Examining the Technical Issues in Teletherapy for Children with Developmental Delays


  • Debraldi Resandono School of Business and Management, Institut Teknologi Bandung
  • Mursyid Hasan Basri School of Business and Management, Institut Teknologi Bandung




Children, digitization, technical issues, teletherapy, therapists


Abstract. Medical digitization has advanced in developing countries, improving work efficiency. Teletherapy has emerged from this advancement. Nevertheless, teletherapy has encountered obstacles, such as software and hardware issues. Problems arose from technological factors such as slow connectivity, inadequate hardware specs, and poor audiovisual. This study aims to examine the technical issues related to teletherapy for children with developmental delays. By implementing descriptive statistical approaches with 43 participants, we found that patients struggled to be involved in teletherapy, resulting in the need for special guidance in the process. Therapists felt their clients' places were extremely crowded, and the low video quality of their devices hampered their ability to conduct optimal observations. Patients had a higher level of satisfaction and interest than therapists, meaning the patients would likely continue to be involved in the future. We also came up with another finding indicating that confidentiality has not become a major concern since building an intimate therapeutic relationship and learning to operate technology are still top priorities. Henceforth, implementing teletherapy would need a solid strategy in the future.

Keywords: Children, digitization, technical issues, teletherapy, therapists

Abstrak. Digitalisasi kesehatan mengalami kemajuan di negara-negara berkembang, sehingga meningkatkan efisiensi kerja. Teleterapi muncul dari kemajuan ini. Meski demikian, teleterapi memiliki berbagai kendala, seperti masalah perangkat lunak dan keras. Masalah muncul dari faktor teknologi seperti konektivitas lambat, spesifikasi perangkat keras yang tidak memadai, dan audiovisual yang buruk. Studi ini bertujuan untuk mengkaji permasalahan teknis terkait teleterapi untuk anak-anak dengan keterlambatan perkembangan. Dengan menerapkan pendekatan statistik deskriptif terhadap 43 partisipan, kami menemukan bahwa pasien kesulitan untuk terlibat dalam teleterapi, sehingga memerlukan bimbingan khusus dalam prosesnya. Terapis merasa tempat klien mereka sangat ramai, dan kualitas video yang rendah pada perangkat mereka menghambat kemampuan mereka untuk melakukan observasi yang optimal. Para pasien memiliki tingkat kepuasan dan minat yang lebih tinggi dibandingkan para terapis, di mana para pasien kemungkinan besar akan terus terlibat di masa mendatang. Kami juga menemukan temuan lain yang menunjukkan bahwa kerahasiaan belum menjadi perhatian utama karena membangun hubungan terapeutik yang intim dan belajar mengoperasikan teknologi masih menjadi prioritas utama. Untuk selanjutnya, penerapan teleterapi akan memerlukan strategi yang solid ke depannya.

Kata kunci: Anak-anak, digitalisasi, permasalahan teknis, teleterapi, terapis


Download data is not yet available.

Author Biography

Mursyid Hasan Basri, School of Business and Management, Institut Teknologi Bandung

Associate Professor
Operation and Performance Management Interest Group
Assistant Professor



Ahrens, R. de B., Lirani, L. da S., & de Francisco, A. C. (2020). Construct validity and reliability of the work environment assessment instrument WE-10. International Journal of Environmental Research and Public Health, 17(20), 1–19. doi: 10.3390/ijerph17207364

Andrade, C. (2021). The Inconvenient Truth About Convenience and Purposive Samples. Indian Journal of Psychological Medicine, 43(1), 86–88. doi: 10.1177/0253717620977000

Antarsih, N. R., Setyawati, S. P., Ningsih, S., Deprizon, Sulaiman, E., & Pujiastuti, N. (2022). Telehealth Business Potential in Indonesia. Proceedings of the International Conference on Social, Economics, Business, and Education (ICSEBE 2021), 205(Icsebe 2021), 73–78. doi: 10.2991/aebmr.k.220107.015

Békés, V., Aafjes-van Doorn, K., Luo, X., Prout, T. A., & Hoffman, L. (2021). Psychotherapists’ Challenges With Online Therapy During COVID-19: Concerns About Connectedness Predict Therapists’ Negative View of Online Therapy and Its Perceived Efficacy Over Time. Frontiers in Psychology, 12(July), 1–10. doi: 10.3389/fpsyg.2021.705699

