Previous studies have shown that telehealth can be an effective way to deliver behavior‐analytic services. In this study, we provided a demonstration of the use of telehealth to assess and initiate ...treatment of problem behavior in an outpatient clinic. We coached parents of children with autism via telehealth to conduct functional analyses during 1 appointment that lasted 1 hr and subsequently coached them as they implemented functional communication training during 3 subsequent appointments (15 min each). Social functions were identified for most children, and problem behavior was reduced by an average of 65.1%.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Treatments based on differential reinforcement may inadvertently increase the recurrence of problem behavior in the face of challenges because reinforcers for appropriate behavior occur in the same ...context as problem behavior. The current study evaluated one potential approach to mitigating these problems with differential reinforcement treatments based on behavioral momentum theory. Specifically, appropriate behavior was trained in contexts without a history of reinforcement prior to intervening with problem behavior. Participants were 4 children with autism spectrum disorder. Treatment used telehealth to implement functional communication training (FCT) in three alternative contexts with minimal or no history of reinforcement for problem behavior before initiating FCT in the treatment context. Evaluations of the effects of treatment and tests of resurgence were conducted intermittently during treatment to evaluate maintenance. When FCT treatment was initiated in alternative contexts, initial results were comparable to more typical implementations of FCT. Resurgence was reduced to similar levels during tests of resurgence for all participants when compared to more typical previously published implementations of FCT, but clinically significant reductions in resurgence occurred more quickly in the present study. These findings support training appropriate behavior in an alternative context to mitigate the resurgence of problem behavior during differential reinforcement treatments.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
We conducted a retrospective, descriptive evaluation of the fidelity with which parents of three children with autism spectrum disorders conducted functional communication training (FCT) in their ...homes. All training was provided to the parents via telehealth by a behavior consultant in a tertiary-level hospital setting. FCT trials coached by the behavior consultant were conducted during weekly 1-h visits. Parents made video recordings of treatment trials in which they conducted the procedures independent of coaching. We evaluated the levels of fidelity during coached and independent trials within a multielement design and recorded parents' omission and commission errors during different components of the treatment over time. The results showed no consistent differentiation between the coached and the independent trials. Some errors (e.g., omission errors associated with reinforcing manding) occurred more frequently overall, but none of the errors appeared to have a strong relationship with treatment outcomes. All children showed substantial reductions in problem behavior during the final treatment trials and especially during the coached trials. These results suggest that behavior analysts can use telehealth to implement FCT with acceptable fidelity and to achieve substantial reductions in children's problem behavior.
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BFBNIB, DOBA, EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, IZUM, KILJ, KISLJ, MFDPS, NLZOH, NMLJ, NUK, OBVAL, OILJ, PILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, SIK, UILJ, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
The prevalence of students with behavioral problems who also have learning problems has been reported to be as high as 50% (Glassberg et al.
Behavioral Disorders, 25
, 9–21,
1999
). In the current ...study, we progressively evaluated the effects of positive reinforcement, instructional strategies, and, if needed, negative reinforcement on both academic performance (i.e., on-task academic behavior, task accuracy, reading fluency) and problem behavior with two boys who displayed a combination of behavioral and learning problems at school. A three-phase analysis was conducted within a combination multielement and reversal design. Phase 1 evaluated the effects of contingent positive reinforcement. Phase 2 evaluated the combined effects of positive reinforcement and instructional strategies. Phase 3, conducted for one participant, evaluated the inclusion of contingent negative reinforcement. Data were collected using interval and permanent product recording systems, with IOA averaging 97% across both participants. For one participant, contingent positive reinforcement with an instructional strategy improved task accuracy and fluency, and decreased problem behavior. For the second participant, contingent negative reinforcement with an instructional strategy decreased problem behavior and improved on-task academic behavior and task accuracy. Results showed that highly individualistic treatment packages can be developed if based on experimental analyses of both reinforcement and antecedent strategies to address multiple behavioral concerns.
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DOBA, EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, IZUM, KILJ, KISLJ, MFDPS, NLZOH, NUK, OBVAL, OILJ, PILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UILJ, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Functional communication training (FCT) is a widely used and effective function-based treatment for problem behavior. The purpose of this article is to present two cases in which FCT was unsuccessful ...in reducing the occurrence of problem behavior displayed by two young children with an autism spectrum disorder. Both children received the same functional analysis plus FCT treatment package via telehealth that had proven to be highly successful for the other participants. The FCT package was conducted within tightly controlled single-case designs for each participant, which permitted subsequent analyses to determine why FCT was unsuccessful. These analyses suggested distinct reasons for the treatment failure for each child. Although the negative results of treatment appeared to be similar for both children, the specific reasons for treatment failure were highly individualistic and identifiable via the single-case analyses conducted. We present findings from both our initial and subsequent analyses and discuss the implications.
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NUK, OILJ, SAZU, UKNU, UL, UM, UPUK
The researchers in the project used telehealth to conduct functional analyses and functional communication training in homes of children diagnosed with autism who displayed problem behavior. Parents ...conducted all assessment and treatment procedures within their homes while receiving coaching from applied behavior analysts located approximately 200 miles away from them. In this article, the researchers summarize the technical systems they used to develop a telehealth service and the concerns and problems they have encountered using telehealth and provide some guidelines for how to troubleshoot those problems.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Previous research has documented the effects of prompting mands at a relatively high rate (i.e., rich schedule) or low rate (i.e., lean schedule). These previous studies have not addressed the ...possibility of prompt dependency as an explanation for these results. Furthermore, the implications of a collateral effect of prompt density, increased response-reinforcer pairings, have not been investigated. The current studies sought to address these two questions. During Experiment 1, the effect of prompt density (i.e., high and low prompt rate) on manding was evaluated. The inclusion of a control condition (i.e., prompts in the absence of the relevant establishing operation and reinforcement) isolated the effect of prompts on manding. During Experiment 2, a collateral effect of relatively high prompt density, increased reinforcer rate, on response persistence was evaluated. Results showed that manding rates varied with prompt rate and did not appear to be prompt dependent. Finally, mands persisted longer following a relatively rich prompt schedule than a relatively lean prompt schedule.
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DOBA, EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, IZUM, KILJ, KISLJ, MFDPS, NLZOH, NUK, ODKLJ, OILJ, PILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, SIK, UILJ, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
8.
Telehealth Wacker, David P.; Schieltz, Kelly M.; Suess, Alyssa N. ...
Handbook of Evidence-Based Practices in Intellectual and Developmental Disabilities
Book Chapter
In this chapter, we provide a description of a behavioral assessment (functional analysis) and treatment (functional communication training) program that we deliver to parents of young children with ...autism spectrum disorder in their homes via telehealth. We first describe the development of this assessment and treatment model that was initiated in the homes of young children with developmental disabilities who engaged in severe behavior problems such as self-injury, aggression and property destruction. Parents conducted all sessions with coaching from trained behavior analysts, and most achieved clinically significant reductions in the problem behaviors displayed by their children. We next conducted these same procedures, but did so using clinic-to-clinic telehealth. Instead of behavior analysts travelling to parents’ homes, the parents instead travelled to local pediatric specialty clinics that were connected to our university hospital via an optic cable system. Similar results in reductions in problem behavior were achieved even though the behavior analysts were never in physical contact with the children or parents. Our current project is conducting the same procedures via telehealth but now directly in the homes of the parents and children. Thus far, we are achieving similar results, and again without having physical contact with the families or children. We provide case examples and descriptions of the procedures.
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