No abstract

To address the daunting behavioral and mental health needs of Kansas’ rural and underserved communities, Telehealth ROCKS (Rural Outreach for the Children of Kansas) Schools project partnered with school-based health centers, school districts, and special education cooperatives to provide a range of telebehavioral health intervention services and teletraining. This project used the Project Extension for Community Healthcare Outcomes (ECHO) telementoring framework to connect specialty providers with school/community providers for web-based continuing education and case consultation to support students with special education needs. Our team created Function Friday for Better Behavior ECHO series to address challenging behaviors in schools, based on the concept of functional behavior assessment and function-based treatment. Part of the ECHO series occurred after the onset of the COVID-19 pandemic. This article describes how our ECHO series provided an effective mechanism for supporting school and community providers during the pandemic, and participating educators utilized skills as they transitioned from onsite education to the virtual learning environment with students.

With admiration and appreciation to Telehealth ROCKS (Regional Outreach to Communities, Kids, and Schools) participating families, their schools, and their communities; telemedicine coordinator/champions; the extended team; and our funders.

There is a well-documented lack of service providers trained to provide early intensive behavioral intervention (EIBI) to the growing number of families who have a child diagnosed with autism spectrum disorder (ASD). Although several states have begun offering service providers EIBI training to increase local capacity to provide EIBI services, there is limited information about how these programs are implemented at scale and their effect on trainees' knowledge and skill acquisition. This article describes the Autism Training Program (ATP), a training program implemented in a Midwestern state over 9.5 years. Three hundred fifteen trainees enrolled, consented, and completed both pre-and postknowledge and skill assessments. Assessments showed that trainees significantly increased their knowledge and implementation of EIBI procedures and reported high satisfaction with training. This model of training can be delivered within a shorter time frame with significant training effects for individuals working with children with ASD.

Background: Rural children are more at risk for childhood obesity but may have difficulty participating in pediatric weight management clinical trials if in-person visits are required. Remote assessment of height and weight observed via videoconferencing may provide a solution by improving the accuracy of self-reported data. This study aims to validate a low-cost, scalable video-assisted protocol for remote height and weight measurements in children and caregivers. Methods: Families were provided with a low-cost digital scale and tape measure and a standardized protocol for remote measurements. Thirty-three caregiver and child (6-11 years old) dyads completed remote (at home) height and weight measurements while being observed via videoconferencing by research staff, as well as in-person measurements with research staff in the clinic. We compared the overall and absolute mean differences in child and caregiver weight, height, body mass index (BMI), and child BMI adjusted Z-score (BMIaz) between remote and in-person measurements using paired samples t-tests and one sample t-tests, respectively. Bland-Altman plots were used to estimate the limits of agreement (LOA) and assess systematic bias. Simple and multivariable regressions were used to examine whether sociodemographic factors and the number of days between measurements were associated with measurement discrepancies. Results: Overall mean differences in child and caregiver weight, height, BMI, and child BMIaz were not significantly different between remote and in-person measurements. LOAs were -2.1 and 1.7 kg for child weight, -5.2 and 4.0 cm for child height, -1.5 and 1.7 kg/m2 for child BMI, -0.4 and 0.5 SD for child BMIaz, -3.0 and 2.8 kg for caregiver weight, -2.9 and 3.9 cm for caregiver height, and -2.1 and 1.6 kg/m2 for caregiver BMI. Absolute mean differences were significantly different between the two approaches for all measurements. Child sociodemographic variables, caregiver education level, or time between measurements were not significantly associated with measurement discrepancies. Conclusions: Remotely observed weight and height measurements using non-research grade equipment may be a feasible and valid approach for pediatric clinical trials in rural communities. However, researchers should carefully evaluate their measurement precision requirements and intervention effect size to determine whether remote height and weight measurements suit their studies. Trial registration: ClinicalTrials.gov NCT04142034. Registered October 29, 2019