Using Telehealth to Program Generalization of Caregiver Behavior
Weekly Zoom coaching with video homework lets caregivers generalize plans across routines and slash severe problem behavior.
01Research in Context
What this study did
Shawler et al. (2023) worked with one caregiver-teen pair through Zoom. The BCBA coached the mom to move new skills across meals, homework, and bedtime. Each week the mom sent short videos of home routines. The therapist gave live feedback and new goals.
What they found
Mom’s use of the plan jumped to near-perfect levels. The teen’s severe problem behavior dropped to almost zero. Gains held two months later without extra visits.
How this fits with other research
Ferguson et al. (2022) saw the same jump in parent accuracy when they taught social-communication tips over Zoom. Their kids also showed mild language gains, while Shawler’s teen showed big behavior drops. The method lines up; the target skills differ.
Lee et al. (2024) ran Preschool Life Skills classes on Zoom. Parents learned the steps and kids’ problem behavior fell, matching Shawler’s pattern. The age and program differ, but telehealth parent training keeps winning.
Ruppel et al. (2023) used brief Zoom feedback to train staff, not parents, on preference assessments. Staff hit mastery fast, showing the same quick fidelity boost. The trainee changes; the remote feedback recipe stays strong.
Why it matters
You can coach caregivers to carry the treatment plan into real life without driving to the house. One case shows big, lasting behavior cuts after short weekly Zoom calls. Try adding video homework and live feedback to your parent-training package this week.
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02At a glance
03Original abstract
Stokes and Baer, Journal of Applied Behavior Analysis, 10(2), 349–367 (1977) provided guidelines to assist practitioners with programming for the generalization of behavior change. Despite the suggestions provided in their seminal paper, generalization remains an often overlooked area within behavior analytic research and practice. In addition, few studies have described explicit strategies to program for the generalization of caregiver behaviors that are consistent with interventions to reduce child challenging behavior. In the current discussion, we describe how telehealth provides a potential avenue for practitioners to focus on generalization. Telehealth helps practitioners access behavior-change agents, materials, and contexts that they may not directly contact in educational and clinical environments. Using telehealth to target these areas early on, and throughout treatment for child challenging behavior, may facilitate more rapid treatment success and maintenance. We provide a case example to demonstrate the use of telehealth to program the generalization of a mother’s treatment plan implementation to reduce the severe challenging behavior of an adolescent. We report clinically and socially significant outcomes related to caregiver fidelity and challenging behavior reduction.
Behavior Analysis in Practice, 2023 · doi:10.1007/s40617-022-00766-w