
with rural families.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with
respect to the research, authorship, and/or publication of this
article.
Funding
The author(s) received no financial support for the research,
authorship, and/or publication of this article.
References
American Recovery and Reinvestment Act of 2009, Pub. L. No.
111- 5, 123 Stat. 115 (2009).
American Speech-Language-Hearing Association. (2010).
Professional issues statement: Professional issues in tele-
practice for speech-language pathologists. Retrieved from
http://www.asha.org/policy
Baharav, E., & Reiser, C. (2010). Using telepractice in parent train-
ing in early autism. Telemedicine and e-Health, 16, 727–731.
Baker, D., & Bufka, L. (2011). Preparing for the telehealth
world: Navigating legal, regulatory, reimbursement, and
ethical issues to an electronic age. Professional Psychology:
Research and Practice, 42, 405–411.
Berry, A. B., & Gravelle, M. (2013). The benefits and challenges
of special education positions in rural settings: Listening to
the teachers. Rural Educator, 34(2), 1–13.
Blaire, P., Bambas, A., & Stone, T. (1998). Legal and ethical
issues. In S. F. Viegan & K. Dunn (Eds.), Telemedicine:
Practicing in the information age (pp. 49–59). Philadelphia,
PA: Lippincott-Raven.
Brennan, D., Tindall, L., Theodoros, D., Brown, J., Campbell, M.,
Christiana, D., . . . Lee, A. (2010). A blueprint for telerehabili-
tation guidelines. International Journal of Telerehabilitation,
2(2), 31–34.
Brookman-Frazee, L. (2004). Using parent/clinician partner-
ships in parent education programs for children with autism.
Journal of Positive Behavior Interventions, 6, 195–213.
Bruder, M. B. (2010). Early childhood intervention: A promise to
children and families for their future. Exceptional Children,
76, 339–355.
Cason, J. (2011). Telerehabilitation: An adjunct service delivery
model for early intervention services. International Journal
of Telerehabilitation, 3(1), 19–28.
Cason, J., Behl, S., & Ringwalt, S. (2012). Overview of states’
use of telehealth for the delivery of early intervention (IDEA
Part C) services. International Journal of Telerehabilitation,
4, 39–46. doi:10.5195/ijt.2012.6105
Clark, T. (1986). Cost effective, home based delivery system
for rural, early childhood special education programs. Rural
Special Education Quarterly, 7(1), 7–8.
Davis, M. (2002). Teacher retention and small rural school dis-
tricts in Montana. The Rural Educator, 24(2), 45–52.
Division for Early Childhood. (2014). DEC recommended prac-
tices in early intervention/early childhood special education.
182 Rural Special Education Quarterly 37(3)
Retrieved from https://divisionearlychildhood.egnyte.com/dl/
tgv6GUXhVo
Dixon, R., Verenikina, I., Costley, D., & Pryor, S. (2015). The use
of iPads in the home setting for students with autism spec-
trum disorder. Journal of Special Education Technology, 30,
193–206.
Downing, J. E., & Peckham-Hardin, K. (2007). Supporting inclu-
sive education for students with severe disabilities in rural
areas. Rural Special Education Quarterly, 26, 10–15.
Finkelstein, S., Speedie, S., Demeris, G., Veen, M., Lundgren, J.,
& Potthoff, S. (2004). Telehomecare: Quality, perception, sat-
isfaction. Telemedicine and e-Health, 10, 122–128.
Gouseti, A. (2013). An overview of web-based school collabora-
tion: A history of success or failure? Cambridge Journal of
Education, 43, 377–390.
Hebbeler, K., Spiker, D., & Kahn, L. (2012). Individuals With
Disabilities Education Act’s early childhood programs:
Powerful vision and pesky details. Topics in Early Childhood
Education, 31, 199–207.
Hinton, S., Sheffield, J., Sanders, M. R., & Sofronoff, K. (2017).
A randomized controlled trial of a telehealth parenting inter-
vention: A mixed-disability trial. Research in Developmental
Disability, 65, 74–85.
Houston, K., & Behl, D. (2012). Using telepractice to improve
outcomes for children with hearing loss and their families.
In L. Schmeltz (Ed.), A resource guide for early hearing
detection and intervention. Logan, UT: National Center for
Hearing Assessment and Management. Retrieved from http://
www.infanthearing.org/ehdi-ebook/index.html
Houston, K., Munoz, K., & Bradham, T. (2011). Professional
development: Are we meeting the needs of state EHDI pro-
grams? The Volta Review, 111, 209–223.
