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| Trials and Triumphs With Telehealth |
| Sunday, September 29, 2019 |
| 2:00 PM–3:50 PM |
| Stockholm Waterfront Congress Centre, Level 2, C3 |
| Area: CSS/DDA; Domain: Translational |
| Chair: Jennifer J. McComas (University of Minnesota) |
| Discussant: Kelly M. Schieltz (University of Iowa) |
| Abstract: Functional communication training (FCT) is a widely used and effective function-based treatment for socially-maintained problem behavior. Further, parents can be effective behavior change agents and providing rural caregivers with increased access to behavioral expertise via telehealth is a promising approach. However, challenges do occasionally arise, including lack of high-speed internet in rural areas, providing behavioral coaching internationally, and problem-solving when typically effective procedures prove ineffective. Further, less is known about the utility of FCT for individuals who have no formal communication system but who do not engage in severe destructive behavior, including individuals with Rett syndrome and related neurodevelopmental disorders. Kristín Guðmundsdóttir will kick off the symposium with the presentation "Caregiver training via telecommunication with rural Icelandic families of children with autism: Experimental findings and social validity," followed by Loukia Tsami who will present "An Application of Delivering Functional Communication Training via Telehealth Internationally." Kelly Schieltz will then present "Single-Case Analysis to Determine Reasons for Failure of Behavioral Treatment via Telehealth" and then Rebecca Kolb will then present on "The effects of functional communication training coached via telehealth for individuals with Rett syndrome." David Wacker will discuss the presentations in terms of methodological, clinical, and conceptual implications of behavioral consultation delivered via telehealth technology. |
| Instruction Level: Intermediate |
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Caregiver Training via Telecommunication With Rural Icelandic Families of Children With Autism: Experimental Findings and Social Validity |
| (Service Delivery) |
| KRISTÍN GUDMUNDSDOTTIR (University of Akureyri), Zuilma Gabriela Sigurdardottir (University of Iceland), Shahla Alai-Rosales (University of North Texas), Lise Renat Roll-Pettersson ( Stockholm University) |
| Abstract: Parents can be effective behavior change agents and providing rural caregivers with increased access to behavioral expertise via telehealth is a promising approach. This presentation will describe results from two experimental studies of the effects of using telecommunication in training of rural Icelandic caregivers of children with autism. Furthermore, results from evaluation of the social validity of the training will be described. Participants included five caregivers and their preschool children with autism and one child‘s teacher. The intervention, included teaching the caregivers basic naturalistic teaching strategies to increase the frequency of their child’s socio-communicative skills. According to the results experimental control was demonstrated with all families. Measurable progress was displayed for all caregivers and children across all skill areas. Preliminary analysis of the social validity data indicates the caregivers believed the telecommunication training was feasible and viable. Challenges encountered during the studies regarding technical aspects, measurement and training procedures will be discussed. The results extend and confirm previous research on the effectiveness of teaching naturalistic strategies to caregivers via telecommunication. They also indicate that training via telecommunication is a promising alternative for families that have limited access to evidence-based behavioral expertise. However, further development and experimental study is important. |
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| An Application of Delivering Functional Communication Training via Telehealth Internationally |
| (Service Delivery) |
| LOUKIA TSAMI (University of Houston-Clear Lake), Kelly M. Schieltz (University of Iowa), Dorothea C. Lerman (University of Houston-Clear Lake) |
| Abstract: Functional communication training (FCT) based on functional analysis (FA) results is highly effective for treating socially maintained problem behavior. When compared to in-vivo in-home models, the FA + FCT package has, recently, been demonstrated to be as effective (M = 97% reduction in problem behavior; M = 76% increase in manding) and acceptable (M = 6.25 on a 7 point scale) when the FA + FCT package is conducted by caregivers in their homes with coaching from a behavior therapist via telehealth (Lindgren et al., 2016). Additionally, the costs to deliver these services has been shown to be significantly reduced when provided via telehealth (Lindgren et al.). Therefore, in this presentation, we will summarize the results of the FA + FCT package on the problem behavior of young children with autism when their caregivers conducted these procedures in their homes, with coaching from a behavior therapist, via telehealth in the United States. We will then present case examples of how the FA + FCT package has been applied via telehealth internationally, in which similar results were obtained (e.g., reductions in child problem behavior, improvements in manding, high levels of parent acceptability). |
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| Single-Case Analysis to Determine Reasons for Failure of Behavioral Treatment via Telehealth |
| (Applied Research) |
| Kelly Schieltz (University of Iowa), Patrick Romani (University of Colorado, Anschutz Medical Campus), DAVID WACKER (The University of Iowa), Alyssa N. Suess (Chatter Therapy), Pei Huang (The University of Iowa), Wendy K. Berg (The University of Iowa), Scott D. Lindgren (The University of Iowa), Todd G. Kopelman (The University of Iowa Hospitals and Clinics) |
| Abstract: Functional communication training (FCT) is a widely used and effective function-based treatment for problem behavior. The purpose of this presentation is to present two cases in which FCT was unsuccessful in reducing the occurrence of problem behavior displayed by two young children with an autism spectrum disorder. Both children received the same functional analysis plus FCT treatment package via telehealth that had proven to be highly successful for the other participants. The FCT package was conducted within tightly controlled single-case designs for each participant, which permitted subsequent analyses to determine why FCT was unsuccessful. These analyses suggested distinct reasons for the treatment failure for each child. Although the negative results of treatment appeared to be similar for both children, the specific reasons for treatment failure were highly individualistic and identifiable via the single-case analyses conducted. We present findings from both our initial and subsequent analyses and discuss the implications. |
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The Effects of Functional Communication Training Coached via Telehealth for Individuals With Rett Syndrome |
| (Applied Research) |
| REBECCA KOLB (University of Minnesota), Jennifer J. McComas (University of Minnesota), Alefyah Shipchandler (University of Minnesota), Emily Katrina Unholz (University of Minnesota), Shawn Girtler (University of Minnesota) |
| Abstract: Functional communication training (FCT) based on functional analysis (FA) results is highly effective for treating socially maintained problem behavior of individuals with intellectual disabilities (ID) and ASD. Less is known about the utility of FCT for promoting a formal system of communicative behavior for individuals with Rett syndrome or other related neurodevelopmental disorders. We will describe the assessment and intervention procedures we have used with more than 15 participants with Rett syndrome who used idiosyncratic forms of communication as their primary means to communicate with family members. In addition, we will present illustrative case examples of various formal communication modes (e.g., microswitches operated with hands, eye pointing at picture cards, and eye-gaze activated speech-generating computer system). Challenges, limitations, and future directions will be discussed. |
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