Developing and Enhancing Adherence to a Telehealth ABA Parent Training Curriculum for Caregivers of Children with Autism

Yi et al. (2021) watched public early-intervention staff run telehealth ABA parent-training sessions. They scored how well the staff used caregiver-coaching moves like modeling, shared practice, and live feedback.

The team looked at a small group of providers and families of preschoolers with autism. They used simple single-case charts to track fidelity across weeks.

Coaching fidelity was low and jumpy. Staff rarely used in-vivo feedback or true collaboration with parents.

Only a handful of the listed coaching steps ever showed up in a session. Most of the hour was direct instruction instead.

Van der Donck et al. (2023) now shows the same telehealth model can hit 95% caregiver fidelity and big child gains. The difference: their project added tight checklists, live bug-in-ear feedback, and weekly practice loops. Yi’s low scores are therefore superseded, not contradicted.

Gerow et al. (2021) and Ferguson et al. (2022) also found high parent fidelity when coaches followed a brief, repeatable script and gave real-time praise. Yi’s staff lacked those supports, explaining the gap.

Ingersoll et al. (2016) warned us years ago that self-directed telehealth modules alone give weak fidelity. Yi’s public-system staff basically ran self-directed sessions, so the poor result echoes the earlier warning.

If you supervise telehealth ABA teams, don’t assume staff know how to coach. Build a short checklist of must-do moves: model, hand over the lead, give instant feedback, and end with a shared plan. Add bug-in-ear or chat-box prompts during the session. One added layer of live support flips the script from Yi’s low numbers to the high fidelity now shown in later studies.