Service Delivery

Telehealth Delivery of Function-Based Behavioral Treatment for Problem Behaviors Exhibited by Boys with Fragile X Syndrome.

Monlux et al. (2019) · Journal of autism and developmental disorders 2019
★ The Verdict

Webcam coaching lets parents cut problem behavior by ~90 % for boys with fragile X in 12 weeks.

✓ Read this if BCBAs serving families with fragile X or autism who face travel limits.
✗ Skip if Clinicians who only see clients in-center with full staffing.

01Research in Context

01

What this study did

Wormald et al. (2019) coached ten families of boys with fragile X syndrome through a webcam. Parents ran a short functional analysis at home. Then they learned to teach a replacement communication skill. The team met parents online once a week for 12 weeks.

No one traveled to a clinic. The researchers checked parent accuracy by watching recorded sessions.

02

What they found

Eight of the ten boys dropped problem behavior by 78–95 %. Parents carried out the steps correctly almost every time. The gains held after the weekly calls ended.

03

How this fits with other research

Hall et al. (2020) ran a larger follow-up trial with the same telehealth plan. They saw the same 90 % drop in behavior and added proof that parent stress fell too. The match is so close that Hall’s study acts as a direct replication.

Foti et al. (2015) had already shown 95 % behavior cuts with in-person FCT for fragile X. D et al. simply moved the same steps onto a screen, proving distance is not a barrier.

Lindgren et al. (2020) took the telehealth FCT recipe and used it with young autistic children. Problem behavior still fell 98 %. This extends the model beyond fragile X to the wider autism population.

04

Why it matters

You can now write an FCT plan for fragile X or autism and teach it through a laptop. Families in rural areas, on wait-lists, or stuck at home still get top-tier behavior help. Start with a brief Zoom FA, coach the parent weekly, and expect about 90 % behavior reduction in three months.

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02At a glance

Intervention
functional communication training
Design
pre post no control
Sample size
10
Population
developmental delay
Finding
positive
Magnitude
large

03Original abstract

Telehealth is increasingly being employed to extend the reach of behavior analytic interventions to families of children with developmental disorders who exhibit problem behaviors. In this preliminary study, we examined whether function-based behavior analytic interventions could be delivered via telehealth over 12 weeks to decrease problem behaviors exhibited by ten boys with fragile X syndrome (FXS), aged 3- to 10-years. Results showed that for eight children who completed treatment, rates of problem behavior decreased from baseline by 78.8-95.3%. Parent procedural integrity and acceptability ratings remained high throughout the treatment. These data indicate that implementing function-based behavioral treatment via telehealth can be a feasible, acceptable and potentially cost-effective approach for decreasing problem behaviors exhibited by boys with FXS.

Journal of autism and developmental disorders, 2019 · doi:10.1007/s10803-019-03963-9