Abstract
In this chapter, we provide a description of a behavioral assessment (functional analysis) and treatment (functional communication training) program that we deliver to parents of young children with autism spectrum disorder in their homes via telehealth. We first describe the development of this assessment and treatment model that was initiated in the homes of young children with developmental disabilities who engaged in severe behavior problems such as self-injury, aggression and property destruction. Parents conducted all sessions with coaching from trained behavior analysts, and most achieved clinically significant reductions in the problem behaviors displayed by their children. We next conducted these same procedures, but did so using clinic-to-clinic telehealth. Instead of behavior analysts travelling to parents’ homes, the parents instead travelled to local pediatric specialty clinics that were connected to our university hospital via an optic cable system. Similar results in reductions in problem behavior were achieved even though the behavior analysts were never in physical contact with the children or parents. Our current project is conducting the same procedures via telehealth but now directly in the homes of the parents and children. Thus far, we are achieving similar results, and again without having physical contact with the families or children. We provide case examples and descriptions of the procedures.
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American Telemedicine Association. (2013). Practice guidelines for video-based online mental health services. Washington, DC: ATA.
American Telemedicine Association. (2015). What is telemedicine? Retrieved from www.americantelemed.org/
Asmus, J. M., Ringdahl, J. E., Sellers, J. A., Call, N. A., Andelman, M. S., & Wacker, D. P. (2004). Use of a short-term inpatient model to evaluate aberrant behavior: Outcome data summaries from 1996 to 2001. Journal of Applied Behavior Analysis, 37, 283–304.
Barretto, A., Wacker, D. P., Harding, J., Lee, J., & Berg, W. K. (2006). Using telemedicine to conduct behavioral assessments. Journal of Applied Behavior Analysis, 39, 333–340.
Berg, W., Wacker, D., Harding, J., Ganzer, J., & Barretto, A. (2007). An evaluation of multiple dependent variables across distinct classes of antecedent stimuli pre and post functional communication training. Journal of Early and Intensive Behavioral Intervention, 3(4)–4(1), 305–333.
Carr, E. G., & Durand, V. M. (1985). Reducing behavior problems through functional communication training. Journal of Applied Behavior Analysis, 18, 111–126.
Ciccia, A. H., Whitford, B., Krumm, M., & McNeal, K. (2011). Improving the access of young urban children to speech, language and hearing screening via telehealth. Journal of Telemedicine and Telecare, 17, 240–244.
Dailey, J. I., & Stanfa-Brew, M. R. (2014). Telebehavioral health in Afghanistan. Military Medicine, 179, 708–710.
DelliFraine, J. L., & Dansky, K. H. (2008). Home-based telehealth: A review and meta-analysis. Journal of Telemedicine and Telecare, 14, 62–66.
Feibel, C. (2015, April). Doctors make house calls on tablets carried by Houston firefighters. NPR. Retrieved from http://www.npr.org/blogs/health/2015/04/09/396583624/doctors-make-house-calls-on-tablets-carried-by-houston-firefighters
Fisher, W. W., Luczynski, K. C., Hood, S. A., Lesser, A. D., Machado, M. A., & Piazza, C. C. (2014). Preliminary findings of a randomized clinical trial of a virtual training program for applied behavior analysis technicians. Research in Autism Spectrum Disorders, 8, 1044–1054.
Freeman, L. W., White, R., Ratcliff, C. G., Sutton, S., Stewart, M., Palmer, J. L., … Cohen, L. (2015). A randomized trial comparing live and telemedicine deliveries of an imagery-based behavioral intervention for breast cancer survivors: Reducing symptoms and barriers to care. Psycho-Oncology. 24, 910. doi: 10.1002/pon.3656
Frieder, J. E., Peterson, S. M., Woodward, J., Crane, J., & Garner, M. (2009). Teleconsultation in school settings: Linking classroom teachers and behavior analysts through web-based technology. Behavior Analysis in Practice, 2(2), 32–39.
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.