Bele, N., Kumar, S., & Singay, J. (2018). Digitization of Hospital Services and Operations: A Conceptual Framework. International Journal of Healthcare Education & Medical Informatics, 05(01), 1–5. doi: 10.24321/2455.9199.201801

Bolton, J. (2017). The ethical issues which must be addressed in online counselling. Australian Counselling Research Journal, 11(1), 1–29. https://www.acrjournal.com.au/resources/assets/journals/Volume-11-Issue-1-2017/Volume-11-Issue-1-2017-FULL.pdf

Cambridge Dictionary. (n.d.). Confidentiality. https://dictionary.cambridge.org/dictionary/english/confidentiality

Campbell, S., Greenwood, M., Prior, S., Shearer, T., Walkem, K., Young, S., Bywaters, D., & Walker, K. (2020). Purposive sampling: complex or simple? Research case examples. Journal of Research in Nursing, 25(8), 652–661. doi: 10.1177/1744987120927206

Cataldo, F., Chang, S., Mendoza, A., & Buchanan, G. (2021). A perspective on client-psychologist relationships in videoconferencing psychotherapy: Literature review. JMIR Mental Health, 8(2), 1–14. doi: 10.2196/19004

Chaudhary, T., Kanodia, A., Verma, H., Singh, C. A., Mishra, A. K., & Sikka, K. (2021). A Pilot Study Comparing Teletherapy with the Conventional Face-to-Face Therapy for Speech-Language Disorders. Indian Journal of Otolaryngology and Head and Neck Surgery, 73(3), 366–370. doi: 10.1007/s12070-021-02647-0

Cheng, C., Humphreys, H., & Kane, B. (2022). Transition to telehealth: Engaging medical students in telemedicine healthcare delivery. Irish Journal of Medical Science, 191(5), 2405–2422. doi: 10.1007/s11845-021-02720-1

Choo, Y. Y., Agarwal, P., How, C. H., & Yeleswarapu, S. P. (2019). Developmental delay: Identification and management at primary care level. Singapore Medical Journal, 60(3), 119–123. doi: 10.11622/smedj.2019025

Cipolletta, S. (2015). When therapeutic relationship is online: some reflections on Skype sessions. Costruttivismi, January 2015, 88–97. doi: 10.23826/2015.01.088.097

Cipolletta, S., Frassoni, E., & Faccio, E. (2018). Construing a therapeutic relationship online: An analysis of videoconference sessions. Clinical Psychologist, 22(2), 220–229. Doi: 10.1111/cp.12117

Cole, B., Pickard, K., & Stredler-Brown, A. (2019). Report on the use of telehealth in early intervention in colorado: Strengths and challenges with telehealth as a service delivery method. International Journal of Telerehabilitation, 11(1), 33–40. doi: 10.5195/ijt.2019.6273

de Guzman, K. R., Snoswell, C. L., Giles, C. M., Smith, A. C., & Haydon, H. H. (2022). GP perceptions of telehealth services in Australia: a qualitative study. BJGP Open, 6(1), 1–11. doi: 10.3399/BJGPO.2021.0182

Eguia, K. F., & Capio, C. M. (2022). Teletherapy for children with developmental disorders during the COVID-19 pandemic in the Philippines: A mixed-methods evaluation from the perspectives of parents and therapists. Child: Care, Health and Development, 48(6), 963–969. doi: 10.1111/cch.12965

Erlandsson, A., Forsström, D., Rozental, A., & Werbart, A. (2022). Accessibility at What Price? Therapists’ Experiences of Remote Psychotherapy with Children and Adolescents During the COVID-19 Pandemic. Journal of Infant, Child, and Adolescent Psychotherapy, 21(4), 293–308. doi: 10.1080/15289168.2022.2135935

Etikan, I., Musa, S. A., & Alkassim, R. S. (2016). Comparison of Convenience Sampling and Purposive Sampling. American Journal of Theoretical and Applied Statistics, 5(1), 1. doi: 10.11648/j.ajtas.20160501.11

Fairburn, C. G., & Patel, V. (2017). The impact of digital technology on psychological treatments and their dissemination. Behaviour Research and Therapy, 88, 19–25. doi: 10.1016/j.brat.2016.08.012

Fernandez, E., Woldgabreal, Y., Day, A., Pham, T., Gleich, B., & Aboujaoude, E. (2021). Live psychotherapy by video versus in-person: A meta-analysis of efficacy and its relationship to types and targets of treatment. Clinical Psychology and Psychotherapy, 28(6), 1535–1549. doi: 10.1002/cpp.2594

