Conducting Functional Analyses of Problem Behavior via Telehealth

Abstract

Behavior consultants conducted functional analyses (FAs) via telehealth with 20 young children with autism spectrum disorders between the ages of 29 and 80 months who displayed problem behavior and lived an average of 222 miles from the tertiary hospital that housed the behavior consultants. Participants’ parents conducted all procedures during weekly telehealth consultations in regional clinics located an average of 15 miles from the participants’ homes. Behavior consultants briefly trained parent assistants to provide on-site support for families during consultations. FAs completed within a multielement design identified environmental variables that maintained problem behavior for 18 of the 20 cases, and interrater agreement averaged over 90%. Results suggested that behavior analysts can conduct FAs effectively and efficiently via telehealth.

Telehealth and Autism: Treating Challenging Behavior at Lower Cost

“…Only children who completed FA and were started in FCT were included in the current analysis. Information on a subsample of children from group 1 was reported previously by Wacker et al 12 Wacker et al 5,11 reported selected data from 20 of the participants from group 2, and Suess et al 14 described treatment fidelity data from the first 3 participants in group 3. Among the 107 children who started FCT in these 3 groups, 8 discontinued treatment in group 1 (3 with ASD, 5 with other DD), 3 discontinued treatment in group 2, and 2 discontinued treatment in group 3.…”

“…5,11 Telehealth workstations were equipped with a Windows-based PC, video monitor, webcam, and headset. 21 For group 2, existing videoconferencing software was used at the hospital site.…”

“…Wacker et al 5 demonstrated that weekly coaching for parents can identify the social functions of problem behavior and replace these behaviors with alternative communication. [11][12][13] In the initial studies in this series, 12,13 behavior consultants traveled to family homes weekly to coach parents in conducting FA and FCT. The same strategies have subsequently been tested via telehealth, initially by having families travel to outpatient clinics near their homes 5, 11 and later by providing telehealth coaching to parents in their own homes.…”

“…[11][12][13] In the initial studies in this series, 12,13 behavior consultants traveled to family homes weekly to coach parents in conducting FA and FCT. The same strategies have subsequently been tested via telehealth, initially by having families travel to outpatient clinics near their homes 5, 11 and later by providing telehealth coaching to parents in their own homes. 14 The purpose of the current study was to compare the behavioral outcomes, costs, and family acceptance of in-home telehealth with the results obtained when consultants coached parents in person at home or via telehealth at regional clinics.…”

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

“…Clinic-to-Clinic (Wacker et al, 2013b) Clinic-to-Home Clinic-to-Clinic (Wacker et al, 2013b) Clinic-to-Home Clinic-to-Clinic (Wacker et al, 2013b Clinic-to-Home Fig. 1 Comparison of telehealth equipment needs between the clinic-to-clinic and clinic-to-home projects needs such as laptops and Ethernet cables being sent to the majority of families, and the need to install antivirus software on the laptops sent to the families.…”