Harding, J. W., Wacker, D. P., Berg, W. K., Lee, J. F., & Dolezal, D. (2009). Conducting functional communication training in home settings: A case study and recommendations for practitioners. Behavior Analysis in Practice, 2, 21–33.
Hay-Hansson, A. W., & Eldevik, S. (2013). Training discrete trials teaching skills using videoconference. Research in Autism Spectrum Disorders, 7, 1300–1309.
Heitzman-Powell, L. S., Buzhardt, J., Rusinko, L. C., & Miller, T. M. (2014). Formative evaluation of an ABA outreach training program for parents of children with autism in remote areas. Focus on Autism and Other Developmental Disabilities, 29, 23–38.
IOM (Institute of Medicine). (2012). The role of telehealth in an evolving health care environment: Workshop summary. Washington, DC: National Academy Press.
Iwata, B. A., Dorsey, M. F., Slifer, K. J., Bauman, K. E., & Richman, G. S. (1994). Toward a functional analysis of self-injury. Journal of Applied Behavior Analysis, 27, 197–209 (Reprinted from Analysis and Intervention in Developmental Disabilities, 2, 3–20, 1982).
Kienzle, M. (2000, March). Rural-academic integration: Iowa’s national laboratory for the study of rural telemedicine. Retrieved from http://collab.nlm.nih.gov/tutorialspublicationsandmaterials/telesymposiumcd/UIowaFinalReport.pdf
Lee, J. F., Schieltz, K. M., Suess, A. N., Wacker, D. P., Romani, P. W., Lindgren, S. D., … Padilla Dalmau, Y. C. (2015). Guidelines for developing telehealth services and troubleshooting problems with telehealth technology when coaching parents to conduct functional analyses and functional communication training in their homes. Behavior Analysis in Practice, 8, 190. doi: 10.1007/s40617-014-0031-2
Lindgren, S. D., & Wacker, D. P. (2009). Behavioral treatment for autism in community settings using a telehealth network. Washington, DC: Department of Health and Human Services, National Institute of Mental Health.
Lindgren, S. D., & Wacker, D. P. (2011). Behavioral treatment through in-home telehealth for young children with autism. Washington, DC: Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau.
Maa, A. Y., Evans, C., DeLaune, W. R., Patel, P. S., & Lynch, M. G. (2014). A novel tele-eye protocol for ocular disease detection and access to eye care services. Telemedicine and e-Health, 20, 318–323.
Machalicek, W., O’Reilly, M., Chan, J. M., Lang, R., Rispoli, M., Davis, T., … Didden, R. (2009). Using videoconferencing to conduct functional analysis of challenging behavior and develop classroom behavioral support plans for students with autism. Education and Training in Developmental Disabilities, 44, 207–217.
Machalicek, W., O’Reilly, M., Chan, J. M., Rispoli, M., Lang, R., Davis, T., … Langthorne, P. (2009). Using videoconferencing to support teachers to conduct preference assessments with students with autism and developmental disabilities. Research in Autism Spectrum Disorders, 3, 32–41.
Machalicek, W., O’Reilly, M. F., Rispoli, M., Davis, T., Lang, R., Hetlinger Franco, J., & Chan, J. M. (2010). Training teachers to assess the challenging behaviors of students with autism using video tele-conferencing. Education and Training in Autism and Developmental Disabilities, 45, 203–215.
Northup, J., Wacker, D., Sasso, G., Steege, M., Cigrand, K., Cook, J., & DeRaad, A. (1991). A brief functional analysis of aggressive and alternative behavior in an outclinic setting. Journal of Applied Behavior Analysis, 24, 509–522.
Novak, M. (2012, March). Telemedicine predicted in 1925: With video screens and remote control arms, any doctor could make a virtual housecall. Smithsonian.com. Retrieved from http://www.smithsonianmag.com/history/telemedicine-predicted-in-1925-124140942/
Reese, R. J., Slone, N. C., Soares, N., & Sprang, R. (2012). Telehealth for underserved families: An evidence-based parenting program. Psychological Services, 9, 320–322.
