This comparison draws in part from “Virtual Oncology Care Delivery – a 'Nice to Have', or a New 'Standard of Care'?” by Peter Manning, MBA (BehaviorLive), and extends it with peer-reviewed research from our library of 27,900+ ABA research articles. The decision framework, BACB ethics code references, and cross-links below are synthesized by Behaviorist Book Club.
View the original presentation →One of the most consequential decisions a behavior analyst makes is not just what intervention to use, but how to approach the clinical question in the first place. For virtual oncology care delivery – a 'nice to have', or a new 'standard of care'?, the difference between an evidence-based, individualized approach and a traditional, protocol-driven one can significantly impact outcomes.
This guide lays out the key factors side by side to support your clinical decision-making.
| Factor | Evidence-Based Approach | Traditional Approach |
|---|---|---|
| Access Reach | Maximizes geographic reach and reduces transportation barriers. Enables service delivery to rural and underserved areas where in-person providers are unavailable. | Limited by provider travel radius and client transportation capacity. Geographic access barriers may exclude underserved populations. |
| Observation Quality | Dependent on camera quality, positioning, and bandwidth. Some behaviors may not be fully observable. Requires adapted observation protocols. | Direct observation in the natural environment provides the highest quality behavioral data. Physical proximity allows detection of subtle behaviors. |
| Caregiver Involvement | Inherently involves the caregiver as mediator, building their capacity and promoting generalization. May produce stronger long-term family outcomes. | Caregiver involvement depends on the service model and may be less intensive. Direct service sessions may not build caregiver skills as naturally. |
| Service Intensity | May be limited for clients requiring intensive direct intervention, physical prompting, or complex environmental arrangements. | Supports full range of service intensities including intensive early intervention with physical prompting and environmental manipulation. |
| Operational Efficiency | Reduces travel time, increases scheduling flexibility, and allows higher client contact hours per day. Lower overhead costs for physical space. | Significant time allocated to travel between clients. Higher overhead for vehicles, mileage reimbursement, and physical office space. |
| Equity Considerations | Creates new barriers for families without technology, reliable internet, or suitable home environments. Must actively address the digital divide. | Creates barriers for families without transportation or in geographic areas with limited providers. Must actively address geographic and transportation access. |
The ABA Clubhouse has 60+ on-demand CEUs including ethics, supervision, and clinical topics like this one. Plus a new live CEU every Wednesday.
Use this framework when approaching virtual oncology care delivery – a 'nice to have', or a new 'standard of care'? in your practice:
Does the data support a need for intervention? Is there a meaningful impact on the individual's quality of life, safety, or access to reinforcement?
YES → Proceed to assessment NO → Document reasoning, monitor
A functional assessment should guide intervention selection. Avoid defaulting to standard protocols without individual analysis. Consider environmental variables, setting events, and private events.
YES → Select evidence-based approach matched to function NO → Complete assessment first
Goals should be co-developed. Assent and informed consent are ethical requirements. The individual's preferences and values matter in selecting both goals and methods.
YES → Proceed with collaborative plan NO → Engage in shared decision-making
This course covers the clinical and ethical dimensions in detail with structured learning objectives and CEU credit.
Virtual Oncology Care Delivery – a 'Nice to Have', or a New 'Standard of Care'? — Peter Manning · 1 BACB Ethics CEUs · $30
Take This Course →We extended this decision guide with research from our library — dig into the peer-reviewed studies behind each approach, in plain-English summaries written for BCBAs.
183 research articles with practitioner takeaways
153 research articles with practitioner takeaways
139 research articles with practitioner takeaways
1 BACB Ethics CEUs · $30 · BehaviorLive
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All behavior-analytic intervention is individualized. The information on this page is for educational purposes and does not constitute clinical advice. Treatment decisions should be informed by the best available published research, individualized assessment, and obtained with the informed consent of the client or their legal guardian. Behavior analysts are responsible for practicing within the boundaries of their competence and adhering to the BACB Ethics Code for Behavior Analysts.