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Becraft JL, Hardesty SL, Goldman KJ, Shawler LA, Edelstein ML, Orchowitz P. Caregiver involvement in applied behavior-analytic research: A scoping review and discussion. J Appl Behav Anal 2024; 57:55-70. [PMID: 37937407 DOI: 10.1002/jaba.1035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 10/20/2023] [Indexed: 11/09/2023]
Abstract
We conducted a scoping review to characterize the role of caregiver involvement in behavior-analytic research. We reviewed eight behavioral-learning journals from 2011-2022 for works that included children or caregivers as participants and characterized caregiver involvement as passive (implications for caregivers, input, social validity) and active (implementation, caregiver behavior, training, caregiver-collected data). The review identified 228 studies, and almost all (96.1%; n = 219) involved caregivers in some capacity; 94.3% (n = 215) had passive involvement (26.8% had only passive involvement; n = 61), 69.3% (n = 158) had active involvement (1.8% had only active involvement; n = 4), and 3.9% (n = 9) had neither passive nor active involvement. Involvement generally increased over publication years. The most common types of involvement were implications for caregivers, implementation, and input; caregiver-collected data were rare. We propose considerations when engaging caregivers in research and suggest new avenues of inquiry related to caregivers' treatment objectives and social validity, treatment implementers, and caregiver-collected data.
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Affiliation(s)
- Jessica L Becraft
- Department of Behavioral Psychology, Kennedy Krieger Institute, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Samantha L Hardesty
- Department of Behavioral Psychology, Kennedy Krieger Institute, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kissel J Goldman
- Department of Behavioral Psychology, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Lesley A Shawler
- School of Psychological and Behavioral Sciences, Southern Illinois University, Carbondale, IL, USA
| | - Matthew L Edelstein
- Department of Behavioral Psychology, Kennedy Krieger Institute, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Phillip Orchowitz
- Department of Behavioral Psychology, Kennedy Krieger Institute, Baltimore, MD, USA
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Nuske HJ, Young AV, Khan FY, Palermo EH, Ajanaku B, Pellecchia M, Vivanti G, Mazefsky CA, Brookman-Frazee L, McPartland JC, Goodwin MS, Mandell DS. Systematic review: emotion dysregulation and challenging behavior interventions for children and adolescents on the autism spectrum with graded key evidence-based strategy recommendations. Eur Child Adolesc Psychiatry 2023:10.1007/s00787-023-02298-2. [PMID: 37740093 DOI: 10.1007/s00787-023-02298-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 09/04/2023] [Indexed: 09/24/2023]
Abstract
Challenging behavior, such as aggression, is highly prevalent in children and adolescents on the autism spectrum and can have a devastating impact. Previous reviews of challenging behavior interventions did not include interventions targeting emotion dysregulation, a common cause of challenging behavior. We reviewed emotion dysregulation and challenging behavior interventions for preschoolers to adolescents to determine which evidence-based strategies have the most empirical support for reducing/preventing emotion dysregulation/challenging behavior. We reviewed 95 studies, including 29 group and 66 single case designs. We excluded non-behavioral/psychosocial interventions and those targeting internalizing symptoms only. We applied a coding system to identify discrete strategies based on autism practice guidelines with the addition of strategies common in childhood mental health disorders, and an evidence grading system. Strategies with the highest quality evidence (multiple randomized controlled trials with low bias risk) were Parent-Implemented Intervention, Emotion Regulation Training, Reinforcement, Visual Supports, Cognitive Behavioral/Instructional Strategies and Antecedent-Based Interventions. Regarding outcomes, most studies included challenging behavior measures, while few included emotion dysregulation measures. This review highlights the importance of teaching emotion regulation skills explicitly, positively reinforcing replacement/alternative behaviors, using visuals and metacognition, addressing stressors proactively, and involving parents. It also calls for more rigorously designed studies and for including emotion dysregulation as an outcome/mediator in future trials.
