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| Behavior Analysis and Telehealth: Examples of Application |
| Monday, May 30, 2022 |
| 4:00 PM–5:50 PM |
| Meeting Level 1; Room 104A |
| Area: CBM/DDA; Domain: Service Delivery |
| Chair: Shawn P. Quigley (Melmark) |
| Discussant: Sean D. Casey (Heartland Feeding) |
| CE Instructor: Sean D. Casey, Ph.D. |
| Abstract: Technology has been leveraged to improve life conditions for many individuals. The use of technology to improve educational, behavioral, and medical conditions is often referred to as telehealth. Behavior analysts have experience providing supports in telehealth models that span several decades. The applications include educational instruction, reduction of challenging behavior, feeding, training, and much more. The COVID-19 pandemic created a context for professionals to implement telehealth based models to safely provide continuity of care. The purpose of this symposium is to review general considerations of telehealth (e.g., definition, technology, practice guidelines), review outcomes of behavior analytic telehealth service delivery models (e.g., feeding; outpatient university clinic), and discuss social validity of a behavior analytic telehealth service delivery model. |
| Instruction Level: Intermediate |
| Keyword(s): Service Delivery, Telehealth |
| Target Audience: Intermediate Audience Experience with telehealth models, varied service delivery models, and populations with help with application of information presented. |
| Learning Objectives: 1) Attendees will state the Health Resources and Services Administration (HRSA) definition for telehealth and compare to other discipline specific definitions (e.g., medicine). 2) Attendees will state at least four considerations for implementing a behavior analytic telehealth service model. 3) Attendees will describe the application of a behavior analytic telehealth model to support individuals with an identified feeding disorders and receiving outpatient services. 4) Attendees will state social validity factors associated with behavior analytic telehealth services. |
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The Effects of Transition to Telehealth Delivery of Applied Behavior Analysis Treatment During the COVID-19 Pandemic |
| VANESSA CALHOUN (Behavior Change Institute), Joy Pollard (Behavior Change Institute; Stanford University), Linda A. LeBlanc (LeBlanc Behavioral Consulting LLC), Christan Ann Griffin (Behavior Change Institute), Joseph Baker (Stanford University) |
| Abstract: New telehealth service delivery models have emerged during the COVID-19 pandemic to address access barriers, including a direct telehealth service model of ABA services. Recent research has suggested that direct delivery of ABA treatment via telehealth can be successful for some patients (DiGennarro Reed, 2020; Ferguson et al., 2020; Pollard et.al, 2020). Telehealth service delivery models benefit families by facilitating patient choice and timely access to care in both rural and urban communities. In this session, we will review data from patients who transitioned from in-person delivery of ABA services to direct delivery via synchronous videoconference. We will also review how we addressed challenges with implementing different telehealth service delivery models. Case studies and video examples of clients receiving direct ABA treatment via telehealth will be presented to demonstrate different models of direct telehealth service delivery outlined in the Council for Autism Service Providers Telehealth Practice Parameters. |
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| Efficacy of and Unexpected Benefits in the Treatment of Pediatric Food Refusal Using a Fully Virtual Treatment Model |
| JENNIFER E. DAWSON (Devereux Advanced Behavioral Health SPARC), Dena Kelly (Devereux Advanced Behavioral Health SPARC), Desiree Noelle Heckers (Devereux Advanced Behavioral Health SPARC), Brittany Ann Doan (Devereux Advanced Behavioral Health SPARC) |
| Abstract: The efficacy of the behavioral treatment of pediatric feeding disorders is well documented in the literature. In addition to the intensity of the procedures often utilized in treatment, the time commitment from the family is typically immense. Most treatment programs, and hence most research, are conducted in structured clinic or hospital settings, most often utilizing trained therapists as the feeder, at least in the initial phase of treatment. Generalization to parents and other family members as well as to other environments, is critically important in the maintenance and continuation of gains. Given the amount of research in this area and the well-established treatment protocols used in clinical practice, the effectiveness of conducing intensive feeding protocols entirely via a telehealth model was questionable. This talk will present data from over 25 individuals whose entire intensive feeding treatment was conducted via telehealth between the months of April 2020-August 2021. Child gains were on par with in-person treatment while parent fidelity and acceptability were high. Additional, outcomes observed include increased client attendance in follow up visits, decreased cancellations, and a decrease in the use of extinction based procedures. |
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| A Comparison of Behavioral and Social Validity Outcomes Across Distinct In-Vivo and Telehealth Behavioral Treatment Models |
| MATTHEW O'BRIEN (The University of Iowa), Kelly M. Schieltz (University of Iowa), David P Wacker (The University of Iowa) |
| Abstract: Researchers at the University of Iowa have shown that behavioral assessment and treatment delivered via telehealth is feasible (Wacker et al., 2013), effective (Lindgren et al., 2020), and efficient (Lindgren et al., 2016) in treating challenging behavior displayed by young children with autism. Results from these studies have shown that there is little difference in child behavior or parent acceptability between telehealth and in-vivo models when using the same treatment (Lindgren et al., 2016). However, some clinical care models utilize very different types and degrees of assessment and treatment, which may impact the outcomes achieved. To further understand outcomes related to differences in services we compared outcomes for matched samples (age, gender, developmental level) from two distinct service delivery models that utilized different service modalities (in-vivo versus telehealth) and different timing and dosage of treatment (intensive outpatient versus weekly therapy) for young children with autism that use the same assessment and treatment approach (i.e., functional analysis and functional communication training). Our results show that, on average, both models provide effective treatment with high parent satisfaction. We discuss the results in relation to (a) how to systematically expand telehealth services, and (b) how to further evaluate treatment by treatment delivery interactions. |
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| The Social Acceptability of Consultative Behavior Analytic Service Provided via Telehealth |
| JESSICA DETRICK (Western Michigan University ), Stephanie M. Peterson (Western Michigan University), Kelsey E. Stapleton (Western Michigan University), Leanne Latocha (Western Michigan University), Daphne Snyder (Western Michigan University) |
| Abstract: “Telehealth” can be defined as the use of audio-visual transmission of information using videoconferencing and broadband internet (Machalicek et al., 2016). The demand for services to be implemented via telehealth has increased due to the COVID-19 pandemic. Research has demonstrated that a telehealth model of behavioral consultation is effective for implementing assessment and treatment services within behavior analysis (Machalicek et al., 2016; Wacker et al., 2013). However, as behavior analysts we are obligated to assess client and stakeholder preference for services (Behavior Analyst Certification Board, 2020). We collected data on the social acceptability of our consultative behavior analytic services delivered using a telehealth model at approximately quarterly intervals via descriptive surveys for one year. Survey data were collected from both caregivers and clients. In this presentation, we will review the results of our social acceptability surveys, which indicated that our services remained generally accepted over time. We will review issues encountered with telehealth services, as well. Finally, we suggest a hybrid model for delivering telehealth services as a “best-possible solution.” |
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