|Practitioner Experiences With Telehealth Across the World|
|Sunday, May 29, 2022|
|11:00 AM–12:50 PM |
|Meeting Level 2; Room 256|
|Area: DDA; Domain: Translational|
|Chair: Yaniz C. Padilla Dalmau (Flamboyan Behavioral Services)|
|Discussant: Kelly M. Schieltz (University of Iowa)|
|CE Instructor: Kelly M. Schieltz, Ph.D.|
Due to the COVID-19 pandemic, many behavior analysts who serve individuals with developmental disabilities had to transform their practice swiftly using telehealth in order to continue supporting their clients. In this international symposium, we invited practitioners from across the world who adapted their services to telehealth to share their experiences. Smita Awasthi will present a study that reports how Behavior Momentum India shifted their in-clinic services across their 10 clinics in India to in-home telehealth during the pandemic using smartphones. Guido D’Angelo will present a study conducted in Italy through their agency, Dalla Luna, in which telehealth supervision was provided to two therapists in conducting functional analysis and functional communication training. Kristín Guðmundsdóttir, from University of Akureyri, will present a study in which the authors developed and implemented a telehealth parent training protocol with 5 families in rural Iceland before the pandemic despite challenges such as low-speed internet access. Iris Heidsha Pons from Starbright Academy in Puerto Rico will share her experiences shifting to telehealth during the pandemic for a school and clinic that serves over 200 individuals. Presenters will share cultural variables they considered, barriers they faced, and will present recommendations for other professionals implementing behavior analysis through telehealth.
|Instruction Level: Intermediate|
|Target Audience: |
Board certified behavior analysts; licensed psychologists; graduate students.
|Learning Objectives: At the conclusion of the presentation, participants will be able to: (1) describe how smartphones can be used to teach skills typically taught in IBI programs for children with ASD; (2) describe the three models of tele-health service delivery; (3) discuss scaling up behavior analytic services beyond the horizon; (4) describe ethical challenges in transitioning services to telehealth; (5) idenitfy adaptation to therapists’s supervision via telehealth; (6) describe how to implement functional assessment and FCT via telehealth; (7)state critical components of an evidence-based telehealth behavioral caregiver training with families of young children with autism, using a low-speed internet connection; (8) state and discriminate between possible procedural, technological, ethical and cultural challenges during behavioral caregiver training; (9) state critical training components for higher and continuing education in behavioral caregiver consultation via telehealth in low-speed internet connection; (10) describe how telemedicine was used to work with children with ASD in Puerto Rico to deliver education-based ABA during the pandemic.|
Using the Ubiquitous Smartphone to Deliver Behavior Analytic Telehealth Services: An Indian Organizations Response During the Pandemic
|SMITA AWASTHI (Behavior Momentum India), Sridhar Aravamudhan (Behavior Momentum India), Anupama Jagdish (Behavior Momentum India (BMI)), Bhavana Joshi (Behavior Momentum India (BMI)), Papiya Mukherjee (Behavior Momentum India (BMI)), Rajeshwari Kalkivaya (Behavior Momentum India (BMI)), Razia Shahzad Ali (Behavior Momentum India (BMI)), Sonika Srivastava (Behavior Momentum India (BMI)), Sreemon Edasserykkudy (Behavior Momentum India (BMI))|
Telehealth services have been applied in the treatment of a variety of problems across geographies (Tsami et al., 2019). The COVID-19 pandemic provided such an opportunity to scale up the impact of behavior analysis for children with autism when in-clinic services stopped abruptly worldwide. This qualitative and quantitative case study details how Behavior Momentum India (BMI), an organisation with 10 clinics across India transitioned services from in clinic to telehealth using the ubiquitous smartphone. A cohort of 92 students diagnosed with autism participated in this study under a team of 51 therapists, 9 behavior supervisors, and a doctoral-level Board Certified Behavior Analyst. Smartphones were used by 78% students and 82% therapists for direct 1:1 and parent-mediated sessions with 82 students. With 10 students, behavior supervisors provided parent training to continue interventions during lockdown. The critical transition decisions, logistics, and ethical challenges were identified using qualitative methods. All students continued to acquire targeted skills, while 52% of the students acquired more skills in telehealth compared to in clinic as per curriculum modification. A social validity survey provided high ratings on our organization’s initiative, and 72% parents reported that their familiarity and confidence with the science of applied behavior analysis had increased.
|Dr. Smita Awasthi is a psychologist, behavioral scientist, and a BCBA-D. She completed her Master’s in Psychology in 1986, and earned her Ph.D. from Queen’s University Belfast, Ireland, in 2017. Dr. Awasthi started her career on a UNICEF project in community-based rehabilitation of people with special needs and has devoted 36 years of her professional career working across the lifespan with individuals and families affected by autism and other developmental disabilities.