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Affiliation(s)
- Heather J Nuske
- Penn Center for Mental Health, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, Floor 3, Philadelphia, PA, 19104, USA.
| | - Amanda V Young
- Penn Center for Mental Health, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, Floor 3, Philadelphia, PA, 19104, USA
- Mayo Clinic, Mayo Eugenio Litta Children's Hospital, Rochester, USA
| | - Farzana Y Khan
- Penn Center for Mental Health, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, Floor 3, Philadelphia, PA, 19104, USA
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Emma H Palermo
- Penn Center for Mental Health, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, Floor 3, Philadelphia, PA, 19104, USA
| | - Bukola Ajanaku
- Penn Center for Mental Health, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, Floor 3, Philadelphia, PA, 19104, USA
| | - Melanie Pellecchia
- Penn Center for Mental Health, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, Floor 3, Philadelphia, PA, 19104, USA
| | - Giacomo Vivanti
- A. J. Drexel Autism Institute, Drexel University, Philadelphia, USA
| | - Carla A Mazefsky
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, USA
| | | | | | | | - David S Mandell
- Penn Center for Mental Health, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, Floor 3, Philadelphia, PA, 19104, USA
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3
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Lloveras LA, McKeown CA, Lichtenberger SN, Sellers TP, Vollmer TR. Recommendations Regarding Use of the Term " Ignore" in Applied Behavior Analysis. Perspect Behav Sci 2023; 46:399-408. [PMID: 37425990 PMCID: PMC10322799 DOI: 10.1007/s40614-023-00373-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2023] [Indexed: 07/11/2023] Open
Abstract
Ignore is a common term used in behavioral assessment, behavior intervention plans, textbooks, and research articles. In the present article, we recommend against the typical usage of the term in most applications of behavior analysis. First, we briefly outline some history of the use of the term in behavior analysis. Then, we describe six main concerns about ignore and the implications for its continued use. Finally, we address each of these concerns with proposed solutions, such as alternatives to the use of ignore.
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Nuske HJ, Young AV, Khan F, Palermo EH, Ajanaku B, Pellecchia M, Vivanti G, Mazefsky CA, Brookman-Frazee L, McPartland JC, Goodwin MS, Mandell DS. Systematic Review: Emotion Dysregulation and Challenging Behavior Interventions for Children andAdolescents with Autism with Graded Key Evidence-Based Strategy Recommendations. RESEARCH SQUARE 2023:rs.3.rs-2802378. [PMID: 37131592 PMCID: PMC10153364 DOI: 10.21203/rs.3.rs-2802378/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Challenging behavior, such as aggression, is highly prevalent in children and adolescents with autism and can have a devastating impact. Previous reviews of challenging behavior interventions did not include interventions targeting emotion dysregulation, a common cause of challenging behavior. We reviewed emotion dysregulation and challenging behavior interventions for preschoolers to adolescents to determine which evidence-based strategies have the most empirical support for reducing/preventing emotion dysregulation/challenging behavior. We reviewed 95 studies, including 29 group and 66 single-case designs. We excluded non-behavioral/psychosocial interventions and those targeting internalizing symptoms only. We applied a coding system to identify discrete strategies based on autism practice guidelines with the addition of strategies common in childhood mental health disorders, and an evidence grading system. Strategies with the highest quality evidence (multiple randomized controlled trials with low bias risk) were Parent-Implemented Intervention, Emotion Regulation Training, Reinforcement, Visual Supports, Cognitive Behavioral/Instructional Strategies and Antecedent-Based Interventions. Regarding outcomes, most studies included challenging behaviors measures while few included emotion dysregulation measures. This review highlights the importance of teaching emotion-regulation skills explicitly, positively reinforcing replacement/alternative behaviors, using visuals and metacognition, addressing stressors proactively, and involving parents. It also calls for more rigorously-designed studies and for including emotion dysregulation as an outcome/mediator in future trials.
