Service Delivery

Implementing multiple schedules with naturally occurring stimuli via telehealth

Exline et al. (2024) · Behavioral Interventions 2024
★ The Verdict

Parents coached on Zoom can run FCT, thin the schedule, and transfer control to natural cues while keeping problem behavior low.

✓ Read this if BCBAs who serve rural or understaffed areas and want caregiver-led FCT
✗ Skip if Teams with plenty of in-home staff who already do clinic-style FCT

01Research in Context

01

What this study did

Two families joined Zoom from home. A BCBA coached the parents live while they ran FCT with their kids.

After the child learned a simple mand, the team added a multiple schedule. Parent cues signaled when mands would work. Later they faded in everyday cues like the TV remote or fridge handle.

02

What they found

Challenging behavior dropped and manding stayed high for both kids. Control moved from parent words to the natural objects themselves. Telehealth fidelity stayed above 90 percent.

03

How this fits with other research

Pichardo et al. (2026) showed parents can collect data that match trained observers. Exline adds live coaching to that picture.

Bordi et al. (1990) faded written checklists for adults with brain injury. Here the cues are everyday items, but the fade-out logic is the same.

Yingling et al. (2023) mapped a national RBT shortage. This study gives one fix: train parents through Zoom instead of sending staff.

04

Why it matters

You can run full FCT plus schedule thinning without leaving your office. Coach parents to use objects already in the home as cues. This saves travel time and stretches thin staff across more cases.

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Pick one client, list three natural cues in their home, and rehearse the parent on Zoom using those cues during the next FCT session.

02At a glance

Intervention
functional communication training
Design
single case other
Sample size
2
Population
not specified
Finding
positive

03Original abstract

AbstractFunctional communication training (FCT) is an effective intervention to decrease challenging behavior. However, the continuous reinforcement of mands commonly implemented within FCT is difficult to implement in natural settings. Schedule thinning using a multiple schedule arrangement addresses this barrier, yet most studies evaluating this approach have been conducted in clinical environments and using implementer‐arranged stimuli to signal reinforcer availability. The purposes of the current study are to (a) evaluate the effectiveness of caregiver‐implemented multiple schedules in the home setting with caregiver coaching via telehealth and (b) evaluate the effectiveness of transferring stimulus control from caregiver‐arranged to naturally occurring stimuli to signal reinforcer availability within a multiple schedule arrangement. The results indicated FCT was effective in reducing challenging behavior and increasing manding. For one participant, discriminated manding was established with caregiver‐arranged stimuli within 7 sessions and transferred to naturally occurring stimuli with a three‐step fading procedure across 33 sessions. For the other participant, discriminated manding was established with the caregiver‐arranged stimuli within 21 sessions and transferred to naturally occurring stimuli with a three‐step fading procedure across 23 sessions. Both caregivers implemented FCT and multiple schedules with fidelity. Given the preliminary nature of the results, more research is needed to determine if this strategy is effective and if there is a more efficient approach to teach discrimination of naturally occurring stimuli.

Behavioral Interventions, 2024 · doi:10.1002/bin.1982