Children living in geographically rural areas may have limited access to early, intensive evidence-based interventions suggesting children residing in these areas are less likely to experience positive outcomes than their urban-dwelling peers.  Telehealth offers an option to rural families seeking early intervention by using communication technologies where providers are able to consult and deliver services in real-time over geographical distances. To our knowledge, no other study has examined the implementation of P-ESDM in rural natural environments within the framework of the state’s early intervention program. Using a multiple baseline design across participants, the current study investigated the effects of the parent-Early Start Denver Model implemented within a rural northeastern state’s existing IDEA Part C early intervention program.  Parents demonstrated increased fidelity to intervention strategies and reported satisfaction with the program’s ease of implementation and observed child gains.  Statistically significant pre-to post- change in children’s ASD symptomatology were reported for the domains of communication, social reciprocity and repetitive and restricted behaviors.  Support for parent-mediated interventions, the importance of fidelity of implementation for sustainability of intervention strategies, and the need to explore telehealth as a viable service delivery option to improve developmental trajectories for toddlers with autism are discussed.

Years can elapse between parental suspicion of a developmental delay and a diagnostic assessment, ultimately delaying access to medically necessary, autism-specific intervention. Using a single-case, concurrent multiple baseline design, autism spectrum disorder symptomology (i.e., higher-order restrictive and repetitive behaviors and interests; higher-order RRBIs) was targeted in toddlers (21–35 months) waiting for a diagnostic appointment. Caregivers were coached via telehealth to mediate early intervention to decrease interfering, inflexible higher-order RRBIs during play using four evidence-based applied behavior analytic strategies: modeling, prompting, differential reinforcement of appropriate behaviors, and response interruption and redirection. Six mother–child dyads were recruited from pediatrician offices and early intervention service districts in the United States. All families were considered under-served, under-resourced, or living in rural locations. A visual analysis of the data combined with Tau-U revealed a strong basic effect between the intervention package and parent strategy use and child flexible and inflexible behavior. Findings were consistent across participants with one exception demonstrating a moderate effect for flexible behaviors yet a strong effect for inflexible behaviors. Standardized mean difference was beyond zero for all participants. Implications for science and practice include support for early intervention of higher-order RRBIs for young children with and at risk for ASD.

Individuals with disabilities who are English learners (ELs) and communicate using speech generating devices (SGDs) may demonstrate a preference for instructional language and language output of their SGDs. The influence of interventionist language on the preference of SGD language output and frequency of mands was examined using an alternating-treatments design with an embedded concurrent-chain arrangement with a 10-year-old with Down syndrome whose heritage language was Spanish. Language preference assessment for ELs is recommended because heritage language may be preferred for children with disabilities who use SGDs.

Due to a variety of factors, many paraeducators receive little to no opportunities to advance their professional skills. Asynchronous online learning opportunities offer a flexible way for districts to provide paraeducators opportunities to advance their knowledge, although little is known about what online resources are available, their features, or their overall quality. A review was conducted of 19 freely available online learning opportunities to evaluate features, alignment with federal legislation and professional standards, active engagement features, and usability. Results indicated that features and quality indicators varied across resources and half of the resources required active user engagement. Limitations, suggestions for future development, and future research directions are discussed with an emphasis on factors related to online delivery.