Abstract
This single-case investigation was designed to evaluate the effects of telehealth training on practitioner implementation of a naturalistic developmental behavioral intervention (NDBI). Six general education preschool practitioners engaged in an intervention with six children with varying disabilities in inclusive classroom settings. The telehealth training package included a collaborative approach to intervention planning, online training module, video self-evaluation, and performance feedback via videoconferencing. Following telehealth training, practitioners reached criteria for implementation fidelity and increased communication opportunities. Additionally, child participants increased communication behaviors above baseline levels. All behaviors generalized to a different activity context and maintained over time. Social validity was measured and results suggest high levels of acceptability for the telehealth training package.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Change history
01 February 2021
The original version of the article has incorrect labels for Figs. 1 and 2.
References
Amsbary, J., & AFIRM Team. (2017). Naturalistic intervention. Chapel Hill, NC: National Professional Development Center on Autism Spectrum Disorder, FPG Child Development Center, University of North Carolina. Retrieved September 4, 2018 from http://afirm.fpg.unc.edu/Naturalistic-intervention.
Barton, E., & Smith, B. (2015). Advancing high quality preschool inclusion: A discussion and recommendations for the field. Topics in Early Childhood Special Education, 35, 69–78. https://doi.org/10.1177/0271121415583048.
Barton, E. E., Lloyd, B. P., Spriggs, A. D., & Gast, D. L. (2018). Visual analysis of graphic data. In Single case research methodology (pp. 179–214). Routledge.
Brock, M., & Carter, E. (2017). A meta-analysis of educator training to improve implementation of interventions for students with disabilities. Remedial and Special Education, 38, 131–144. https://doi.org/10.1177/0741932516653477.
Bruns, D. A., & Mogharreban, C. C. (2008). Working with young children with disabilities: Perceptions, skills, and training needs of Head Start teachers. NHSA DIALOG, 11, 54–66. https://doi.org/10.1080/15240750701831958.
Bzoch, K. R., League, R., & Brown, V. L. (2003). Receptive-expressive emergent language test third edition (REEL-3). St. Antonio: Pearson.
Carter, S. (2010). The social validity manual: A guide to subjective evaluation of behavioral interventions. Boston, MA: Academic Press.
Douglas, S., McNaughton, D., & Light, J. (2013). Online training for paraeducators to support the communication of young children. Journal of Early Intervention, 35, 223–242. https://doi.org/10.1177/1053815114526782.
Dunst, C. J., & Bruder, M. B. (2014). Preservice professional preparation and teachers’ self-efficacy appraisals of natural environment and inclusion practices. Teacher Education and Special Education, 37, 121–132.
Dunst, C. J., & Trivette, C. M. (2009). Using research evidence to inform and evaluate early childhood intervention practices. Topics in Early Childhood Special Education, 29, 40–52. https://doi.org/10.1177/0271121408329227.
Ferguson, J., Craig, E., & Dounavi, K. (2018). Telehealth as a model for providing behaviour analytic interventions to individuals with autism spectrum disorder: A systematic review. Journal of Autism and Developmental Disorders, 49, 1–35. https://doi.org/10.1007/s10803-018-3724-5.
Fischer, A. J., Dart, E. H., Radley, K. C., Richardson, D., Clark, R., & Wimberly, J. (2016). An evaluation of the effectiveness and acceptability of teleconsultation. Journal of Educational and Psychological Consultation, 27, 1–22. https://doi.org/10.1080/10474412.2016.1235978.
Gebbie, D., Ceglowski, D., Taylor, L., & Miels, J. (2012). The role of teacher efficacy in strengthening classroom support for preschool children with disabilities who exhibit challenging behaviors. Early Childhood Education Journal, 40, 35–46. https://doi.org/10.1007/s10643-011-0486-5.
Gibson, J. L., Pennington, R. C., Stenhoff, D. M., & Hopper, J. S. (2010). Using desktop videoconferencing to deliver interventions to a preschool student with autism. Topics in Early Childhood Special Education, 29, 214–225.
Goldstein, S., & Naglieri, J. A. (2013). Autism spectrum rating scales: ASRS. North Tonawanda (NY): MHS.
Hay-Hansson, A. W., & Eldevik, S. (2013). Training discrete trials teaching skills using videoconference. Research in Autism Spectrum Disorders, 7(11), 1300–1309.
Hieneman, M., Dunlap, G., & Kincaid, D. (2005). Positive support strategies for students with behavioral disorders in general education settings. Psychology in the Schools, 42, 779–794. https://doi.org/10.1002/pits.20112.
Ingersoll, B., & Berger, N. (2015). Parent engagement with a telehealth-based parent-mediated intervention program for children with autism spectrum disorders: Predictors of program use and parent outcomes. Journal of Medical Internet Research, 17, 227–245. https://doi.org/10.2196/jmir.4913.
