|Advancements in Telehealth Treatments of Aberrant Behavior and Virtual Supervision During the COVID-19 Pandemic|
|Monday, May 31, 2021|
|10:00 AM–11:50 AM |
|Area: AUT/EDC; Domain: Translational|
|Chair: Christina Simmons (Rowan University)|
|Discussant: Amanda Zangrillo (University of Nebraska Medical Center, Munroe-Meyer Institute)|
|CE Instructor: Amanda Zangrillo, Ph.D.|
The COVID-19 pandemic necessitated a rapid transition to virtual service delivery for many practitioners. In this symposium, we present three innovative virtual assessment and treatment evaluations for aberrant behavior in children with autism spectrum disorder and an evaluation of virtual supervision. Somervell and colleagues discuss a virtual single-stimulus preference assessment, measuring engagement with on-screen stimuli. Researchers validated relative preference hierarchies by measuring compliance and subsequent aberrant behavior. Moretti and colleagues present a telehealth treatment evaluation for protests maintained by social control. Researchers implemented functional communication training and compared multiple and mixed schedules for reinforcement schedule thinning on aberrant behavior, schedule thinning efficiency, and participant/therapist preference. Bean and colleagues present a demonstration of the transition from clinic-based treatment to parent-implemented intervention via telehealth. Researchers compared differential reinforcement of alternative behavior (DRA) with synthesized and isolated contingencies on compliance, targeted avoidant movements, and nontargeted dangerous acts. When transferred to the home setting, DRA with synthesized contingencies continued to produce decreases in both target and nontarget aberrant behaviors. Ford and colleagues present results of a national survey on satisfaction and feasibility of virtual behavior analytic supervision. Dr. Amanda Zangrillo will discuss implications, challenges, and recommendations for delivering evidence-based virtual assessment, treatment, and supervision.
|Instruction Level: Intermediate|
|Keyword(s): aberrant behavior, telehealth, virtual|
|Target Audience: |
The target audience includes behavior analytic practitioners, particularly those providing telehealth services for aberrant behavior and supervisors. Necessary prerequisite skills include a general understanding of preference assessment methodology, functional communication training and schedule thinning procedures, and differential reinforcement procedures. Presentations will describe these methodologies as well as present advancements in each domain.
|Learning Objectives: At the conclusion of the presentation, participants will be able to: (1) describe recent research-based extensions to telehealth assessment and treatment of aberrant behavior; (2) describe how to adapt evidence-based assessment and treatment of aberrant behavior to virtual platforms; and (3) describe the acceptability and feasibility of virtual behavior analytic supervision.|
Virtual Single-Stimulus Preference Assessment on Engagement During Telehealth Sessions and Reinforcer Efficacy Validation
|SHERAH SOMERVELL (Rowan University), Kimberly Ford (Rowan University), Christina Simmons (Rowan University), Courtney Russell (Rowan University)|
Practitioners routinely conduct preference assessments to identify reinforcers, with multiple procedural variations. A single-stimulus preference assessment (Pace et al., 1985) is an approach-based procedure, recommended when individuals have difficulty selecting between stimuli or if activities are difficult to present in a selection-based format (Hagopian et al., 2001). In the current study, we conducted a virtual single-stimulus preference assessment (VSSPA) for two participants with autism spectrum disorder during telehealth sessions for challenging behavior. Therapists presented one randomized item or activity, of eight nominated by caregivers, on the screen for 2 min, with three series conducted. Total duration of engagement per stimulus was recorded for each 2-min session, with mean duration of engagement across the three series used to create a relative preference hierarchy. We validated the VSSPA by evaluating compliance with mastered tasks when a high-, moderate-, and low-preferred stimulus was delivered as compared to vocal praise. Results indicated that the VSSPA created a relative preference hierarchy for both participants, stimuli yielded greater on-screen engagement than baseline, and highest ranked stimuli served as reinforcers relative to the lowest ranked stimuli and praise. Participants engaged in the lowest rates of aberrant behavior when higher ranked stimuli were delivered for compliance.
