Association for Behavior Analysis International

Behavior analytic interventions delivered via telehealth have undergone a number of experimental evaluations with evidence supporting the use of telehealth to reduce problem behavior and increase functional communication. This symposium presents the results of four studies, conducted across three different research labs, evaluating innovations in the assessment and treatment of problem behavior via telehealth with a focus on parent-implemented assessments and interventions. The symposium will begin with a brief literature review focused on the evidence supporting functional assessment and function-based treatment delivered via telehealth (Talk 1). Researchers will then present advances in assessment including results from a brief functional analysis delivered via telehealth (Talk 2) and telehealth-mediated functional communication training conducted internationally with families in Asia (Talk 3). Author(s) also demonstrate the generalizability of functional communication training beyond training contexts (Talk 4). Finally, as a leader in this area of behavior analysis, Dr. Jennifer McComas, will discuss the studies, findings, and implications for research and practice.

As the world continues to navigate the COVID-19 health crisis, behavior analysts are considering how best to support families while maintaining services and ensuring the health and safety of everyone involved. Telehealth is one service delivery option that provides families with access to care in their own communities and homes. This presentation will review the findings of Schieltz and Wacker (2020) by providing a brief review of the behavior analytic telehealth literature in applied behavior analysis that provided coaching and training to families for individuals who displayed challenging behavior. These studies targeted functional assessment and function-based treatment for challenging behavior. Specifically, we will briefly summarize what is known relative to the assessment and treatment of challenging behavior via telehealth, place these results within a descriptive context of the decisions made by our research team, and discuss what we, as behavior analysts, should consider next to advance our understanding and practice of telehealth.

Interventions combining functional analysis (FA) and functional communication training (FCT) are effective in mitigating socially maintained problem behaviors. Recent studies evaluating the effectiveness of using telehealth to train caregivers across large geographical distances in the United States (Wacker et al., 2016) and internationally (Tsami & Lerman, 2019) indicate that this modality can increase families’ accessibility to evidence-based interventions for problem behavior, such as FCT. Additionally, the telehealth model reduces service costs while maintaining caregiver procedural integrity (Ferguson et al., 2018). Providing these services to international families might decrease barriers to effective treatment and promote parental well- being (e.g., reduce stress and depression; Frantz et al., 2018). In this study, practitioners and interpreters in the United States remotely coached six caregivers of children with autism residing in two countries in Asia (i.e., Pakistan and Vietnam) to implement FA and FCT. All children reached the 90% reduction of problem behavior criterion and acquired the communicative response. Additionally, all caregivers indicated that the procedures were acceptable. The impact of training on levels of parenting stress, psychological distress, and self- efficacy also will be discussed. Overall, our findings suggest telehealth is a feasible modality for service delivery in Asia.

Functional communication training (FCT) is a well-established treatment for problem behavior in young children with autism (National Autism Center, 2015; Wong et al., 2014). Parent-mediated FCT delivered in the home, but facilitated by therapists through telehealth is an effective approach that extends the treatment model into a natural context (Lindgren et al., 2016). Despite an extensive literature base supporting FCT, little is known about the generalized effects of FCT outside of the training context. In this study, generalization of treatment effects were evaluated as part of a large multi-site study on parent-delivered FCT for children with autism using telehealth. To meet this purpose, data were collected from pre- and post-treatment parent ratings of targeted and non-targeted problem behavior in settings and contexts outside of the training conditions. Results suggest that the effects of FCT may extend beyond the behaviors and contexts targeted for treatment. Possible reasons for successful generalization, implications for practice, and suggestions for future research will be discussed.