By Todd A. Ward, PhD, BCBA-D
Founding Editor, bSci21.org
A crucial skill emphasized by behavior analysts working with children with autism is communication, encapsulated via Functional Communication Training (FCT). If a child can gain communication skills, the probability that many other adaptive social and intellectual skills will subsequently develop increases greatly.
A study by David Wacker and team in the Journal of Developmental and Physical Disabilities documents the successful implementation of FCT with 17 children, with one catch. The programs were run by parents under the guidance of behavioral consultants hundreds of miles away. The consultants were operating via a telehealth model which utilizes web technology to deliver services to locations that otherwise might not receive care.
In Wacker’s study, 16 mothers and two fathers acted as therapists for their own children, with the help of a local assistant with no formal background in applied behavior analysis before the study. The assistant provided logistical support with materials, physical assistance, and helped ensure safety. The behavioral consultant met with the parent remotely before and after each session to discuss procedures and results.
In addition to FCT, a Functional Analysis was conducted by the parents to determine the function of problem behaviors such as aggression, self-injurious behavior, and property destruction. The FCT was then linked to the function of problem behavior for each child. For example, if a child acted out aggressively in order to escape a demand, FCT focused on building appropriate alternative behaviors to achieve the same result, such as asking for a break.
Overall, Waker’s team successfully replaced problem behavior with adaptive alternative communication by 93.5% across all participants over an average of 21 weeks. Moreover, parents rated the program very favorably. The authors additionally noted that the average weekly cost of the telehealth program was approx. $58 per child, compared to an estimated $335 per child if a therapist were to travel to each home.
Be sure to check out the full study here for many more details, and let us know your experiences with telehealth in the comments below. Also, don’t forget to subscribe to bSci21 via email to receive the latest articles directly to your inbox!
Todd A. Ward, PhD, BCBA-D is President of bSci21 Media, LLC, which owns bSci21.org and BAQuarterly.com. Todd serves as an Associate Editor of the Journal of Organizational Behavior Management and as an editorial board member for Behavior and Social Issues. He has worked as a behavior analyst in day centers, residential providers, homes, and schools, and served as the director of Behavior Analysis Online at the University of North Texas. Todd’s areas of expertise include writing, entrepreneurship, Acceptance & Commitment Therapy, Instructional Design, Organizational Behavior Management, and ABA therapy. Todd can be reached at firstname.lastname@example.org.
Telehealth has been real effective for coaching our clinicians how to facilitate social skills while they ride with our learners in a stretch limo with a camera installed.