This study is designed to test methods for improving access to function-based behavioral
treatment for young children with autism spectrum disorders (ASD). Our recent research has
been evaluating the efficacy of conducting behavioral treatment through telehealth consultation provided at regional clinics for young children (ages 1-6 years) who reside in underserved areas of a rural state. Our current data are showing that this model can be a highly effective and efficient means of delivering applied behavior analysis (ABA) interventions. The proposed project is designed to extend telehealth consultation to the home setting and to use a randomized controlled trial to systematically evaluate the effectiveness of providing ABA via in-home telehealth. The study will also examine the costs of providing this intervention as well as identify key family characteristics that influence successful behavioral outcomes for parents raising children with ASD.
This study addresses three primary research objectives. First, the study will conduct a
rigorous analysis of the behavioral intervention package (functional behavior analysis plus
reinforcement-based behavioral treatment) by randomizing participants to an immediate
treatment group or to a group that receives treatment after a brief delay that is no longer than the time families typically wait to receive behavioral services. The effect of treatment in reducing disruptive and destructive behavior will be evaluated by comparing the immediate treatment group to the control group that has not yet received treatment. Second, the study will analyze the costs of providing this treatment package through in-home telehealth and compare them to the costs of delivering behavioral interventions to families by sending therapists to homes in person. Finally, we will evaluate the relation of family factors, including parental stress and family support, to overall intervention effectiveness and to treatment acceptance by families. This project thus will extend a highly efficient and effective ABA intervention model to underserved areas and will determine which families may need additional supports to benefit optimally from these interventions. By intervening early, it should be possible to decrease problem behavior before it becomes resistant to treatment and to help children become ready to fully engage in the early intervention programs available to them. If successful, this research could provide a model for other states in how to increase access to ABA services and reduce treatment costs for children
with ASD and their families.
Autism, Developmental Disabilities, Telehealth & Health Information Technology, Rural, Access to Health Care, Early Intervention, Health Care Costs, Parent-Child Relationship, Stress