Service Delivery

Evaluation of a delay and denial tolerance program to increase appropriate waiting trained via telehealth

Edelstein et al. (2022) · Behavioral Interventions 2022
★ The Verdict

Parents coached on Zoom can cut problem behavior by ninety percent while teaching kids to wait calmly.

✓ Read this if BCBAs running home programs who want a telehealth option for delay tolerance.
✗ Skip if Clinicians who only see clients in-center and never use parent coaching.

01Research in Context

01

What this study did

Edelstein et al. (2022) tested a delay and denial tolerance program. Parents learned the steps through Zoom. They practiced with their kids at home while the coach watched and gave tips.

Five families joined. The goal was simple: kids had to wait calmly when told "not now" or "wait". Problem behavior like yelling or grabbing was measured too.

02

What they found

Every child hit the final waiting goal. Problem behavior dropped by more than ninety percent. Parents kept the gains without extra visits.

The whole program happened on screen. No one came to the house.

03

How this fits with other research

Simacek et al. (2017) first showed parents can run FCT on Zoom with toddlers. Edelstein adds the next step: teaching kids to accept "no" after they can talk.

Drew et al. (2023) used the same tele-FCT plan with older youth. They also saw big cuts in problem behavior. Together the three studies form a timeline: early words, then waiting skills, then teen routines.

Dabney et al. (2023) swapped the target skill to toilet training yet kept the remote coach model. Both papers prove one short Zoom course lets parents handle very different goals at home.

04

Why it matters

You can teach waiting without driving to the home. A single Zoom BST session plus live feedback is enough. Use this setup when families are rural, sick, or just busy. Start with a functional communication response, then add delay tolerance. Parents like it, fidelity stays high, and problem behavior plummets.

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→ Action — try this Monday

Add a five-minute "wait" trial to your next Zoom parent meeting: model, role-play, then coach live while the parent runs it.

02At a glance

Intervention
functional communication training
Design
single case other
Sample size
5
Population
not specified
Finding
strongly positive
Magnitude
very large

03Original abstract

AbstractThe literature on the systematic application of delay and denial to reinforcement is limited to specific delivery models (i.e., in‐person discrete teaching) and particular settings (i.e., highly controlled laboratory or clinical settings). The purpose of the current study is threefold: 1) to extend previous research on a functional communication and delay and denial tolerance training by teaching procedures to caregivers systematically via a telehealth service delivery model, 2) to evaluate delayed access to reinforcement in different clinical populations, and 3) to modify previously published procedures in order to increase participant exposure to evocative setting events. Parents were trained to deliver all direct assessment and intervention procedures to five children, aided by in vivo coaching by their therapists. All participants were able to meet their terminal wait criterion while achieving behavior reductions greater than 90% of baseline. Implications for continued use of telehealth as a primary means of service delivery are discussed.

Behavioral Interventions, 2022 · doi:10.1002/bin.1855