Telehealth Comparison of Multiple and Mixed Schedules During Functional Communication Training Schedule Thinning
|ABIGAIL MORETTI (Rowan University), Christina Simmons (Rowan University), Giovanna Salvatore (Rowan University)|
During the COVID-19 pandemic, behavior analysts have increasingly delivered interventions for challenging behavior via telehealth. The efficacy of implementing functional communication training (FCT) via telehealth has been previously established (e.g., Suess et al., 2014; Wacker et al., 2013), with less research investigating remote schedule thinning. The current study compares virtual FCT reinforcement schedule thinning using a multiple and mixed schedule with a 7-year-old participant with autism spectrum disorder. Virtual functional analysis results indicated that protests were maintained by social control. Therapists taught a functional communication response to access to the functional reinforcer (engaging in child-directed high-preferred virtual activities) and evaluated the efficacy of FCT in an A-B-A-B withdrawal design. Multiple (signaled alteration of reinforcement and extinction contingencies via color-correlated stimuli) and mixed (unsignaled contingencies) schedules were alternated during schedule thinning. Therapists conducted terminal-schedule probes (75-s SD/300-s S?) throughout schedule thinning. After reaching the terminal goal in one condition, participant and therapist preference for the mixed/multiple schedule was assessed. Results suggest that telehealth FCT and schedule thinning were effective at decreasing protests, increasing functional communication, and thinning the reinforcement schedule, with the multiple schedule facilitating more rapid schedule thinning. We discuss the practical application of FCT and schedule thinning via telehealth.
|An Evaluation of Treatment Utilizing Synthesized Contingencies: Transfer to Parent Implementation via Telehealth|
|YVETTE BEAN (University of Georgia Center for Autism and Behavioral Education Research), Andrea Zawoyski (University of Georgia Center for Autism and Behavioral Education Research), Rose Morlino (University of Georgia Center for Autism and Behavioral Education Research), Courtney Mauzy (University of Georgia Center for Autism and Behavioral Education Research), Karla Zabala (University of Georgia Center for Autism and Behavioral Education Research), Joel Eric Ringdahl (University of Georgia Center for Autism and Behavioral Education Research)|
|Abstract: The current case study demonstrated that differential reinforcement of alternative behavior (DRA) with a synthesized contingency increased compliance with demands and decreased targeted avoidant movements, as well as nontargeted dangerous acts exhibited by one participant. In comparison, DRA with an isolated contingency had the same effects on targeted behavior, but did not result in reduction of the nontargeted behavior. Schedule thinning with the synthesized DRA began in the clinic setting. Due to the COVID-19 pandemic, treatment shifted to a telehealth format. Therapists conducted behavioral skills training via telehealth to train the participant’s mother to implement the synthesized DRA with schedule thinning. With continued telehealth coaching, the parent implemented the intervention with high levels of procedural fidelity. Therapeutic effects of the synthesized DRA persisted in the home, and schedule thinning continued. The current case study recommends extensions for synthesized contingency research into examining nontargeted behavior and has implications for future telepractice.|
Acceptability and Feasibility of Virtual Behavior Analysis Supervision
|Kimberly Ford (Rowan University
), Christina Simmons (Rowan University), GIOVANNA SALVATORE (Rowan University), Abigail Moretti (Rowan University)|
The COVID-19 pandemic necessitated a rapid transition to virtual service delivery and supervision. This study examined the acceptability and feasibility of virtual supervision for 94 BCBA/BCaBA supervisees during COVID-19, including variables that impacted perceived satisfaction, effectiveness, and supervision preference. Results indicate a decrease in accrual of direct client hours during the pandemic, with a third of participants reporting a decrease in individual supervision. Participants were largely satisfied with virtual individual and group supervision as indicated by high satisfaction domain scores and individual item means, with minimal overall change in satisfaction. Participants indicated preference for in-person or hybrid supervision and considered in-person most effective. Participants reported that supervisors used best-practice strategies and that virtual supervision was largely feasible. We discuss variables that impacted satisfaction (length of supervisory relationship), preference (age, services provided), and perceived effectiveness (time supervisor was a BCBA). We provide practical implications and recommendations for virtual behavior analytic supervision.