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Behavioral Treatment through In-Home Telehealth for Young Children with Autism
Project Number: R40 MC 22644
Grantee: University of Iowa
Department/Center: Pediatrics / Carver College of Medicine
Project Date: 9/1/2011
Scott Lindgren, PhD
Iowa City, IA 52242-1083
- Toddlerhood (13-35 months)
- Early Childhood (3-5 years)
- Middle Childhood (6-11 years)
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.
Listed is descending order by year published.
Suess AN, Romani PW, Wacker DP, et al.. Evaluating the treatment fidelity of parents who conduct in-home functional communication training with coaching via telehealth. Journal of Behavioral Education, 23, 34-59.
Wacker DP, Lee JF, Dalmau YC, Kopelman TG, Lindgren SD, Kuhle J, Pelzel KE, Waldron DB. Conducting functional analyses of problem behavior via telehealth. J Appl Behav Anal. 2013 Spring;46(1):31-46. doi: 10.1002/jaba.29. PubMed PMID: 24114083.
Wacker DP, Lee JF, Padilla Dalmau YC, Kopelman TG, Lindgren SD, Kuhle J, Pelzel KE, Dyson S, Schieltz KM, Waldron DB. Conducting Functional Communication Training via Telehealth to Reduce the Problem Behavior of Young Children with Autism. J Dev Phys Disabil. 2013 Feb 1;25(1):35-48. Epub 2012 Nov 11. PubMed PMID: 23543855; PubMed Central PMCID: PMC3608527.
Autism, Developmental Disabilities, Telehealth, Rural, Access to Health Care, Early Intervention, Health Care Costs, Stress, Special Health Care Needs, Social & Emotional Development