In response to the COVID-19 pandemic, many behavior analysts and other health professionals modified their services for delivery via telehealth modalities. The transition to telehealth is especially important for providers working with foster youth who exhibit challenging behavior because these youth often move to another placement due to such behaviors. The primary objective of this article was to evaluate the extent to which service indicators for a state-funded team working with foster youth changed after the service delivery model changed from in-person to telehealth services. In particular, we evaluated changes in monthly count of client contacts, appointments, intakes, closed cases, and medication reviews. The secondary objective was to outline potential benefits and environmental barriers encountered by the team and to integrate our findings with the literature on behavior-analytic services provided via telehealth. Overall, results show that we maintained service quality with a broad range of behavioral interventions and increased overall client appointments. Given these outcomes, our team may continue to provide behavioral services via telehealth after the COVID-19 pandemic.
Over a 1‐year period, we trained caregivers to employ a color‐coded daily behavior rating system whereby green denoted a high level of appropriate behavior, yellow denoted a mix of some appropriate behavior and mild problem behavior, and red denoted a high level of problem behavior. We then used these ratings to generate graphs that caregivers brought to their child's prescriber appointments. Preliminary data comparing unconditional and conditional probabilities from 25 prescriber visits with 12 participants indicate prescribers were most likely (a) to decrease psychotropic medication following green ratings, (b) increase psychotropic medication following red ratings, and (c) make no changes following yellow ratings. Across participants, prescribers' decisions matched the color code for 76% of trials. These preliminary findings support continued inclusion of the medication‐advocacy training component to facilitate deprescribing of psychotropic medication within our state‐funded project.
Adolescents living in residential juvenile justice facilities often receive mental health services during their stay to address committed offenses, yet some display challenging behavior during moments of conflict within the facility. These challenging behaviors could result in risk of harm to self or others, or the individual may experience punishment from facility staff. The purpose of this study was to explore the effects of an additive voluntary focused intervention for individuals who continued to display challenging behavior despite participation in “treatment as usual” in a juvenile justice facility. We implemented a self-management intervention, supported through interprofessional collaboration, via telehealth with four male adolescents. Using Behavior Skills Training, we taught participants to self-monitor precursors for challenging behavior and identify an alternative behavior to engage in to prevent overt challenging behavior events. Alternative behaviors were responses incompatible with the challenging behavior, or served as a rule to prompt self-management of further behavior. Results show all four participants increased their selection of alternative behaviors when presented with an evocative situation and a precursor for a severe behavior event during simulations. In addition, three participants stated they would use alternative behaviors across precursors
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presented during teaching; however, two participants required booster sessions to maintain appropriate responding during simulations. Outside of simulated sessions, facility staff reported modest decreases in participants’ challenging behavior during and after the intervention.
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