Reimers, T., Wacker, D., Cooper, L., & DeRaad, A. (1992). Clinical evaluation of the variables associated with treatment acceptability and their relation to compliance. Behavioral Disorders, 18, 67–76.
Reynolds, C. A., & Maughan, E. D. (2015). Telehealth in the school setting: An integrative review. The Journal of School Nursing, 31, 44–53.
Roane, H. S., Vollmer, T. R., Ringdahl, J. E., & Marcus, B. A. (1998). Evaluation of a brief stimulus preference assessment. Journal of Applied Behavior Analysis, 31, 605–620.
Southard, E. P., Neufeld, J. D., & Laws, S. (2014). Telemental health evaluations enhance access and efficiency in a critical access hospital emergency department. Telemedicine and e-Health, 20, 664–668.
Suess, A. N., Kopelman, T. G., Wacker, D. P., Lindgren, S. D., Lee, J. F., Romani, P. W., & Schieltz, K. M. (2014). Orienting caregivers to conduct in-home functional analyses via telehealth. Association of Professional Behavior Analysts Reporter, 50.
Suess, A. N., Romani, P. W., Wacker, D. P., Dyson, S. M., Kuhle, J. L., Lee, J. F., … Waldron, D. B. (2014). Evaluating the treatment fidelity of parents who conduct in-home functional communication training with coaching via telehealth. Journal of Behavioral Education, 23, 34–59.
Turner, K. M., Dadds, C. M., & Sanders, M. R. (2002). Facilitator’s manual for Group Triple P. Brisbane, QLD: Australian Academic Press.
Wacker, D. P. (2013, May). Transferring effective practices to the community: Functional analysis as an example. Invited presentation at the 39th annual Association for Behavior Analysis International Convention, Minneapolis, MN.
Wacker, D. P., & Berg, W. K. (1992). Inducing reciprocal parent/child interactions. Washington, DC: Department of Health and Human Services, National Institute of Child Health and Human Development.
Wacker, D. P., Berg, W. K., Harding, J. W., Derby, K. M., Asmus, J. M., & Healy, A. (1998). Evaluation and long-term treatment of aberrant behavior displayed by young children with disabilities. Journal of Developmental and Behavioral Pediatrics, 19, 260–266.
Wacker, D. P., Berg, W. K., & Harding, J. W. (1996). Promoting stimulus generalization with young children. Washington, DC: Department of Health and Human Services, National Institute of Child Health and Human Development.
Wacker, D. P., Berg, W. K., & Harding, J. W. (2000). Functional communication training augmented with choices. Washington, DC: Department of Health and Human Services, National Institute of Child Health and Human Development.
Wacker, D. P., Harding, J. W., Berg, W. K., Lee, J. F., Schieltz, K. M., Padilla, Y. C., … Shahan, T. A. (2011). An evaluation of persistence of treatment effects during long-term treatment of destructive behavior. Journal of the Experimental Analysis of Behavior, 96, 261–282.
Wacker, D. P., Lee, J. F., Padilla Dalmau, Y. C., Kopelman, T. G., Lindgren, S. D., Kuhle, J., … Waldron, D. B. (2013a). Conducting functional communication training via telehealth to reduce the problem behavior of young children with autism. Journal of Developmental and Physical Disabilities, 25, 35–48.
Wacker, D. P., Lee, J. F., Padilla Dalmau, Y. C., Kopelman, T. G., Lindgren, S. D., Kuhle, J., … Waldron, D. B. (2013b). Conducting functional analyses of problem behavior via telehealth. Journal of Applied Behavior Analysis, 46, 31–46.
Wade, S. L., Oberjohn, K., Conaway, K., Osinska, P., & Bangert, L. (2011). Live coaching of parenting skills using the internet: Implications for clinical practice. Professional Psychology: Research and Practice, 42, 487–493.
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Wacker, D.P. et al. (2016). Telehealth. In: Singh, N. (eds) Handbook of Evidence-Based Practices in Intellectual and Developmental Disabilities. Evidence-Based Practices in Behavioral Health. Springer, Cham. https://doi.org/10.1007/978-3-319-26583-4_22
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