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5
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Kane CL, DeBar RM. A Descriptive Review of Telehealth for Individuals With Autism Spectrum Disorder. Behav Modif 2023; 47:504-546. [PMID: 36113035 DOI: 10.1177/01454455221121085] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Since the early 2000s, telehealth has been used to provide behavior analytic intervention to individuals with autism spectrum disorder (ASD). Evaluating evidence supporting telehealth remains valuable, especially as there has been increased accessibility since the COVID-19 pandemic. Although there is empirical support for telehealth as an effective service-delivery option, important variables (e.g., costs, implementer training) remain unknown. Despite potential roles in telehealth service-delivery models, a careful review of participant prerequisite skills, implementer characteristics (e.g., experience, education), technology variables (e.g., HIPAA compliance), and skill(s) targeted (i.e., mastered or untrained skills) have not been considered. Therefore, we aimed to extend prior telehealth literature reviews by evaluating current research across variables important for telehealth service-delivery involving individuals with ASD. We found thorough descriptions of participants and implementers, implementer training, and social validity evaluations. Limitations of telehealth literature include exclusion of teen and adult participants, limited description of prerequisite skills and evaluations of direct telehealth interventions. Future research areas were identified.
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Gerow S, Kirkpatrick M, McGinnis K, Sulak TN, Davis TN, Fritz S. Evaluation of a Telehealth ABA Program for Caregivers of Children with ASD. Behav Modif 2023; 47:349-379. [PMID: 36317793 DOI: 10.1177/01454455221130001] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Children with autism spectrum disorder (ASD) often experience skill deficits that can negatively affect long-term outcomes. Interventions based on applied behavior analysis (ABA) yield improvements in targeted skills. However, families often have difficulty accessing ABA services. The purpose of this study was to evaluate the efficacy of a caregiver coaching program delivered via telehealth. Thirty children with ASD and their caregivers (e.g., parents, grandparents) participated in all phases of the study. The program consisted of therapists providing coaching in English or Spanish to caregivers of children with ASD via synchronous video call telehealth visits, typically provided one to two times per week. Caregivers received coaching in interventions (e.g., functional communication training, discrete trial teaching, total task chaining, and naturalistic teaching) to address individualized goals. We collected data on caregiver treatment fidelity and child outcomes (i.e., Vineland-3, observation, and analysis of time series data). Caregivers implemented intervention procedures with 95% accuracy on average. The single-case effect sizes calculated based on the time series baseline and intervention data yielded medium, large, or very large improvements for 85% of goals addressed. Results indicated that the children improved on appropriate engagement (measured via observation), but there was no statistically significant improvement for the remaining pre-post measures. These results, along with the results of previous studies, provide preliminary support for the use of telehealth to provide ABA services. However, there is a need for additional research evaluating the efficacy of these types of programs.
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Lory C, Rispoli M, Keehn B, Mason RA, Mason BA, Kang S, Borosh AM, Shannon E, Crosley H. Exploring Subtypes of Repetitive Behavior in Children with Autism Through Functional Analysis and Wearable Technology: a Pilot Biobehavioral Assessment. ADVANCES IN NEURODEVELOPMENTAL DISORDERS 2023; 7:1-16. [PMID: 36721856 PMCID: PMC9881513 DOI: 10.1007/s41252-023-00317-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/16/2023] [Indexed: 06/18/2023]
Abstract
Objectives Prior research has established assessment methodologies, such as functional analysis to identify specific contexts in which restricted and repetitive behavior (RRB) occurs, and measures of heart rate variability (HRV) to index the level of autonomic arousal in individuals with autism spectrum disorder (ASD). Yet, a gap remains in integrating multiple assessment methodologies to examine the complex underlying mechanisms of RRB. This study piloted a multi-disciplinary approach to assess both the functional behavioral and neurophysiological factors that may underlie occurrences of RRB. The study (a) evaluated the effect of a modified functional analysis protocol on delineating functional subtypes of RRB and (b) explored the effect of using a wearable technology within a functional analysis on identifying the relationship between RRB and HRV. Method A single-case alternating treatment design was used to randomly alternate noncontingent low-stimulation and high-stimulation conditions in a modified functional analysis protocol. Simultaneous measurement of RRB and HRV was obtained through direct behavioral observations and a wristband that collects blood volume pulse, respectively. Visual analysis of time series data was used to determine the functional subtypes of RRB, and nonparametric correlational analyses were conducted to determine the association between HRV and RRB. Results Findings from a sample of six participants suggest preliminary effectiveness of the assessment protocol in identifying subtypes of RRB and a significant correlation between HRV and RRB. Conclusions This study demonstrates the potential effect and usability of a wearable technology-aided biobehavioral approach to assess RRB and HRV in individuals with ASD.
