Evaluating the Cool Versus Not Cool Procedure via Telehealth
The Cool Versus Not Cool game teaches autistic kids to chat, and Zoom does not water it down.
01Research in Context
What this study did
The team moved the Cool Versus Not Cool social-skills game to Zoom. Three autistic kids and their parents joined from home.
A BCBA coached parents to run the steps: model the cool way, model the not-cool way, have the child practice, give praise and points.
Sessions were short, about 30 minutes. The researchers tracked if each child could start and keep a short chat going.
What they found
Every child hit the mastery goal in four to eight Zoom visits. Two kids still used the skill with new people a month later.
All three kept the skill after the coaching stopped. Parents said the game felt easy and fun to run on screen.
How this fits with other research
Frankel et al. (2010) first showed that parent-led social-skills groups work in person. Cihon et al. (2022) now show the same game works through a webcam.
Knopp et al. (2023) compared Zoom and in-person DTT for labeling objects. They found no clear winner. The new study adds a third win for telehealth, this time for back-and-forth talk instead of labels.
Sivaraman et al. (2021) used Zoom to teach mask wearing. Both papers used the same coach-parent-child setup and got big gains in just a few visits. Together they say: if you train the parent well, the screen stops being a barrier.
Why it matters
You no longer need a clinic room to teach conversation. A BCBA can open Zoom, watch the parent play the game, and give live tips. This cuts travel time and lets rural families get top-tier social-skills training. Try it next time a family is on the wait list or lives two hours away.
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02At a glance
03Original abstract
Autistics/individuals diagnosed with autism spectrum disorder (ASD) commonly display qualitative impairments in social behavior that commonly result in the use of interventions directly targeting the development of social skills. The COVID-19 pandemic has highlighted the need for effective social skills interventions that can be delivered directly via telehealth. The Cool Versus Not Cool procedure has continually been documented as effective within the literature. However, its reported use has been limited to in-person delivery. The purpose of this study was to evaluate the effectiveness of the Cool Versus Not Cool procedure conducted via telehealth to teach three children diagnosed with ASD to change the conversation when someone is bored. The results of a nonconcurrent multiple-baseline across-participants design demonstrated that all three participants reached the mastery criterion in four to eight sessions. Responding generalized to another adult for two of the three participants, and all three participants maintained correct responding. Social validity measures indicated the skill was important to teach, the intervention was acceptable and effective, and the telehealth format was an acceptable replacement for in-person intervention for these three participants.
Behavior Analysis in Practice, 2022 · doi:10.1007/s40617-021-00553-z