Service Delivery

An intensive telehealth assessment and treatment model for an adult with developmental disabilities.

Shawler et al. (2021) · Research in developmental disabilities 2021
★ The Verdict

Caregivers can run a full FA and FCT online for adults with developmental disabilities and nail every step.

✓ Read this if BCBAs who support adults with developmental disabilities in rural or home-based settings
✗ Skip if BCBAs whose caseload is only early-intervention clinic clients with in-home staff

01Research in Context

01

What this study did

One adult with developmental disabilities got a full FA and FCT package through Zoom. The caregiver, not a therapist, ran every session while the BCBA coached from a laptop.

The team met daily for two weeks. They finished the FA, built the FCT plan, and thinned the schedule until the caregiver could handle it solo.

02

What they found

Challenging behavior dropped and functional requests took its place. The caregiver hit every step correctly, proving a parent can do high-level ABA with only screen-based coaching.

Results held after the camera turned off, showing the adult kept the new skills without daily BCBA visits.

03

How this fits with other research

Thompson et al. (2023) and Edelstein et al. (2025) show the same caregiver-led FCT works for preschoolers. The adult in this study extends the age range, telling us the model is not just for little kids.

Greer et al. (2016) mapped out schedule thinning with FCT years ago, but they did not use screens. This 2021 case adds telehealth, so rural or immune-compromised clients can still get the gold-standard package.

Cihon et al. (2022) and Sivaraman et al. (2021) already proved telehealth BST works for social and self-care skills. This paper goes further by moving the hardest part—full FA and FCT—online without watering it down.

04

Why it matters

If you serve adults with developmental disabilities who live far away or have limited clinic access, you can duplicate this two-week intensive. Ask the caregiver to block out daily Zoom windows, ship them a simple data sheet, and coach them through the same FA→FCT sequence. You keep procedural fidelity high while cutting travel time to zero.

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Pick one long-distance adult client, schedule daily 1-hour Zoom sessions for two weeks, and walk the caregiver through a condensed FA followed by FCT with schedule thinning

02At a glance

Intervention
functional communication training
Design
case study
Sample size
1
Population
developmental delay
Finding
positive

03Original abstract

Over the last decade, the provision of applied behavior analysis (ABA) services within a telehealth delivery format has had a flourishing literature base. Research has demonstrated that caregivers can successfully conduct functional analyses and functional communication training to treat challenging behavior with coaching from practitioners via telehealth. Previous limitations include research that has only been conducted with children, typically in 1hr, weekly meetings, so the utility of providing ABA therapy via telehealth across the lifespan is unknown. Additionally, the effects of a more intensive treatment format delivered via telehealth has not been evaluated. The purpose of the current study was to coach caregivers to conduct the assessment and treatment process for a young man with developmental disabilities using an intensive-outpatient model in a telehealth format. Functional analysis procedures led to the development of a function-based treatment to reduce challenging behavior and increase functional communication. Caregivers demonstrated high procedural integrity across all phases of the study and found the intervention highly acceptable and effective. Areas for future research and directions are discussed.

Research in developmental disabilities, 2021 · doi:10.1016/j.ridd.2021.103876