Association for Behavior Analysis International

The Association for Behavior Analysis International® (ABAI) is a nonprofit membership organization with the mission to contribute to the well-being of society by developing, enhancing, and supporting the growth and vitality of the science of behavior analysis through research, education, and practice.


47th Annual Convention; Online; 2021

All times listed are Eastern time (GMT-4 at the time of the convention in May).

Event Details

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Symposium #14
CE Offered: BACB
Lessons Learned from Telehealth Direct Therapy and Implications for Practice
Saturday, May 29, 2021
9:00 AM–9:50 AM
Area: AUT; Domain: Translational
Chair: Christopher Miyake (Center for Autism and Related Disorders)
CE Instructor: Karen Nohelty, M.Ed.
Abstract: With the implementation of stay at home orders related to the COVID-19 pandemic, the occurrence of telehealth direct therapy sessions dramatically increased. While these services were largely provided to fulfill a specific need during the pandemic, clear benefits to telehealth direct therapy have emerged that indicate this method of service delivery should continue to be explored and provided outside of pandemic-related situations. As direct services continue to be provided via telehealth, it is critical to examine them further, in order to ensure that they are of high quality as limited research has been conducted to date on direct services provided via telehealth. In the first talk, a literature review on strategies for rapport and implications for telehealth direct therapy sessions will be discussed. Next, the results from a study demonstrating the effectiveness of telehealth direct therapy will be shared. Finally, a measure to assess treatment integrity of telehealth direct therapy sessions will be described.
Instruction Level: Basic
Keyword(s): engagement, rapport, telehealth, treatment integrity
Target Audience: The target audience include a variety of levels of ABA practitioners, including BCBAs and BCaBAs.
Learning Objectives: 1. Participants will be able to identify at least 3 strategies to build rapport during a telehealth direct therapy session. 2. Participants will be able to summarize the evidence surrounding effectiveness of telehealth direct therapy. 3. Participants will be able to identify 7 critical components for assessing treatment integrity of telehealth direct therapy sessions.
Importance of Rapport in Telehealth Direct Therapy
CHRISTOPHER MIYAKE (Center for Autism and Related Disorders)
Abstract: The delivery of telehealth direct therapy to individuals with autism spectrum disorder provides many benefits but also introduces potential hurdles. Whether delivered in-person or via telehealth direct sessions, patient engagement and assent are critical components of any therapy session. However, telehealth direct sessions have placed an increased role on establishing rapport between clinicians and patients as patients can more easily escape interactions with clinicians by simply closing an application or leaving an area. Thus, a clinician must rely on techniques and procedures that increase social approach and a patient's desire to engage with them during sessions. Research has shown that taking the time to build rapport can increase social approach and decrease challenging behavior during the implementation of in-person therapy sessions. While more research needs to be done on the effects of rapport building on telehealth sessions, this review examines the current research on techniques and procedures and provides suggestions on how they can be utilized in the context of telehealth direct sessions.

Effectiveness of Telehealth Direct Therapy for Individuals With Autism Spectrum Disorder

(Applied Research)
LEAH HIRSCHFELD (Center for Autism and Related Disorders), Karen Nohelty (Center for Autism and Related Disorders), Casey Brown Bradford (Center for Autism and Related Disorders), Christopher Miyake (Center for Autism and Related Disorders)

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.


Ensuring Telehealth Direct Therapy is Provided With Integrity

(Service Delivery)
KAREN NOHELTY (Center for Autism and Related Disorders), Leah Hirschfeld (Center for Autism and Related Disorders), Christopher Miyake (Center for Autism and Related Disorders)

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.




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Modifed by Eddie Soh