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Affiliation(s)
- Catharine Lory
- Department of Early Childhood, Multilingual, and Special Education, University of Nevada Las Vegas, Las Vegas, NV USA
| | - Mandy Rispoli
- Department of Curriculum, Instruction, and Special Education, University of Virginia, Charlottesville, VA USA
| | - Brandon Keehn
- Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, IN USA
- Department of Psychological Sciences, Purdue University, West Lafayette, IN USA
| | - Rose A. Mason
- Department of Educational Studies, Purdue University, West Lafayette, IN USA
| | - Benjamin A. Mason
- Department of Educational Studies, Purdue University, West Lafayette, IN USA
| | - Sungwoo Kang
- Department of Educational Studies, Purdue University, West Lafayette, IN USA
| | - Amanda M. Borosh
- Department of Educational Studies, Purdue University, West Lafayette, IN USA
| | - Eric Shannon
- Department of Educational Studies, Purdue University, West Lafayette, IN USA
| | - Hannah Crosley
- Department of Educational Studies, Purdue University, West Lafayette, IN USA
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Fisher AC, Cheung SC, O'Connor CMC, Piguet O. The Acceptability and Usefulness of Positive Behaviour Support Education for Family Carers of People With Frontotemporal Dementia: A Pilot Study. J Geriatr Psychiatry Neurol 2023; 36:73-83. [PMID: 35380488 DOI: 10.1177/08919887221090214] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
AIM This pilot study investigated the acceptability and usefulness of 4 weekly Positive Behaviour Support (PBS) education sessions (delivered face-to-face and online) for family carers of individuals diagnosed with behavioural-variant frontotemporal dementia (bvFTD). These sessions were adapted from the Family-directed Approach to Brain injury (FAB)-PBS program to the FTD population. METHODS A pre-test post-test mixed-methods design was utilized. Primary outcome measures included a Carer Confidence questionnaire and post-intervention Feedback Questionnaire. Assessments were conducted prior to the 4-week education program, immediately following the final session and a 3 months follow-up. RESULTS Ten family carers completed the 4 PBS education sessions and indicated that the program was helpful in providing behaviour support. No significant changes in confidence ratings were found before and following the education sessions. A majority of participants, however, reported positive changes to their approach in providing behaviour support, with key themes including 'recognising the function of behaviour', 'changing their own behaviour' and 'promoting a calmer approach'. CONCLUSIONS The FAB-PBS education sessions demonstrate to be an acceptable approach to increasing the capability of family carers in providing behaviour support to individuals with FTD, which will need to be confirmed in a larger feasibility study.
