title: International telemedicine consultations for neurodevelopmental disabilities.
abstract: BACKGROUND
  A telemedicine program was developed between the Children's National Medical Center (CNMC) in Washington, DC, and the Sheikh Khalifa Bin Zayed Foundation in the United Arab Emirates (UAE). A needs assessment and a curriculum of on-site training conferences were devised preparatory to an ongoing telemedicine consultation program for children with neurodevelopmental disabilities in the underserved eastern region of the UAE.
  
  
  METHODS
  Weekly telemedicine consultations are provided by a multidisciplinary faculty. Patients are presented in the UAE with their therapists and families. Real-time (video over Internet protocol; average connection, 768 kilobits/s) telemedicine conferences are held weekly following previews of medical records. A full consultation report follows each telemedicine session.
  
  
  RESULTS
  Between February 29, 2012 and June 26, 2013, 48 weekly 1-h live interactive telemedicine consultations were conducted on 48 patients (28 males, 20 females; age range, 8 months-22 years; median age, 5.4 years). The primary diagnoses were cerebral palsy, neurogenetic disorders, autism, neuromuscular disorders, congenital anomalies, global developmental delay, systemic disease, and epilepsy. Common comorbidities were cognitive impairment, communication disorders, and behavioral disorders. Specific recommendations included imaging and DNA studies, antiseizure management, spasticity management including botulinum toxin protocols, and specific therapy modalities including taping techniques, customized body vests, and speech/language and behavioral therapy. Improved outcomes reported were in clinician satisfaction, achievement of therapy goals for patients, and requests for ongoing sessions.
  
  
  CONCLUSIONS
  Weekly telemedicine sessions coupled with triannual training conferences were successfully implemented in a clinical program dedicated to patients with neurodevelopmental disabilities by the Center for Neuroscience at CNMC and the UAE government. International consultations in neurodevelopmental disabilities utilizing telemedicine services offer a reliable and productive method for joint clinical programs.
authors.affiliation: 1 Center for Neuroscience and Behavioral Health, Children's National Medical Center , Washington, D.C.
authors.forename: Phillip L
authors.initials: PL
authors.lastname: Pearl
authors.forename: Craig
authors.initials: C
authors.lastname: Sable
authors.forename: Sarah
authors.initials: S
authors.lastname: Evans
authors.forename: Joseph
authors.initials: J
authors.lastname: Knight
authors.forename: Parker
authors.initials: P
authors.lastname: Cunningham
authors.forename: Gaetano R
authors.initials: GR
authors.lastname: Lotrecchiano
authors.forename: Andrea
authors.initials: A
authors.lastname: Gropman
authors.forename: Sheela
authors.initials: S
authors.lastname: Stuart
authors.forename: Penny
authors.initials: P
authors.lastname: Glass
authors.forename: Anne
authors.initials: A
authors.lastname: Conway
authors.forename: Issam
authors.initials: I
authors.lastname: Ramadan
authors.forename: Tania
authors.initials: T
authors.lastname: Paiva
authors.forename: Mark L
authors.initials: ML
authors.lastname: Batshaw
authors.forename: Roger J
authors.initials: RJ
authors.lastname: Packer
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D006801:Humans; D007223:Infant; D038622:Internationality; D008297:Male; D010353:Patient Education as Topic / Q000379:methods*; D011786:Quality Control; D012017:Referral and Consultation / Q000458:organization & administration*; D013673:Technology Assessment, Biomedical; D017216:Telemedicine / Q000379:methods*; D014479:United Arab Emirates; D014481:United States; D055815:Young Adult
keywords: distance learning; education; technology; telehealth; telemedicine