Fitzgerald, T. D., Hunter, P. V., Hadjistavropoulos, T., & Koocher, G. P. (2010). Ethical and legal considerations for internet-based psychotherapy. Cognitive Behaviour Therapy, 39(3), 173–187. doi: 10.1080/16506071003636046

Freeman, S., Marston, H. R., Olynick, J., Musselwhite, C., Kulczycki, C., Genoe, R., & Xiong, B. (2020). Intergenerational effects on the impacts of technology use in later life: Insights from an international, multi‐site study. International Journal of Environmental Research and Public Health, 17(16), 1–14. doi: 10.3390/ijerph17165711

Gebre-Mariam, M., & Bygstad, B. (2019). Digitalization mechanisms of health management information systems in developing countries. Information and Organization, 29(1), 1–22. doi: 10.1016/j.infoandorg.2018.12.002

Geller, S. (2021). Cultivating online therapeutic presence: strengthening therapeutic relationships in teletherapy sessions. Counselling Psychology Quarterly, 34(3–4), 687–703. doi: 10.1080/09515070.2020.1787348

Hajjar, S. T. EL. (2018). Statistical Analysis: Internal-Consistency Reliability and Construct Validity. International Journal of Quantitative and Qualitative Research Methods, 6(1), 27–38. www.eajournals.org

Hanley, T. (2021). Researching online counselling and psychotherapy: The past, the present and the future. Counselling and Psychotherapy Research, 21(3), 493–497. doi: 10.1002/capr.12385

Hermawan, S., & Amirullah. (2016). Metode Penelitian Bisnis. Media Nusa Creative (MNC Publishing), 2156051003, 22–23.

Johnsson, G., & Bulkeley, K. (2021). Practitioner and service user perspectives on the rapid shift to teletherapy for individuals on the autism spectrum as a result of covid-19. International Journal of Environmental Research and Public Health, 18(22). doi: 10.3390/ijerph182211812

Katadata Insight Center. (2022, March 12). Survei: Konsumen Makin Nyaman Menggunakan Layanan Telemedik. Katadata.co.id. https://katadata.co.id/duatahunpandemi

Kiriakaki, S., Tzovanou, M., Sotiriou, A., Lampou, M., & Varsamidou, E. (2022). Online Counseling: Advantages, Disadvantages and Ethical Issues. Homo Virtualis, 5(1), 32–59. doi: 10.12681/homvir.30316

Kotera, Y., Kaluzeviciute, G., Lloyd, C., Edwards, A. M., & Ozaki, A. (2021). Qualitative investigation into therapists’ experiences of online therapy: Implications for working clients. International Journal of Environmental Research and Public Health, 18(19), 1–15. doi: 10.3390/ijerph181910295

Kominfo. (2021, July 8). Dukung telemedicine, Kominfo Gandeng operator Seluler Jaga Kualitas Layanan. Website Resmi Kementerian Komunikasi dan Informatika RI. https://www.kominfo.go.id/content/detail/35541/dukung-telemedicine-kominfo-gandeng-operator-seluler-jaga-kualitas-layanan/0/berita_satker

Kumar, A., Kumar Verma, A., Bharti, J., & Professor, A. (2020). Aspects of Digitalization of Healthcare in India. International Journal of Research and Analytical Reviews, 7(1), 404–407. www.ijrar.org

Langkamp, D. L., McManus, M. D., & Blakemore, S. D. (2015). Telemedicine for children with developmental disabilities: A more effective clinical process than office-based care. Telemedicine and E-Health, 21(2), 110–114. doi: 10.1089/tmj.2013.0379

Lau, P. L., Jaladin, R. A. M., & Abdullah, H. S. (2013). Understanding the Two Sides of Online Counseling and their Ethical and Legal Ramifications. Procedia - Social and Behavioral Sciences, 103, 1243–1251. doi: 10.1016/j.sbspro.2013.10.453

Laurenza, E., Quintano, M., Schiavone, F., & Vrontis, D. (2018). The effect of digital technologies adoption in healthcare industry: a case based analysis. Business Process Management Journal, 24(5), 1124–1144. doi: 10.1108/BPMJ-04-2017-0084

Lee, E. C., Grigorescu, V., Enogieru, I., Smith, S. R., Samson, L. W., Conmy, A. B., & Lew, N. De. (2023). Updated National Survey Trends in Telehealth Utilization and Modality: 2021- 2022. Office of the Assistant Secretary for Planning and Evaluation, U. S. Department of Health and Human Services, HP-2023-09, 1–19.