Dr. Awasthi founded Behavior Momentum India in 2010 and pioneered 1:1 behavior analytic services in India. She currently serves as its Executive Director and CEO. Today BMI is the largest autism intervention center outside the United States. With eight intervention centers and a team of behavior analysts and 200+ para-professionals, the agency provides intensive behavior analytic treatment to 350 pediatric and adolescent populations with autism spectrum disorder from India and abroad.|
|Supervision of Therapists and Families via Telehealth: An Italian Experience|
|GUIDO D'ANGELO (DALLA LUNA - BARI)|
|Abstract: The dramatic effect of COVID-19 at the beginning of 2020 in Italy has forced the educational agencies to rapidly reorganize the provision of educational services, moving from an in vivo to a telehealth modality. Although in the international context there is wide evidence of the effectiveness of this approach, only a recent handful of studies have begun to research its application in the Italian context. This study investigates the effectiveness of telehealth therapists’ supervision in the context of two functional communication training (FCT) interventions for two children with autism spectrum disorder. Telehealth supervision was provided first to the therapists and then to the families of the children. The FCT was conducted following the functional analysis implemented by therapists, who had never received specific training on this procedure before. Subsequently, the family implemented an intervention through telehealth for the generalization of the previously taught skills within the home context.
In this presentation we present the findings of both our initial and subsequent analyses, and eventually discuss their implications.|
|Guido D'Angelo is an internationally certified behavior analyst since 2016. He has been working for over 17 years with children and teens with autism and their families. He has been invited as a speaker at 17 national and international conferences on the topics of autism and psychology. He has published 13 books and scientific articles in the psychological field, on autism and other developmental disorders.|
Rural Behavioral Consultation in Iceland Pre-COVID-19 Pandemic: Effects of Caregiver Training Via Telehealth on Child and Family Progress and Considerations for Training and Professional Practice
|KRISTÍN GUDMUNDSDOTTIR (University of Akureyri)|
This paper presents the development and experimental evaluation of telehealth methods in behavioral caregiver training in rural Iceland pre COVID-19 pandemic. Lessons learned from the study will be described and considerations for professional training and practice in behavioral telehealth for families of children with autism will be discussed. The study was conducted with Icelandic families of preschool-aged children with autism that did not have access to evidence-based services. The experimental design was a multiple baseline across parent and child skills, replicated across 5 families. Both quantitative and qualitative data were collected for experimental and social validity purposes. Caregivers were taught to apply the TeachingDANCE (Ala‘i-Rosales, Cermak og Guðmundsdóttir, 2013) during play interaction with their children in order to teach their children social communication skills and enhance the quality of the relationship between the parent and child. The majority of the training was conducted through telecommunication methods. The results showed measurable progress for parents and children across all skill areas. Furthermore, the caregivers valued the increased access to evidence-based intervention and expertise, despite various challenges during the intervention. The results indicated that training via telecommunication is a viable approach for rural families with low-speed internet connection. Critical training components for higher and continuing education will be highlighted and recommendations for professional training and practice will be discussed in the context of the research as well as the lessons learned. These recommendations include considerations regarding technical skills, effective training procedures, ethical and cultural considerations, and challenges when conducting data-based behavioral consultation via telecommunication.
Kristín Guðmundsdóttir is an Assistant Professor in Psychology at the University of Akureyri, Iceland. Kristín holds a Doctoral degree in psychology from the University of Iceland and a Master of Science degree in behavior analysis from the University of North Texas. She is also a Board Certified Behavior Analyst (BCBA) since 2003. Kristín has served as the President of Icelandic ABA and has been an active participant in the shaping of behavior analysis in Iceland. Kristín has worked as a therapist and case manager in early behavior intervention for young children with autism and other developmental disabilities in Iceland and the US. She also has extensive experience teaching and consulting with children and caregivers in the Icelandic school system, specifically in rural parts of Iceland. Kristín’s current research focus includes behavior intervention for families of young children with autism and other developmental disabilities via telehealth. Specific emphasis is on caregiver training for rural families that have limited access to evidence-based services.
Telemedicine in Puerto Rico: A New Challenge During the Pandemic to Deliver Clinical and Educational Applied Behavior Analysis to Individuals With Autism Spectrum Disorders
|IRIS HEIDSHA PONS (Starbright Academy)|
The COVID-19 pandemic has had an impact on the education, family, and social aspects of people with autism spectrum disorders (ASD) in Puerto Rico. Starbright Academy serves 116 individuals from the ages of 2-21 years in our school program and 101 individuals with ASD and other related disorders in our clinical program (MO Therapy). The pandemic challenged us to transfer our educational and clinical system from face-to-face to a virtual one. Within 5 weeks of the initial “shut down” in 2020, Starbright had converted all of our in-person services to telehealth. We conducted academic and clinical programs through telemedicine for 76 children for 10 months. In this discussion I will share the lessons learned during this transition. Specifically, I will discuss how telemedicine has had a positive impact in educating all family members in ABA techniques, the significant improvements we have seen in the well-being of the family threw the application of telehealth in these homes, the development of independence skills and the generalization of other skills learned at school into the home setting. I will also share the obstacles that we faced in Puerto Rico for receiving ABA services, other challenges encountered during this transition to telehealth and provide recommendations for future providers.