Guidelines for Developing Telehealth Services and Troubleshooting Problems with Telehealth Technology When Coaching Parents to Conduct Functional Analyses and Functional Communication Training in Their Homes

Lee, John F.; Schieltz, Kelly M.; Suess, Alyssa N.; Wacker, David P.; Romani, Patrick W.; Lindgren, Scott D.; Kopelman, Todd G.; Dalmau, Yaniz C. Padilla

doi:10.1007/s40617-014-0031-2

Cited by 85 publications

(67 citation statements)

References 7 publications

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“…5,11 Telehealth workstations were equipped with a Windows-based PC, video monitor, webcam, and headset. 21 For group 2, existing videoconferencing software was used at the hospital site. 5,11 This software allowed the consultant to record the telehealth sessions for subsequent data collection.…”

Section: Telehealth Centermentioning

confidence: 99%

Telehealth and Autism: Treating Challenging Behavior at Lower Cost

et al. 2016

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OBJECTIVE: To determine whether challenging behavior in young children with autism and other developmental disabilities can be treated successfully at lower cost by using telehealth to train parents to implement applied behavior analysis (ABA). METHODS:We compared data on the outcomes and costs for implementing evidence-based ABA procedures to reduce problem behavior by using 3 service delivery models: in-home therapy, clinic-based telehealth, and home-based telehealth. Participants were 107 young children diagnosed with autism or other neurodevelopmental disorders, and data analysis focused on the 94 children who completed treatment. RESULTS:All 3 service delivery models demonstrated successful reduction of problem behavior by training parents to conduct functional analysis and functional communication training. The mean percentage reduction in problem behavior was >90% in all 3 groups after treatment, and treatment acceptability based on parent ratings was high for all groups. Total costs for implementing treatment were lowest for home telehealth, but both telehealth models were significantly less costly than in-home therapy.CONCLUSIONS: This research demonstrated that parents can use ABA procedures to successfully treat behavior problems associated with autism spectrum disorders regardless of whether treatment is directed by behavior consultants in person or via remote video coaching. Because ABA telehealth can achieve similar outcomes at lower cost compared with in-home therapy, geographic barriers to providing access to ABA for treating problem behavior can be minimized. These findings support the potential for using telehealth to provide researchbased behavioral treatment to any family that has access to the Internet.

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Section: Telehealth Centermentioning

confidence: 99%

Telehealth and Autism: Treating Challenging Behavior at Lower Cost

et al. 2016

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“…Finally, some technical difficulties were reported in the studies, suggesting a need to document and refine the technological requirements for successful telehealth interventions. This is likely to be a common concern for telehealth interventions across a number of fields and Lee et al (2015) provide an initial analysis of the particular considerations for training relating to FCT interventions. More demonstrations of sufficient technology for conducting telehealth and troubleshooting guidelines are undoubtedly needed if practitioners are to adopt such methodology within their practice.…”

Section: Limitations and Areas For Further Studymentioning

confidence: 99%

Training Individuals to Implement Applied Behavior Analytic Procedures via Telehealth: A Systematic Review of the Literature

2018

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The purpose of this article is to summarize literature relating to training individuals to implement applied behavior analytic procedures via telehealth and identify any gaps in the evidence base for this type of support. A systematic literature search revealed 20 articles focusing on training individuals to implement specific ABA techniques via telehealth. The Evaluative Method (Reichow et al. in J Austism Dev Disord 38:1311-1319; Reichow, in: Reichow, Doehring, Cicchetti, Volkmar (eds) Evidence-based practices and treatments for children with autism, Springer, New York, Reichow 2011) was used to assess the methodological quality of included articles. Results indicated that individuals were trained to implement a range of techniques, including assessments, targeted interventions, and specific teaching techniques. Socially significant outcomes were reported for clients in the form of reduced challenging behavior and increased skills. Trainee fidelity following training via telehealth was variable, and barriers related to the use of telehealth were highlighted. Where evaluated, cost and travel burdens were considerably lower than support provided in-person. The emerging literature is promising and suggests that telehealth may be an effective means of training individuals in ABA techniques; however, wider issues and practical implications related to the use of telehealth should be considered and are discussed as it relates to ABA providers.

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“…The caregivers received a Windows-based laptop (if needed), webcam, and Ethernet cable at the time of their enrollment in the federally funded project (Lee et al, 2015). The caregivers received a Windows-based laptop (if needed), webcam, and Ethernet cable at the time of their enrollment in the federally funded project (Lee et al, 2015).…”

Section: Setting and Materialsmentioning

confidence: 99%

“…The behavior consultant coached the caregivers on the procedures from the telehealth center (Wacker et al, 2013b) located at UICH during 1-hr weekly visits. The telehealth center had four workstations each equipped with a Windows-based PC, video monitor, webcam, and headset (Lee et al, 2015). Skype TM1 was installed on each PC to transmit and receive audio and video to the participants' homes.…”

Section: Setting and Materialsmentioning

confidence: 99%

An evaluation of resurgence following functional communication training conducted in alternative antecedent contexts via telehealth

Suess

Schieltz

Wacker

et al. 2019

J Exper Analysis Behavior

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Treatments based on differential reinforcement may inadvertently increase the recurrence of problem behavior in the face of challenges because reinforcers for appropriate behavior occur in the same context as problem behavior. The current study evaluated one potential approach to mitigating these problems with differential reinforcement treatments based on behavioral momentum theory. Specifically, appropriate behavior was trained in contexts without a history of reinforcement prior to intervening with problem behavior. Participants were 4 children with autism spectrum disorder. Treatment used telehealth to implement functional communication training (FCT) in three alternative contexts with minimal or no history of reinforcement for problem behavior before initiating FCT in the treatment context. Evaluations of the effects of treatment and tests of resurgence were conducted intermittently during treatment to evaluate maintenance. When FCT treatment was initiated in alternative contexts, initial results were comparable to more typical implementations of FCT. Resurgence was reduced to similar levels during tests of resurgence for all participants when compared to more typical previously published implementations of FCT, but clinically significant reductions in resurgence occurred more quickly in the present study. These findings support training appropriate behavior in an alternative context to mitigate the resurgence of problem behavior during differential reinforcement treatments.

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Guidelines for Developing Telehealth Services and Troubleshooting Problems with Telehealth Technology When Coaching Parents to Conduct Functional Analyses and Functional Communication Training in Their Homes

Cited by 85 publications

References 7 publications

Telehealth and Autism: Treating Challenging Behavior at Lower Cost

Telehealth and Autism: Treating Challenging Behavior at Lower Cost

Training Individuals to Implement Applied Behavior Analytic Procedures via Telehealth: A Systematic Review of the Literature

An evaluation of resurgence following functional communication training conducted in alternative antecedent contexts via telehealth

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