Behavioral Telehealth Consultation with Families of Children with Autism Spectrum Disorder

Machalicek et al. (2016) coached parents through a laptop to run a full functional analysis and then teach their child a new communication skill. The team used everyday toys the family already owned. Sessions happened in the living room while the BCBA watched on Zoom.

After the FA showed why problem behavior occurred, parents added an antecedent tweak, a communication response, and a consequence plan. The study used a single-case design with no control group.

Every family finished the telehealth FA and the follow-up treatment. Challenging behavior dropped once parents used the new plan. The paper calls the outcome positive but does not give a percent.

Lindgren et al. (2020) ran an RCT of the same telehealth FCT package and saw a 98% mean drop in problem behavior within 12 weeks. That larger, newer study now sets the benchmark, yet the 2016 paper remains the first to lay out the full parent-led sequence.

Spackman et al. (2025) kept the telehealth coach model but swapped in a progressive FA. All 17 kids hit an 80% reduction, a clearer bar than the 2016 result. The newer protocol is faster and safer, so it has largely replaced the original method.

Schieltz et al. (2022) stretched the 2016 package across 199 families on five continents and still saw strong behavior drops. The basic steps hold up at global scale, not just in small U.S. samples.

If you still think FAs must happen in a clinic, this paper shows parents can do it at home with nothing more than a webcam and toy set. Use it as your proof-of-concept when insurance or rural distance blocks in-person visits. Start with a brief FA script, coach live on Zoom, then layer in FCT the same session. The later RCTs give you the stronger numbers, but this 2016 study gives you the first road map.