Lee, S. (2010). Contemporary Issues of Ethical E-therapy. Journal of Ethics in Mental Health, 5(November), 1–5.

Lucas, J. W., & Villarroel, M. A. (2022). Telemedicine Use Among Adults: United States, 2021. NCHS Data Brief, 445, 1–8.

MacEvilly, D., & Brosnan, G. (2020). Adapting an emotional regulation and social communication skills group programme to teletherapy, in response to the Covid-19 pandemic. Irish Journal of Psychological Medicine, 1–6. doi: 10.1017/ipm.2020.109

MacMullin, K., Jerry, P., & Cook, K. (2020). Psychotherapist experiences with telepsychotherapy: Pre COVID-19 lessons for a post COVID-19 world. Journal of Psychotherapy Integration, 30(2), 248–264. doi: 10.1037/int0000213

Markowitz, J. C., Milrod, B., Heckman, T. G., Bergman, M., Amsalem, D., Zalman, H., Ballas, T., & Neria, Y. (2021). Psychotherapy at a Distance. American Journal of Psychiatry, 178(3), 240–246. doi: 10.1176/appi.ajp.2020.20050557

Mars, M., & Scott, R. E. (2017). Being Spontaneous: The Future of Telehealth Implementation? Telemedicine Journal and E-Health: The Official Journal of the American Telemedicine Association, 23(9), 766–772. doi: 10.1089/tmj.2016.0155

McBeath, A. G., du Plock, S., & Bager-Charleson, S. (2020). The challenges and experiences of psychotherapists working remotely during the coronavirus* pandemic. Counselling and Psychotherapy Research, 20(3), 394–405. doi: 10.1002/capr.12326

McCoyd, J. L. M., Curran, L., Candelario, E., & Findley, P. (2022). “There is Just a Different Energy”: Changes in the Therapeutic Relationship with the Telehealth Transition. Clinical Social Work Journal, 50(3), 325–336. doi: 10.1007/s10615-022-00844-0

Millan, J., Yunda, L., & Valencia, A. (2017). Analysis of Economic and Business Factors Influencing Disruptive Innovation in Telehealth. Nova, 15(28), 125–136. doi: 10.22490/24629448.2136

Morin, A. (2023, October 5). What are developmental delays?. Understood. https://www.understood.org/en/articles/what-you-need-to-know-about-developmental-delays

Neuman, W. L. (2014). Social Research Methods: Qualitative and Quantitative Approaches. In Teaching Sociology (Vol. 30, Issue 3). doi: 10.2307/3211488

Orlowski, E. W., Friedlander, M. L., Megale, A., Peterson, E. K., & Anderson, S. R. (2022). Couple and family therapists’ experiences with Telehealth during the COVID-19 pandemic: a phenomenological analysis. Contemporary Family Therapy, 44(2), 101–114. Doi: 10.1007/s10591-022-09640-x

Pallant, J. (2010). SPSS Survival Manual. In McGraw-Hill Education (4th ed.). McGraw-Hill.

Pesämaa, L., Ebeling, H., Kuusimäki, M. L., Winblad, I., Isohanni, M., & Moilanen, I. (2004). Videoconferencing in child and adolescent telepsychiatry: A systematic review of the literature. Journal of Telemedicine and Telecare, 10(4), 187–192. doi: 10.1258/1357633041424458

Pulat, M., & Yıldırım, F. B.-. (2021). Online Counseling and Ethics: A Systematic Review of Empirical Research. The Journal of Clinical and Mental Health Counseling, 1(January), 1–12.

Rettinger, L., Klupper, C., Werner, F., & Putz, P. (2021). Changing attitudes towards teletherapy in Austrian therapists during the COVID-19 pandemic. Journal of Telemedicine and Telecare, 29(5), 406–414. doi: 10.1177/1357633X20986038

Rojas-Torres, L. P., Alonso-Esteban, Y., & Alcantud-Marín, F. (2020). Early intervention with parents of children with autism spectrum disorders: A review of programs. Children, 7(12), 1–28. doi: 10.3390/children7120294

Rotger, J. M., & Cabré, V. (2022). Therapeutic Alliance in Online and Face-to-face Psychological Treatment: Comparative Study. JMIR Mental Health, 9(5), 1–10. Doi: 10.2196/36775

