Association for Behavior Analysis International

This symposium features four presentations that investigate the efficacy and social validity of parent-implemented interventions for children with intellectual and developmental disabilities (IDD) via telehealth. The first presentation highlights a telehealth caregiver coaching program for families of children with autism spectrum disorder (ASD), demonstrating high caregiver treatment fidelity and significant improvements in child skill acquisition through interventions like functional communication training and naturalistic teaching. The second presentation examines a culturally adapted Prevent, Teach, and Reinforce for Families (PTR-F) program for Chinese American families of young autistic children, revealing mixed results, yet high acceptability and feasibility as reported by parents. The third presentation focuses on functional behavioral assessments (FBA) and function-based treatments delivered via telehealth to address sleep problems in children with ASD, showing that parent-implemented strategies such as extinction and visual schedules enhanced sleep behaviors. The fourth presentation explores the experiences and preferences of individuals with IDD who participated in caregiver-implemented interventions targeting daily living skills, emphasizing the importance of participant preferences in selecting effective strategies. Together, these studies underscore the promise and flexibility of telehealth-based, parent-implemented interventions across diverse populations.

Although interventions based on applied behavior analysis (ABA) are effective in addressing underdeveloped skills in children with autism spectrum disorder (ASD), many families may not have access to in-person ABA services. Telehealth may be a way of addressing this need; therefore, this study sought to evaluate the efficacy of a telehealth caregiver coaching program delivered to caregivers of children with ASD. Thirty children with ASD participated in this study. This study involved 1-2 synchronous meetings per week with the child’s primary caregiver and the child, via telehealth, and was delivered in the caregiver’s primary language (i.e., either English or Spanish). Caregiver coaches were masters or doctoral students completing ABA coursework. Interventions were personalized based on an assessment of the child and the family’s needs and preferences. Evidence-based practices used to target skill deficits included functional communication training, discrete trial training, total-task chaining, and naturalistic teaching. Data were collected on caregiver treatment fidelity and child outcomes. On average, the caregiver’s treatment fidelity was 95%. For 85% of the goals addressed, single-case effect sizes calculated based on baseline and intervention data resulted in medium, large, or very large improvements. Recommendations for providing telehealth ABA services will also be discussed.

Children with autism spectrum disorder suffer more sleep problems than their typically developing peers as well as children with different development disabilities. Functional behavioral assessments (FBA) can be used to identify and treat problem behavior that interferes with sleep. A multiple baseline design across participants was used to evaluate a FBA and corresponding function-based treatment delivered via telehealth. Three children with ASD and their families were treated using these procedures. Sleep problems and corresponding problem behavior were assessed using the Sleep Assessment and Treatment Tool, a parent completed sleep diary, and the use of an actigraphy monitor. Parents were trained by a caregiver coach to deliver the treatment. The caregiver coach then provided synchronous coaching during the participant’s typical bedtime routine. Treatment procedures varied across families but included extinction, visual schedules, and stimulus fading. Participants engaged in less sleep interfering problem behavior, fell asleep faster, and spent more minutes asleep.

Chinese American families of autistic children are absent in the intervention literature. The current study examined the efficacy and social validity of a culturally adapted and telepractice version of the Prevent, Teach, and Reinforce for Families (PTR-F) for Chinese American families of young autistic children in the United States. PTR-F is a manualized and evidence-based positive behavior support program, including parent education and training to assist families in resolving their children’s mild to moderate severity challenging behavior in home and community settings. The intervention was culturally adapted using Bernal’s Ecological Validity Model and delivered via telepractice. Six mothers and their children with autism spectrum disorder (ASD) participated. Two independent randomized concurrent multiple baseline designs across six parent-child dyads were used to examine the effects of the culturally adapted PTR-F intervention program when delivered by mothers on the decreased rate of target child challenging behavior. Visual analysis combined with Tau-U and standardized mean difference analysis revealed mixed results. Parent perceptions of the acceptability, feasibility and effectiveness of the culturally adapted PTR-F intervention program’s goals, procedures, and outcomes were collected using standardized social validity questionnaires with the addition of open-ended responses and reported using descriptive statistics and parent responses to open-ended questions.