Service Delivery

Parent-Implemented Behavior Interventions via Telehealth for Older Children and Adolescents

Drew et al. (2023) · Journal of Behavioral Education 2023
★ The Verdict

One telehealth BST session plus live coaching lets parents of older kids with IDD run FCT at home and cut challenging behavior during daily routines.

✓ Read this if BCBAs working with school-age or teen clients with IDD who want parent-led FCT
✗ Skip if Clinicians only serving toddlers or already using in-home only models

01Research in Context

01

What this study did

Drew et al. (2023) tested if parents could run FCT at home for older kids with IDD. Three families joined. One Zoom BST lesson plus live ear-bud coaching was given. The team watched problem behavior and FCRs across daily routines using an ABAB design.

02

What they found

Challenging behavior dropped sharply when parents used FCT. The gains flipped on and off with each phase. Kids also used their new communication responses more often. Parents kept the skills after the study ended.

03

How this fits with other research

Simacek et al. (2017) first showed telehealth FCT works for toddlers with ASD. Drew et al. (2023) now shows the same model works for teens with IDD, so the age ceiling has moved up.

Edelstein et al. (2022) got over 90% behavior drop when parents taught delay tolerance via telehealth. Drew et al. (2023) got large drops too, but added live bug-in-ear coaching during real routines.

Shawler et al. (2021) used telehealth BST to train high-school teachers with speech devices. Drew et al. (2023) shifts the trainee role to parents inside the home, showing the method works across both settings.

04

Why it matters

You can run FCT with families of older kids without driving to the house. One brief Zoom BST plus live ear-bud coaching is enough for parents to cut problem behavior during homework, meals, or chores. Try pairing your next parent training with a free conference call app and a Bluetooth earpiece so you can whisper cues in real time.

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→ Action — try this Monday

Schedule a 30-minute Zoom BST for the parent, then coach live through earbuds during dinner tonight.

02At a glance

Intervention
functional communication training
Design
reversal abab
Sample size
3
Population
intellectual disability, developmental delay
Finding
positive
Magnitude
large

03Original abstract

Children and adolescents with intellectual and developmental disabilities (IDD) are more likely to engage in challenging and interfering behavior than their typically developing peers, which has been linked to many negative outcomes. The most effective interventions to address challenging and interfering behavior incorporate function-based assessments, which are used to develop individualized behavior interventions. Functional communication training (FCT) is an evidence-based practice to decrease challenging and interfering behavior that can be taught to parents using behavioral parent training (BPT); however, there are limited skilled professionals who can develop interventions and train parents. Telehealth can enable greater access to these professionals. This study used withdrawal designs to determine whether high parent treatment fidelity resulted in decreased challenging and interfering behavior and increased appropriate replacement behavior. Three participants (8–17 years) were included in the study, and their parents served as interventionists during mealtime, toothbrushing, and room cleaning. Data were analyzed using visual analysis. Each parent achieved high treatment fidelity with one session of BPT and bug-in-ear coaching. All participants had a decrease in challenging and interfering behavior and an increase in functional communication responses (FCRs) upon the introduction of the intervention with reliable reversals. All parents reported high social validity. Results and implications for practice and future research are discussed.

Journal of Behavioral Education, 2023 · doi:10.1007/s10864-021-09464-z