Evaluation of a Telehealth ABA Program for Caregivers of Children with ASD.
Telehealth caregiver coaching hit 95 % fidelity and moved 85 % of child goals medium-to-large without anyone leaving home.
01Research in Context
What this study did
Van der Donck et al. (2023) ran a single-case study of a telehealth caregiver coaching program.
Parents of children with autism joined live Zoom sessions. A BCBA taught and then watched them run ABA techniques at home.
The team tracked how well parents followed the steps and whether each child met the goals written in their plan.
What they found
Parents hit 95 % fidelity. They ran the procedures almost exactly like the BCBA showed them.
Eight out of ten child goals made medium-to-very-large gains when the data were graphed.
Standard pre-post tests did not show big changes, but the single-case data did.
How this fits with other research
Yi et al. (2021) looks like a contradiction. That study saw low provider fidelity during telehealth ABA. The difference: Stephanie trained parents, while Yi watched over-worked early-intervention staff. High fidelity is possible when you coach the caregiver.
Gerow et al. (2021) and Azzano et al. (2023) echo the same story. Both used telehealth parent coaching and saw high fidelity plus child gains. The new study widens the skill set beyond daily living or toddler play to full ABA programs.
Simacek et al. (2020) scoping review already said telehealth parent training is growing fast. Stephanie et al. give one clear recipe that actually works.
Why it matters
You can run caregiver coaching through Zoom and still get clinic-level fidelity. Train parents in real time, watch them practice, and give immediate feedback. The child keeps learning at home even when clinic slots are full or miles away.
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02At a glance
03Original abstract
Children with autism spectrum disorder (ASD) often experience skill deficits that can negatively affect long-term outcomes. Interventions based on applied behavior analysis (ABA) yield improvements in targeted skills. However, families often have difficulty accessing ABA services. The purpose of this study was to evaluate the efficacy of a caregiver coaching program delivered via telehealth. Thirty children with ASD and their caregivers (e.g., parents, grandparents) participated in all phases of the study. The program consisted of therapists providing coaching in English or Spanish to caregivers of children with ASD via synchronous video call telehealth visits, typically provided one to two times per week. Caregivers received coaching in interventions (e.g., functional communication training, discrete trial teaching, total task chaining, and naturalistic teaching) to address individualized goals. We collected data on caregiver treatment fidelity and child outcomes (i.e., Vineland-3, observation, and analysis of time series data). Caregivers implemented intervention procedures with 95% accuracy on average. The single-case effect sizes calculated based on the time series baseline and intervention data yielded medium, large, or very large improvements for 85% of goals addressed. Results indicated that the children improved on appropriate engagement (measured via observation), but there was no statistically significant improvement for the remaining pre-post measures. These results, along with the results of previous studies, provide preliminary support for the use of telehealth to provide ABA services. However, there is a need for additional research evaluating the efficacy of these types of programs.
Behavior modification, 2023 · doi:10.1177/01454455221130001