Saptandari, E. W., Praptomojati, A., Handoyo, R. T., Anjarsari, N. D., & Mahambara, Y. G. R. (2022). Layanan Telekonseling: Psychological First Aid dalam Situasi Pandemi COVID-19. Jurnal Psikologi Teori Dan Terapan, 13(1), 51–71. doi: 10.26740/jptt.v13n1.p51-71

Setyowati, D. (2022, April 7). Jumlah Pengguna Baru layanan telemedicine Capai 44% dalam 6 bulan. Katadata.co.id. https://katadata.co.id/desysetyowati/digital/624e9b8b96669/jumlah-pengguna-baru-layanan-telemedicine-capai-44-dalam-6-bulan

Sikka, K. (2023). Parent’s Perspective on Teletherapy of Pediatric Population with Speech and Language Disorder During Covid-19 Lockdown in India. Indian Journal of Otolaryngology and Head and Neck Surgery, 75(1), 14–20. doi: 10.1007/s12070-022-03310-y

Simpson, S., Richardson, L., Pietrabissa, G., Castelnuovo, G., & Reid, C. (2021). Videotherapy and therapeutic alliance in the age of COVID-19. Clinical Psychology and Psychotherapy, 28(2), 409–421. doi: 10.1002/cpp.2521

Smith, J., & Gillon, E. (2021). Therapists’ experiences of providing online counselling: A qualitative study. Counselling and Psychotherapy Research, 21(3), 545–554. doi: 10.1002/capr.12408

Steed, E. A., Phan, N., Leech, N., & Charlifue-Smith, R. (2022). Remote Delivery of Services for Young Children With Disabilities During the Early Stages of the COVID-19 Pandemic in the United States. Journal of Early Intervention, 44(2), 110–129. doi: 10.1177/10538151211037673

Stoll, J., Müller, J. A., & Trachsel, M. (2020). Ethical Issues in Online Psychotherapy: A Narrative Review. Frontiers in Psychiatry, 10(February), 1–16. doi: 10.3389/fpsyt.2019.00993

Tohme, P., De Witte, N. A. J., Van Daele, T., & Abi-Habib, R. (2021). Telepsychotherapy During the COVID-19 Pandemic: The Experience of Lebanese Mental Health Professionals. Journal of Contemporary Psychotherapy, 51(4), 349–355. doi: 10.1007/s10879-021-09503-w

Tongco, M. D. C. (2007). Purposive sampling as a tool for informant selection. Ethnobotany Research and Applications, 5, 147–158. doi: 10.17348/era.5.0.147-158

Tousignant, M., Boissy, P., Moffet, H., Corriveau, H., Cabana, F., Marquis, F., & Simard, J. (2011). Patients’ satisfaction of healthcare services and perception with in-home telerehabilitation and physiotherapists’ satisfaction toward technology for post-knee arthroplasty: An embedded study in a randomized trial. Telemedicine and E-Health, 17(5), 376–382. doi: 10.1089/tmj.2010.0198

Tuna, B., & Avci, O. H. (2023). Qualitative analysis of university counselors’ online counseling experiences during the COVID-19 pandemic. Current Psychology, 2. doi: 10.1007/s12144-023-04358-x

Velayati, F., Ayatollahi, H., Hemmat, M., & Dehghan, R. (2021). Key components and critical factors for developing a telehealth business framework: a qualitative study. BMC Medical Informatics and Decision Making, 21(1), 1–9. doi: 10.1186/s12911-021-01707-3

Vincente, R., & Jean-Jules, J. (2022). When Passion and Compassion Lead to a Technological Innovation: Telehealth Systems. Journal of Applied Business and Economics, 24(1), 259–278. doi: 10.33423/jabe.v24i1.5067

Wood, M. J., Wilson, H. M., & Parry, S. L. (2021). Exploring the development and maintenance of therapeutic relationships through e-Health support: A narrative analysis of therapist experiences. Medicine Access @ Point of Care, 5, 239920262110180. doi: 10.1177/23992026211018087

Yazdani-Darki, M., Rahemi, Z., Adib-Hajbaghery, M., & Izadi, F. (2020). Older adults’ barriers to use technology in daily life: A qualitative study. Nursing and Midwifery Studies, 9(4), 229–236. doi: 10.4103/nms.nms_91_19








How to Cite

Resandono, D., & Basri, M. H. (2023). Examining the Technical Issues in Teletherapy for Children with Developmental Delays. Jurnal Manajemen Teknologi, 22(3), 229–250. https://doi.org/10.12695/jmt.2023.22.3.2




Most read articles by the same author(s)