Effectiveness of Telehealth Direct Therapy for Individuals with Autism Spectrum Disorder
Full telehealth ABA can teach new skills that last and transfer to daily life.
01Research in Context
What this study did
Nohelty et al. (2022) tested full telehealth ABA for kids with autism. Seven children got all their therapy through a computer screen. Therapists used both natural play and table drills to teach language, daily living, and social skills.
The team tracked each child with a multiple-baseline design. They looked for mastery, maintenance, and use of new skills at home.
What they found
Every child hit mastery on their teaching targets. Skills stuck weeks later and showed up in new places like the living room or grocery store.
Parents did not act as therapists. The BCBA ran every trial through the screen and still got full generalization.
How this fits with other research
Dai et al. (2025) extend these results. They added parent coaching after hospital DTT and cut stress while keeping gains. The 2022 study proves the tech works; the 2025 study shows you can hand the baton to parents and keep winning.
Kleinert et al. (2007) is the grandparent. They first showed parents can learn DTT with BST and get generalization. Nohelty simply moves the same BST steps onto Zoom.
Sawyer et al. (2014) used a single-case package to wipe out problem behavior and build communication. Both papers reach mastery and generalization, but one uses telehealth teaching and the other uses in-person FCT.
Why it matters
You can run an entire ABA program through telehealth and still see mastery, maintenance, and real-world use. No in-home visit is required for success. Try starting one client fully remote next week. Track three skills across baseline, intervention, and two home generalization probes. If the curve matches Nohelty’s, you have a new service option for rural or immune-compromised families.
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02At a glance
03Original abstract
The field of applied behavior analysis (ABA) has utilized telehealth for clinical supervision and caregiver guidance with research supporting the use of both modalities. Research demonstrating effectiveness is crucial, as behavior analysts must ensure the services they provide are effective in order to be ethical. With the increased need for patients to access more services via telehealth, due to the novel coronavirus (COVID-19) pandemic, the current study evaluated the efficacy of telehealth direct therapy to teach new skills to individuals with autism spectrum disorder (ASD). This study examined the utility of natural environment teaching and discrete trial training strategies provided over a videoconferencing platform to teach new skills directly to seven individuals with varying ASD severity levels. The targeted skills were taught solely through telehealth direct therapy with varying levels of caregiver support across participants and included skills in the language, adaptive, and social domains. In a multiple baseline design, all seven participants demonstrated mastery and maintenance for all targets; in addition, generalization to family members was assessed for some targets. The evidence suggests that telehealth is a modality that is effective and can be considered for all patients when assessing the appropriate location of treatment.
Behavior Analysis in Practice, 2022 · doi:10.1007/s40617-021-00603-6