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Affiliation(s)
- Alinka C Fisher
- Disability and Community Inclusion, 64767College of Nursing and Health Sciences, Flinders University, Bedford Park, Australia
| | - Sau C Cheung
- School of Psychology and Brain & Mind Centre, 4334The University of Sydney, Sydney, Australia
| | - Claire M C O'Connor
- Centre for Positive Ageing, 94268HammondCare, Sydney, Australia.,School of Population Health, The University of New South Wales, Sydney, Australia
| | - Olivier Piguet
- School of Psychology and Brain & Mind Centre, 4334The University of Sydney, Sydney, Australia
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Craig EA, Dounavi K, Ferguson J. Effectiveness of a Brief Functional Analysis and Functional Communication Training Conducted Through Telehealth. JOURNAL OF DEVELOPMENTAL AND PHYSICAL DISABILITIES 2023; 35:227-246. [PMID: 35967272 PMCID: PMC9358095 DOI: 10.1007/s10882-022-09857-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/20/2022] [Indexed: 05/13/2023]
Abstract
This study evaluates the effectiveness of a brief functional analysis and functional communication training conducted via telehealth. Three interventionist-child dyads took part in the study including one speech and language pathologist and two school teaching assistants, each working with one child with autism spectrum disorder. Interventionists were trained using didactic training to implement a brief functional analysis as well as synchronous coaching from a BCBA® to implement functional communication training. A multiple baseline across participants design was utilised to evaluate if interventionists could implement functional communication training to decrease challenging behaviours that included aggression, elopement and disruption. Sessions concluded earlier than planned due to school closures mandated by the COVID-19 outbreak for two of the three participants; however, existing data provide evidence that telehealth is a valid model for enabling clinicians to work in collaboration with school personnel to effectively deliver assessment and intervention procedures remotely via telehealth.
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Affiliation(s)
- Emma A. Craig
- School of Social Sciences, Education & Social Work, Queen’s University of Belfast, 69-71 University Street, Belfast, BT7 1HL Northern Ireland
| | - Katerina Dounavi
- School of Social Sciences, Education & Social Work, Queen’s University of Belfast, 69-71 University Street, Belfast, BT7 1HL Northern Ireland
| | - Jenny Ferguson
- School of Social Sciences, Education & Social Work, Queen’s University of Belfast, 69-71 University Street, Belfast, BT7 1HL Northern Ireland
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Meadan H, Lee JD, Chung MY. Parent-Implemented Interventions via Telepractice in Autism Research: A Review of Social Validity Assessments. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2022; 9:213-219. [PMID: 36405977 PMCID: PMC9640782 DOI: 10.1007/s40474-022-00259-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2022] [Indexed: 11/09/2022]
Abstract
Purpose of Review Parent-implemented autism interventions are considered empirically validated interventions and the use of telepractice in these interventions is reported as effective. However, little is known about the social validity assessments and outcomes of these interventions. The purpose of this review is to explore the current practices of conducting social validity assessment and reporting its outcomes within parent-implemented telepractice autism interventions. Recent Findings The 11 reviewed studies included caregivers as participants, telepractice intervention focusing on social communication outcomes of young autistic children, and were published in a peer-reviewed journal within the past five years. Summary The researchers in the reviewed articles reported positive outcomes for parent-implemented telepractice autism interventions. Notably, however, information about social validity assessments of the interventions was limited. Researchers are encouraged to evaluate the social validity of interventions using multiple data sources and methods, and report on their findings as they relate to other types of data.
