Association for Behavior Analysis International

Recent advances in telecommunication technologies make it possible to conduct a variety of healthcare services remotely (e.g., behavior analytic intervention services), thereby bridging the gap between consumers in isolated locations and qualified providers. A growing body of empirical research suggests that many behavior analytic training and treatment procedures can be highly effective when delivered remotely via the latest telehealth technologies. In this symposium, we will bring together a cadre of the field’s leading experts on the remote delivery of ABA interventions using telehealth. Each presenter will describe one or more empirical investigations on the use of telehealth methods to expand access to ABA services. The discussant will review the highlights of each study, identify the general themes and important implications that cut across studies, and provide directions for future investigation.

Estimates indicate that autism affects about 1 in 68 American children. Research has shown that Early Intensive Behavioral Interventions (EIBI) is effective when implemented by appropriately trained and supervised technicians. In additional to services provided by technicians, parents often contribute to their child's EIBI programming by extending teaching opportunities throughout the day. However, few empirically supported programs are available for training parents that include performance-based measures. We are conducting a randomized clinical trial to evaluate a 20-hour, web-based, e-learning program for training parents in EIBI protocols. The two primary dependent variables are the Behavioral Implementation Skills for Play Activities (BISPA) and the Behavioral Implementation Skills for Work Activities (BISWA). To date, 10 participants have completed pre-test and post-test assessments on these measures, three in the treatment group and seven in the control group. Mean component skills implemented correctly on the pre-test and post-test for the treatment and control groups for the BISPA were 4.0%, 6.1%, 89%, and 0%, respectively. For the BISWA, the results were 23.6%, 16.9%, 100%, and 27.3%, respectively. The results provide strong preliminary support for the efficacy of our web-based program, which can be delivered to parents anywhere in the world that has broadband internet access.

Many children with autism spectrum disorder (ASD) have feeding difficulties, such as food selectivity (i.e., consumption of a limited variety of foods by type or texture). Inadequate dietary intake is associated with learning and behavior problems. If left untreated, children with ASD and feeding difficulties also may suffer from weight loss or malnutrition. Currently, treatments for pediatric feeding disorders based on ABA research have the most empirical support (Volkert & Piazza, 2012). However, there are a limited number of clinics and professionals in the country that specialize in the behavioral treatment of pediatric feeding disorders. Telehealth methods allow a professional in one location to provide services to a patient in another location. Research has not yet evaluated the effectiveness of using telehealth methods to treat pediatric feeding disorders using behavioral techniques. In the current study, we compared the outcomes (e.g., levels of acceptance, mouth clean [product measure of swallowing], inappropriate mealtime behavior) of children discharged from an intensive day treatment program who were followed up in the clinic versus via telehealth. The children's parents implemented treatment with both methods. Results suggest that clinically relevant outcomes can be achieved regardless of the location of outpatient follow-up.

This presentation will describe an ongoing project, in which we are attempting to train community mental health workers in Michigan to conduct quality functional behavior assessments, including functional analyses, using web-based technologies for teleconsultation. The procedures we are using will be discussed, and outcome data for selected children as well as summary data for trainees will be presented. Issues, problems, and positive developments from the project will also be discussed.

This presentation will provide a summary of how we have used telehealth to implement functional analyses and functional communication training to assess and treat the severe behavior problems of young children with autism. The participants were 30 children with diagnosed autism spectrum disorders who ranged in age from 21–84 months. All assessment and treatment sessions were conducted by parents in their homes with remote coaching provided by behavior analysts located at a tertiary level hospital. The functional analyses were conducted within multi-element designs and social functions were identified for all children. Functional communication training (FCT) was then implemented by the parents and matched to the identified functions of problem behavior. FCT was most often conducted during 1-hour weekly sessions, with individual cases conducted within a reversal design, and the overall group analysis conducted within a randomized clinical trial (3 month delay for second group). The average reduction in problem behavior was 97% (range=77–100%). Interobserver agreement was conducted on approximately 30% of sessions and averaged over 90%.A description of the telehealth and behavioral procedures conducted in the projectwill be presented withvideotaped case examples.