Kennedy, C. (2002). The maintenance of behavior change as an indicator of social validity. Behavior Modification, 26, 594–604. https://doi.org/10.1177/014544502236652.
Koegel, R. L., & Koegel, L. K. (2006). Pivotal response treatments for autism: Communication, social & academic development. Baltimore, MD: Paul H Brookes Publishing.
Ledford, J. R., & Gast, D. L. (2018). Single case research methodology: Applications in special education and behavioral sciences. New York: Routledge.
Lindgren, S., Wacker, D., Suess, A., Schieltz, K., Pelzel, K., Kopelman, T., et al. (2016). Telehealth and autism: Treating challenging behavior at lower cost. Pediatrics, 137, S167–S175. https://doi.org/10.1542/peds.2015-28510.
Martens, B., Witt, J., Elliott, S., & Darveaux, D. (1985). Teacher judgments concerning the acceptability of school-based interventions. Professional Psychology: Research and Practice, 16, 191. https://doi.org/10.1037/0735-7028.16.2.191.
Muccio, L. S., Kidd, J. K., White, C. S., & Burns, M. S. (2014). Head start instructional professionals’ inclusion perceptions and practices. Topics in Early Childhood Special Education, 34, 40–48. https://doi.org/10.1177/0271121413502398.
Neely, L., Rispoli, M., Boles, M., Morin, K., Gregori, E., Ninci, J., et al. (2018). Interventionist acquisition of incidental teaching using pyramidal training via telehealth. Behavior Modification. https://doi.org/10.1177/0145445518781770.
Neely, L., Rispoli, M., Gerow, S., & Hong, E. (2016). Preparing interventionists via telepractice in incidental teaching for children with autism. Journal of Behavioral Education, 25, 393–416. https://doi.org/10.1007/s10864-016-9250-7.
Neely, L., Rispoli, M., Gerow, S., Hong, E., & Hagan-Burke, S. (2017). Fidelity outcomes for autism-focused interventionists coached via telepractice: A systematic literature review. Journal of Developmental and Physical Disabilities, 29, 849–874. https://doi.org/10.1007/s10882-017-9550-4.
Nickelson, D. W. (1998). Telehealth and the evolving health care system: Strategic opportunities for professional psychology. Professional Psychology: Research and Practice, 29, 527–535. https://doi.org/10.1037/0735-7028.29.6.527.
Odom, S. L., & Bailey, D. (2001). Inclusive preschool programs: Classroom ecology and child outcomes. In M. J. Guralnick (Ed.), Early childhood inclusion: Focus on change (pp. 253–276). Baltimore: Brookes.
Odom, S., Buysse, V., & Soukakou, E. (2011). Inclusion for young children with disabilities: A quarter century of research perspectives. Journal of Early Intervention, 33, 344–356. https://doi.org/10.1177/1053815111430094.
Odom, S., Cox, A., Brock, M., & National Professional Development Center on ASD. (2013). Implementation science, professional development, and autism spectrum disorders. Exceptional Children, 79, 233–251. https://doi.org/10.1177/001440291307900207.
Pantermuehl, R. M., & Lechago, S. A. (2015). A comparison of feedback provided in vivo versus an online platform on the treatment integrity of staff working with children with autism. Behavior Analysis in Practice, 8, 219–222.
Reichow, B. (2011). Development, procedures, and application of the evaluative method for determining evidence-based practices in autism. In B. Reichow, P. Doehring, D. V. Cicchetti, & F. R. Volkmar (Eds.), Evidence-based practices and treatments for children with autism (pp. 25–39). New York: Springer.
Reichow, B., Volkmar, F. R., & Cicchetti, D. V. (2008). Development of the evaluative method for evaluating and determining evidence-based practices in autism. Journal of Autism and Developmental Disorders, 38, 1311–1319. https://doi.org/10.1007/s10803-007-0517-7.
Rispoli, M., Neely, L., Lang, R., & Ganz, J. (2011). Training paraprofessional to implement interventions for people with autism spectrum disorder: A systematic review. Developmental Neurorehabilitation, 14, 378–388. https://doi.org/10.3109/17518423.2011.620577.
Schreibman, L., Dawson, G., Stahmer, A. C., Landa, R., Rogers, S., McGee, G., et al. (2015). Naturalistic developmental behavioral interventions: Empirically validated treatments for autism spectrum disorder. Journal of Autism and Developmental Disorders, 45, 2411–2428. https://doi.org/10.1007/s10803-015-2407-8.
Secord, W., & Donohue, J. S. (2014). CAAP-2: Clinical assessment of articulation and phonology-2. Greenville: Super Duper Publications.
