Use of telemediated caregiver coaching to increase access to naturalistic developmental behavioral interventions within a statewide early intervention system

Abstract

Despite the clear efficacy and appeal of naturalistic developmental behavioral interventions for families of young children, they are often difficult for families to access due to the limited availability of trained service providers. In recent years, telehealth has emerged as an effective tool for overcoming issues related to access, especially in rural and underserved communities. However, while telehealth offers a strategy to connect with families, it does not address the limited availability of trained providers. In this article, we provide an overview of a statewide model developed to increase access to naturalistic developmental behavioral interventions for families while building the capacity of early intervention providers. Through this model, expert consultants connect to caregivers and providers via telehealth to provide information and coaching over a limited series of visits. Collectively, child, caregiver, and provider outcomes support the effectiveness, acceptability, and feasibility of this model while demonstrating that services can be provided successfully to diverse participants. Lay abstract Many families seek access to evidence-based therapy to support their child’s learning. Naturalistic developmental behavioral intervention is a set of practices that use a child’s natural motivation and interest to teach skills in everyday routines. Many families find naturalistic developmental behavioral interventions appealing and they have been proven to be effective. However, families may not be able to enroll in naturalistic developmental behavioral intervention–based programs due to the limited availability of trained service providers. Telehealth is the use of technology to engage with care providers, including doctors and therapists. Telehealth is an effective tool for improving access to services, especially for people in rural and underserved communities. Telehealth offers a way for providers to connect with families but it does not address the low numbers of trained providers. In this article, we share a statewide model developed to increase access to naturalistic developmental behavioral interventions for families while increasing training opportunities for early intervention providers. Through this model, expert consultants worked with caregivers and providers via telehealth for a brief series of visits. During these visits, consultants taught caregivers and providers strategies based in naturalistic developmental behavioral interventions. Feedback from caregivers and providers, along with improvement in child skills, show that this model was effective and acceptable.