|Recent Advances in Assessment and Treatment of Challenging and Appropriate Behavior via Remote TeleConsultation|
|Tuesday, May 31, 2016|
|10:00 AM–11:50 AM |
|Grand Ballroom CD North, Hyatt Regency, Gold East|
|Area: DDA/CBM; Domain: Translational|
|Chair: Jennifer J. McComas (University of Minnesota)|
|Discussant: Wayne W. Fisher (Munroe-Meyer Institute, University of Nebraska Medical Center)|
Functional analysis (FA) and functional communication training (FCT) have been conducted via remote teleconsultation for approximately 10 years now. Since the earliest demonstrations of its effectiveness as a service delivery system, the use of teleconsultation has been expanded in a variety of ways. This symposium will feature recent applications of teleconsultation and discuss the issues related to its use. Alyssa Suess will present first with a demonstration of FA and FCT for individuals with autism who are on a waiting list for treatment of problem behavior. Jessica Simacek will give the second presentation on teaching young children with neurodevelopmental disabilities to mand across home contexts. The third presentation, by Traci Ruppert, will address the effects of coaching and performance feedback on parent acquisition of intervention strategies for challenging behavior across family routines. Matt O'Brien will deliver the fourth presentation on a multi-site study that employs a randomized control trial of functional analysis and treatment for challenging behavior. Wayne Fisher will serve as the discussant and synthesize the presentations as well as discuss implications for future research.
|A Demonstration on the Use of Telehealth in an Outpatient Behavior Clinic|
|ALYSSA N. SUESS (Trinity Health), David P. Wacker (The University of Iowa), Jessica Emily Schwartz (The University of Iowa), Nicole H. Lustig (The University of Iowa), Jessica Detrick (University of Iowa)|
|Abstract: There is a high demand for behavior analytic services for the treatment of problem behavior in children with autism, often resulting in long waitlists for outpatient behavior clinics. In the current study, we incorporated telehealth services into the routine services provided in our outpatient clinic in order to provide brief consultation to families waiting to be seen in the clinic. We specifically coached parents of children with autism via telehealth to conduct functional analyses within multielement designs during one 60-min appointment. A nonconcurrent multiple baseline design was used when the parents implemented functional communication training (FCT) during three 15-min appointments. Interobserver agreement was collected on 59.6% of sessions and averaged 91.5%. Results showed that behavioral functions were identified for 4 out of 5 children, and problem behavior was reduced by an average of 61.2%. Manding and task completion also increased during FCT. The results from this study replicated and extended previous findings by demonstrating how telehealth could be incorporated into the clinical practice of an outpatient clinic. The access to services provided to families via telehealth permitted the families to begin treating the children’s problem behavior without having to wait for months to be evaluated in the clinic.|
Parent-Implemented Communication Intervention With Coaching via Telehealth on the Acquisition of Early Communication Skills
|JESSICA J. SIMACEK (University of Minnesota), Adele Dimian (University of Minnesota), Jennifer J. McComas (University of Minnesota)|
There are numerous barriers to children with severe neurodevelopmental disabilities accessing recommended early and intensive intervention services that are related to optimal outcomes. The purpose of the current study was to determine the efficacy of parent-implemented assessment and intervention with coaching via telehealth (i.e., video conferencing) on the acquisition of early communication skills for three young children (3.5-4 years old) with severe neurodevelopmental disabilities. A structured descriptive assessment and functional analysis were used to identify idiosyncratic/potentially communicative responses and communicative contexts for each child. Functional communication training (FCT) was implemented to increase early communication skills. Parents conducted all sessions with remote coaching via telehealth by experts in functional analysis and FCT. The effects of FCT were evaluated using an adapted, multiple-probe design across three contexts for each child. Prior to intervention, none of the children engaged in reliable or easily recognizable communication forms; however, the results indicated that during FCT intervention all three children acquired the targeted communication skills. Implications from this study support the efficacy of parent-implemented intervention delivered with coaching via telehealth and the potential for future research to examine telehealth within a service delivery model to increase access to services for children with disabilities and their families.
Effects of Behavior Specialists' Use of Coaching and Performance Feedback via Telehealth to Train Parent of Children With Challenging Behavior
|TRACI ELAINE RUPPERT (University of Oregon), Wendy A. Machalicek (University of Oregon)|
Although prior studies have evaluated and supported the use of telehealth to deliver coaching and performance feedback to parents of children with developmental disabilities, there have been few studies that have evaluated the use of telehealth to provide behavioral consultation across family routines. The current investigation examines the effects of coaching and performance feedback provided via telehealth on parent acquisition of intervention strategies across desired family routines for three parents of children with developmental disabilities who engage in challenging behavior. A multiple-probe design across participants was used to examine the effects of immediate performance feedback on parent implementation of intervention strategies and of parent implemented intervention on challenging and adaptive behavior. This study broadens the existing research base by training graduate students to deliver behavioral consultation via telehealth to train parents on how to implement multi-component interventions in their home. Suggestions for future research will be discussed.
Using Telehealth to Compare Behavioral Assessment and Treatment for Children With Autism
|MATTHEW O'BRIEN (The University of Iowa), David P. Wacker (The University of Iowa), Jessica Detrick (The University of Iowa), Todd G. Kopelman (The University of Iowa Hospitals and Clinics), Scott D. Lindgren (The University of Iowa)|
Published studies on the use of telecommunication technology in the field of applied behavior analysis date back nearly 10 years (Barretto et al., 2006). Recent research has established the telehealth model as an effective service delivery modality for behavior analytic services. For example, Lindgren and Wacker have recently completed a series of studies using telehealth in home and clinic settings (Lindgren & Wacker, 2009, 2011). In the most recent study (Wacker et al., 2014), telehealth was used to conduct a randomized controlled trial of functional communication training in the home setting. The results revealed outcomes similar to face-to-face service delivery and telehealth in clinic settings. Given robust findings on the effectiveness of the telehealth model for service provision, this model should also be considered an appropriate modality for conducting behavior analytic research. A new, multi-site research grant (Lindgren & Wacker, 2015) is underway using telehealth to conduct a randomized controlled trial of functional analysis. This presentation will provide insight into the use of telehealth as a research tool to evaluate functional assessment and treatment and will offer a look at case studies from early grant participants.