Houston, K., & Perigoe, C. (2010). Speech-language pathologists:
Vital listening and spoken language professionals. The Volta
Review, 110, 219–230.
Houston, K., & Stredler-Brown, A. (2012). A model of early inter-
vention for children with hearing loss provided through tele-
practice. The Volta Review, 112, 283–296.
Huysman, J. (2008). Rural teacher satisfaction: An analysis of
beliefs and attitudes of rural teachers’ job satisfaction. The
Rural Educator, 29(2), 31–37.
Individuals With Disabilities Education Act (IDEA), 20 U.S.C. §
1400 (2004).
Lajoie, S., & Lu, J. (2012). Supporting collaboration with technol-
ogy: Does shared cognition lead to co-regulation in medicine?
Metacognition and Learning, 7, 45–62.
Malloy, W., & Allen, T. (2007). Teacher retention in a teacher
resiliency-building rural school. The Rural Educator, 28(2),
19–27.
McCarty, D., & Clancy, C. (2002). Telehealth: Implications for
social work practice. Social Work, 47, 153–161.
McConnochie, K., Wood, N., Kitzman, H., Herendeen, N., Roy,
J., & Roghmann, K. (2005). Telemedicine reduces absence
resulting from illness in urban child care: Evaluation of an
innovation. Pediatrics, 115, 1273–1282.
McLaren, E., & Rutland, J. (2013). Preparing early childhood
special educators in Appalachian Kentucky. Rural Special
Education Quarterly, 32(1), 46–55.
Meadan, H., Meyer, L. E., Snodgrass, M. R., & Halle, J. W. (2013).
Coaching parents of young children with autism in rural areas
using Internet-based technologies: A pilot program. Rural
Special Education Quarterly, 32(3), 3–10.
Menzano, S., Goodwin, A., Rockett, G., & Morris, K. (2011).
Practical, ethical, and legal considerations regarding vid-
eocounseling in college and university counseling centers:
A response to Quarto’s “influencing college students’ per-
ceptions of videocounseling.” Journal of College Student
Psychotherapy, 25, 326–333.
Moffatt, J., & Eley, D. (2010). The reported benefits of telehealth
for rural Australians. Australian Health Review, 34, 276–281.
Nagykaldi, Z., Fox, C., Gallo, S., Stone, J., Fontaine, P., Peterson,
K., & Arvanitis, T. (2008). Improving collaboration between
primary care research networks using access grid technology.
Journal of Informatics in Primary Care, 16, 51–58.
Olsen, S., Fiechtl, B., & Rule, S. (2012). An evaluation of virtual
home visits in early intervention: Feasibility of “virtual inter-
vention.” The Volta Review, 112, 267–281.
Rural Early Childhood Special Education Task Force American
Council on Rural Special Education. (2010). Response to PL
99-457, Titles I and II: Issues concerning families residing
in rural and remote areas of the United States. Rural Special
Education Quarterly, 29(1), 13–16.
Schmidt, M., MacSuga Gage, A., Gage, N., Cox, P., & McLeskey,
J. (2015). Bringing the field to the supervisor: Innovation in
distance supervision for field-based experiences using mobile
technology. Rural Special Education Quarterly, 34(1), 37–43.
Shaddock, A., & Batchler, M. (1986). An analysis of the use of
teleconferencing to support a rural early intervention pro-
gram. International Journal of Disability Development and
Education, 33, 215–219.
Shaddock, A., & Edwards, H. (1984). Special education at a dis-
tance. Armidale, Australia: N.E.E.D. Centre
Suppo, J. L., & Mayton, M. R. (2014). Expanding training oppor-
tunities for parents of children with autism. Rural Special
Education Quarterly, 33(3), 19–28.
U.S. Department of Commerce. (2013). U.S. broadband avail-
ability: June 2010–June 2012. Retrieved from http://www.
ntia.doc.gov/report/2013/us-broadbandavailability-june-
2010-june-2012
Vismara, L., Young, G., & Rogers, S. (2012). Telehealth for
expanding the reach of early autism training to parents.
Autism Research and Treatment, 2012, Article 121878.
doi:10.1155/2012/121878
Votava, K., & Chiasson, K. (2015). Perceptions of Part C coor-
dinators on family assessment in early intervention. Rural
Special Education Quarterly, 34(2), 17–24.