Association for Behavior Analysis International

In order to maintain ethical obligations, behavior analysts must ensure the treatment they provide to patients is effective. While research has demonstrated that applied behavior analysis (ABA) therapy provided over telehealth modalities is effective for clinical supervision and caregiver consultation, there is limited research on the effectiveness of ABA over telehealth directly to individuals with autism spectrum disorder (ASD). This study utilized natural environment teaching and discrete trial training procedures provided over a videoconferencing platform to teach new skills directly to eight individuals, between 4 and 16 years old, with a primary diagnosis of ASD. Skills were taught directly to each individual solely over the videoconferencing platform in a multiple baseline research design. Skills taught were in the language, adaptive, and social domains. All eight individuals acquired mastery for all targets. Additionally, generalization was assessed to caregivers for some targets and findings are discussed. Results suggest that ABA provided over telehealth directly to the patient is a modality that is effective and can be considered for all patients when assessing the appropriate location of treatment.

As telehealth direct therapy is increasingly provided to individuals with autism spectrum disorder, it is critical to ensure that the intervention is provided with integrity. Not only is this central in ensuring services are of a high quality; measuring integrity is also a necessary part of meeting ethical practice requirements. The telehealth therapy treatment integrity measure (TTTIM) includes seven sections that address various aspects of a telehealth direct therapy session: 1) caregiver engagement and support, 2) planning, 3) patient engagement, 4) downtime, 5) behavior intervention plan, 6) skill acquisition, and 7) data collection. Each section includes items that specify critical behaviors the behavior technician (BT) should implement. Items specify behaviors that are telehealth specific as well as behaviors that require generalization of an existing BT skill set to the videoconferencing platform. A description of the TTTIM and strategies for implementation will be discussed. The TTTIM provides an initial definition of behaviors a BT should implement during a telehealth direct therapy session in order to ensure they are providing quality services within their scope of competence.