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Affiliation(s)
- Hedda Meadan
- grid.35403.310000 0004 1936 9991Department of Special Education, University of Illinois Urbana-Champaign, 1310 South Sixth Street, Champaign, IL 61820 USA
| | - James D. Lee
- grid.34477.330000000122986657Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA USA
| | - Moon Y. Chung
- grid.419689.b0000 0000 8867 2215Department of Education Studies, Stonehill College, Easton, MA USA
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11
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Hendrix NM, Pickard KE, Binion GE, Kushner E. A systematic review of emotion regulation in parent-mediated interventions for autism spectrum disorder. Front Psychiatry 2022; 13:846286. [PMID: 36213921 PMCID: PMC9544248 DOI: 10.3389/fpsyt.2022.846286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 08/26/2022] [Indexed: 12/03/2022] Open
Abstract
Autistic individuals are at elevated risk for difficulties with emotion regulation (ER) that emerge early in life and are associated with a range of internalizing and externalizing disorders. Existing interventions that support ER have focused on school-age autistic children and adolescents as well as adults. Proactive approaches to improving ER in early childhood are thus needed, as is understanding the approaches by which ER skills can be feasibly supported in this young population. This review summarizes how ER has been measured within parent-mediated interventions for children at or under the age of 6 years and the extent to which ER is measured concurrently with or distinctly from observable behaviors that have been referenced in existing literature as externalizing or challenging behavior. Using PsycInfo, EBSCOhost, and PubMed databases, we searched for peer-reviewed journal articles published through August 2021, that focused on the use of parent-mediated interventions targeting ER and/or challenging behavior. The systematic search resulted in 4,738 publications; following multi-stage screening, the search yielded 20 studies. Eighteen of 20 studies were designed to target challenging behavior using manualized curricula or behavior analytic methodologies and assessed child outcomes through validated caregiver rating scales and/or direct behavioral observation. One study measured changes in ER as secondary to the social communication skills that were targeted in the intervention. Only one study specifically supported ER skill development and measured changes in ER as the primary intervention outcome. Findings highlight the need for better assessment of ER outcomes within the context of parent-mediated interventions for toddlers and young autistic children.
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Affiliation(s)
- Nicole M. Hendrix
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States
- Marcus Autism Center, Children's Healthcare of Atlanta, Atlanta, GA, United States
| | - Katherine E. Pickard
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States
- Marcus Autism Center, Children's Healthcare of Atlanta, Atlanta, GA, United States
| | - Grace E. Binion
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States
- Marcus Autism Center, Children's Healthcare of Atlanta, Atlanta, GA, United States
| | - Elizabeth Kushner
- Marcus Autism Center, Children's Healthcare of Atlanta, Atlanta, GA, United States
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Davis TN, Gerow S, Wicker M, Cosottile D, Exline E, Swensson R, Lively P. Utilizing Telehealth to Coach Parents to Implement Trial-Based Functional Analysis and Treatment. JOURNAL OF BEHAVIORAL EDUCATION 2022; 32:1-23. [PMID: 35378841 PMCID: PMC8966851 DOI: 10.1007/s10864-022-09468-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/24/2022] [Indexed: 06/14/2023]
Abstract
The trial-based functional analysis (TBFA) offers several advantages in natural settings, such as time efficiency and ecological validity. Previous studies have successfully trained or coached a variety of professionals and parents to conduct a TBFA utilizing in-person training procedures; however, no study has evaluated the effectiveness of telehealth coach or train others to implement a TBFA. Utilizing telehealth coaching, we coached three mothers of children with autism to conduct a TBFA in their home. The TBFA identified consequences maintaining challenging behavior for all three participants. Based on the results of the TBFA, we developed a functional communication training (FCT) intervention. Experimenters coached the mothers to implement the FCT intervention in their home. All interventions resulted in decreased challenging behavior and increased communication. The results suggest parents are capable of conducting a valid TBFA with telehealth coaching and support.
