Feasibility of Parent Training via Telehealth for Children with Autism Spectrum Disorder and Disruptive Behavior: A Demonstration Pilot

Abstract

Telehealth is a potential solution to limited access to specialized services for children with autism spectrum disorder (ASD) in rural areas. We conducted a feasibility trial of parent training with children ages 3-8 with ASD and disruptive behavior from rural communities. Fourteen children (mean age 5.8 ± 1.7) from four telehealth sites enrolled. Thirteen families (92.9%) completed treatment, with 91.6% of core sessions attended. Therapists attained 98% fidelity to the manual and 93% of expected outcome measures were collected at week 24. Eleven of 14 (78.6%) participants were rated as much/very much improved. Parent training via telehealth was acceptable to parents and treatment could be delivered reliably by therapists. Preliminary efficacy findings suggests further study is justified.

Telehealth as a Model for Providing Behaviour Analytic Interventions to Individuals with Autism Spectrum Disorder: A Systematic Review

“…Age and gender for the interventionists were reported rarely with only 25% ( n = 7) of studies reporting both characteristics (Bearss et al 2017 ; Barkaia et al 2017 ; Higgins et al 2017 ; Neely et al 2016 ; Machalicek et al 2010 ; Wacker et al 2013a , b ). Another 25% ( n = 7) of studies reported neither age nor gender (Benson et al 2017 ; Kuravackel et al 2018 ; Machalicek et al 2009a , b ; Simacek et al 2017 ; Suess et al 2016 ; Vismara et al 2009 ).…”

“…Age and gender of participants with ASD were reported more frequently than for interventionists, with both variables being reported in 75% ( n = 21) of studies (Barretto et al 2006 ; Barkaia et al 2017 ; Bearss et al 2017 ; Benson et al 2017 ; Gibson et al 2010 ; Higgins et al 2017 ; Ingersoll and Berger 2015 ; Kuravackel et al 2018 ; Lindgren et al 2015 ; Machalicek et al 2009a , b , 2010 , 2016 ; Meadan et al 2016 ; Neely et al 2016 ; Simacek et al 2017 ; Suess et al 2014 , 2016 ; Vismara et al 2016 ; Wilczynski et al 2017 ). Only 3% ( n = 1) of studies did not report any information about the age or gender of participants with ASD (Heitzman-Powell et al 2014 ).…”

“…Techniques derived from naturalistic and incidental teaching were employed in 36% ( n = 10) of studies (Barkaia et al 2017 ; Ingersoll et al 2016 ; Ingersoll and Berger 2015 ; Meadan et al 2016 ; Neely et al 2016 ; Vismara et al 2009 , 2012 , 2016 ; Wainer and Ingersoll 2015 ). Behaviour support strategies, including positive behaviour support were investigated in 7% ( n = 2) of studies (Bearss et al 2017 ; Kuravackel et al 2018 ). Training participants to conduct preference assessments was examined in 7% ( n = 2) of studies (Higgins et al 2017 ; Machalicek et al 2009a ).…”

“…Equipment included laptops, cameras, scanners and commercially available videoconferencing software. A hybrid approach including coaching and technology-based training was undertaken in 75% ( n = 21) of studies (Barkaia et al 2017 ; Bearss et al 2017 ; Gibson et al 2010 ; Heitzman-Powell et al 2014 ; Higgins et al 2017 ; Ingersoll and Berger 2015 ; Ingersoll et al 2016 ; Kuravackel et al 2018 ; Machalicek et al 2009a , 2010 ; Meadan et al 2016 ; Neely et al 2016 ; Suess et al 2014 ; Vismara et al 2009 , 2012 , 2013 , 2016 ; Wacker et al 2013a , b ; Wainer and Ingersoll 2015 ; Wilczynski et al 2017 ).…”

“…1–2 h Coaching: video conferenced coached sessions focused on mand training and echoics, teaching contingencies of positive consequences, feedback and prompting opportunities. 10 min at end of coaching session recorded for analysis Interventionist variables: fidelity/correct implementation of sequence and feedback Social validity questionnaire ASD participant: mands and echoic responses Mixed All therapists increased correct commands from baseline Small increase in feedback for two participants larger increase for one Levels of fidelity were low < 60% Mixed increases in mands and echoics Weak Bearss et al ( 2017 ) Group research design; quasi experimental pre-post test with no comparison group Interventionists: 13 parents Gender not specified Ages: mothers ( M = 38.3), fathers ( M = 39.8) Not clear which parent took part in trial Participants with ASD: 13, 9 males, 5 females Age: ( M = 5.8 years) Diagnosis: ASD Diagnostic tool: ADOS Equipment: Computers, scanners, projectors, cameras. No detailed specifics reported Videoconferencing Software: not reported Behaviour support 6-month direct instruction parent training program designed to teach parents behaviour management strategies, conducted via videoconferencing.…”