Shonkoff, J. P., & Phillips, D. A. (2000). From neurons to neighbourhoods. The science of early childhood development. Washington DC: Academic Press.
Suhrheinrich, J., Chan, J., Melgarejo, M., Reith, S., Stahmer, A., & AFIRM Team. (2018). Pivotal response training. Chapel Hill, NC: National Professional Development Center on Autism Spectrum Disorder, FPG Child Development Center, University of North Carolina. Retrieved September 4, 2018 from http://afirm.fpg.unc.edu/Pivotal-response-training.
Taylor, B. A., LeBlanc, L. A., & Nosik, M. R. (2018). Compassionate care in behavior analytic treatment: Can outcomes be enhanced by attending to relationships with caregivers? Behavior Analysis in Practice, 12(3), 654–666. https://doi.org/10.1007/s40617-018-00289-3.
Tomlinson, S. R., Gore, N., & McGill, P. (2018). Training individuals to implement applied behavior analytic procedures via telehealth: A systematic review of the literature. Journal of Behavioral Education, 27, 172–222. https://doi.org/10.1007/s10864-018-9292-0.
U.S. Department of Education. (2018). Annual report to congress on the implementation of the Individuals with Disabilities Act. Washington, DC: U.S. Department of Education.
VandenBos, G. R., & Williams, S. (2000). The Internet versus the telephone: What is telehealth anyway? Professional Psychology: Research and Practice, 31(5), 490–492.
Vismara, L., Young, G., Stahmer, A., Griffith, E., & Rogers, S. (2009). Dissemination of evidence-based practice: Can we train therapists from a distance? Journal of Autism and Developmental Disorders, 39, 1636–1651. https://doi.org/10.1007/s10803-009-0796-2.
Wacker, D. P., Lee, J. F., Dalmau, Y. C. P., Kopelman, T. G., Lindgren, S. D., Kuhle, J., et al. (2013). Conducting functional analyses of problem behavior via telehealth. Journal of Applied Behavior Analysis, 46, 31–46.
Wainer, A., & Ingersoll, B. (2013). Disseminating ASD interventions: A pilot study of a distance learning program for parents and professionals. Journal of Autism and Developmental Disorders, 43, 11–24. https://doi.org/10.1007/s10803-012-1538-4.
Wainer, A. L., & Ingersoll, B. (2015). Increasing access to an ASD imitation intervention via a telehealth parent training program. Journal of Autism and Developmental Disorders, 45, 3877–3890. https://doi.org/10.1007/s10803-014-2186-7.
Wainer, A., Pickard, K., & Ingersoll, B. (2017). Using web-based instruction, brief workshops, and remote consultation to teach community-based providers a parent-mediated intervention. Journal of Child and Family Studies, 26, 1592–1602. https://doi.org/10.1007/s10826-017-0671-2.
Walls, S. (2007). Early childhood preservice training and perceived teacher efficacy beliefs concerning the inclusion of young children with disabilities. Doctoral dissertation.
Wolf, M. (1978). Social validity: The case for subjective measurement or how applied behavior analysis is finding its heart. Journal of Applied Behavior Analysis, 11, 203–214.
Wong, C., Odom, S., Hume, K., Cox, A., Fettig, A., Kucharczyk, S., et al. (2015). Evidence-based practices for children, youth, and young adults with autism spectrum disorder: A comprehensive review. Journal of Autism and Developmental Disorders, 45, 1951–1966. https://doi.org/10.1080/10459881003785506.
Zimmerman, I. L., Steiner, V. G., & Pond, R. E. (2012). Preschool language scale (5th ed.). San Antonio, TX: Harcourt Assessment.
Acknowledgments
The authors would like to acknowledge that this manuscript was prepared from the first author’s doctoral dissertation. Research enhancement funds from Michigan State University partially supported technology purchases for this dissertation research. The authors would also like to thank the participants and education professionals for their collaboration and support of this study.
Author Contributions
SRD conceived of the study, participated in the design and coordination, conducted all intervention sessions, analyzed and interpreted data, and drafted and revised the entire manuscript. SND participated in the design, assisted in data analyzation, and helped to draft and revise the manuscript. EH was the secondary coder of data and helped draft and revise the manuscript. All authors read and approved of the final manuscript.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflicts of interest.
Ethical Approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the Michigan State University institutional research committee (STUDY00000919) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed Consent
Informed consent was obtained for all individual participants included in this study.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
D’Agostino, S., Douglas, S.N. & Horton, E. Inclusive Preschool Practitioners’ Implementation of Naturalistic Developmental Behavioral Intervention Using Telehealth Training. J Autism Dev Disord 50, 864–880 (2020). https://doi.org/10.1007/s10803-019-04319-z
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10803-019-04319-z