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Affiliation(s)
- Tonya N. Davis
- Department of Educational Psychology, Baylor University, One Bear Place #97301, Waco, TX 76798 USA
| | - Stephanie Gerow
- Department of Educational Psychology, Baylor University, One Bear Place #97301, Waco, TX 76798 USA
| | - MacKenzie Wicker
- Department of Educational Psychology, Baylor University, One Bear Place #97301, Waco, TX 76798 USA
| | - David Cosottile
- Department of Educational Psychology, Baylor University, One Bear Place #97301, Waco, TX 76798 USA
| | - Emily Exline
- Department of Educational Psychology, Baylor University, One Bear Place #97301, Waco, TX 76798 USA
| | - Remington Swensson
- Department of Educational Psychology, Baylor University, One Bear Place #97301, Waco, TX 76798 USA
| | - Providence Lively
- Department of Educational Psychology, Baylor University, One Bear Place #97301, Waco, TX 76798 USA
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13
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Treszl A, Koudys J, O'Neill P. Evaluating the effects of Picture Exchange Communication System
®
mediator training via telehealth using behavioral skills training and general case training. BEHAVIORAL INTERVENTIONS 2021. [DOI: 10.1002/bin.1835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Alyssa Treszl
- Department of Applied Disability Studies Brock University St. Catharines Ontario Canada
| | - Julie Koudys
- Department of Applied Disability Studies Brock University St. Catharines Ontario Canada
| | - Paige O'Neill
- Department of Applied Disability Studies Brock University St. Catharines Ontario Canada
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14
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Ellison KS, Guidry J, Picou P, Adenuga P, Davis TE. Telehealth and Autism Prior to and in the Age of COVID-19: A Systematic and Critical Review of the Last Decade. Clin Child Fam Psychol Rev 2021; 24:599-630. [PMID: 34114135 PMCID: PMC8191715 DOI: 10.1007/s10567-021-00358-0] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2021] [Indexed: 01/20/2023]
Abstract
There has been growing interest in the use of telehealth; however, the COVID-19 pandemic and the subsequent isolation and restrictions placed on in-person services have fast-tracked implementation needs for these services. Individuals with autism spectrum disorder (ASD) have been particularly affected due to the often-intensive service needs required by this population. As a result, the aim of this review was to examine the evidence base, methodology, and outcomes of studies that have used telehealth for assessment and/or intervention with children and adolescents with ASD as well as their families over the last decade. Further, the goal is to highlight the advances in telehealth and its use with this special population. A systematic search of the literature was undertaken, with 55 studies meeting inclusion criteria and quality analysis. Specified details were extracted from each article, including participant characteristics, technology, measures, methodology/study design, and clinical and implementation outcomes. Services provided via telehealth included diagnostic assessments, preference assessments, early intervention, applied behavior analysis (ABA), functional assessment and functional communication training, and parent training. Findings, although still emerging, encouragingly suggested that services via telehealth were equivalent or better to services face-to-face. Results support the benefits to using telehealth with individuals with ASD. Future research should continue to explore the feasibility of both assessments and interventions via telehealth with those having ASD to make access to assessment services and interventions more feasible for families, while acknowledging the digital divide it could create.
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Affiliation(s)
- Kimberly S Ellison
- Department of Psychology, Louisiana State University, 236 Audubon Hall, Baton Rouge, LA, 70803, USA
| | - Jerrica Guidry
- Department of Psychology, Louisiana State University, 236 Audubon Hall, Baton Rouge, LA, 70803, USA
| | - Paige Picou
- Department of Psychology, Louisiana State University, 236 Audubon Hall, Baton Rouge, LA, 70803, USA
| | - Paige Adenuga
- Department of Psychology, Louisiana State University, 236 Audubon Hall, Baton Rouge, LA, 70803, USA
| | - Thompson E Davis
- Department of Psychology, Louisiana State University, 236 Audubon Hall, Baton Rouge, LA, 70803, USA.
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15
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Oblak MK. An analysis of a system under pandemic conditions. J Appl Behav Anal 2021; 54:530-546. [PMID: 33817789 DOI: 10.1002/jaba.836] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 03/15/2021] [Accepted: 03/15/2021] [Indexed: 01/05/2023]
Abstract
Recent events have emphasized the need for behavior-analytic service delivery models that can remain clinically consistent and produce high-quality outcomes while adapting to environmental change. This paper reports outcomes of an organization that adapted to changes in its service delivery model during a worldwide pandemic. The organization utilized components from the Comprehensive Application of Behavior Analysis to Schooling (CABAS®) model. The components were interconnected within the system and linked by specific interlocking contingencies. Performance data were used to make decisions within the organization on both individual and organizational levels during the transition to telehealth for clients and staff. Results are discussed in terms of how the interconnectedness of components within the organization contributed to the reliable, positive outcomes of the system during the transition to telehealth.
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