A Comparison Between Direct Telehealth and In-Person Methods of Teaching Expressive Labels to Children Diagnosed With Autism Spectrum Disorder

Abstract

Recent behavior analytic research has demonstrated that the provision of applied behavior analytic services via direct telehealth can be an effective teaching modality for some learners with autism spectrum disorder (ASD). Historically, teaching procedures based on applied behavior analysis (ABA), including discrete trial teaching (DTT), have been provided and evaluated via in-person delivery. This study sought to compare the implementation of DTT via direct telehealth to DTT implemented in-person within and across participants. Specifically, this study evaluated the two delivery modalities in terms of skill acquisition, maintenance, efficiency, and learner responding during teaching sessions. Results of an adapted alternating treatments design nested into a multiple baseline design demonstrated that all three participants diagnosed with ASD met the mastery criteria for the expressive labels taught. Areas of future research, participant prerequisite skills, and clinical implications will be discussed in the context of these results.

Keywords

telehealth discrete trial teaching autism spectrum disorder

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References

Akers

J. S.

Pyle

Higbee

T. S.

Pyle

Gerencser

K. R.

(2016). A synthesis of script fading effects with individuals with autism spectrum disorder: A 20-year review. Review Journal of Autism and Developmental Disorders, 3, 1–17. https://doi.org/10.1007/s40489-015-0062-9

Awasthi

Aravamudhan

Jagdish

Joshi

Mukherjee

Kalkivaya

Ali

R. S.

Srivastava

S. N.

Edasserykkudy

(2021). Transitioning ABA services from in clinic to telehealth: Case study of an Indian organization’s response to COVID-19 lockdown. Behavior Analysis in Practice, 14, 893–912. https://doi.org/10.1007/s40617-021-00600-9

Baer

D. M.

Wolf

M. M.

Risley

T. R.

(1968). Some current dimensions of applied behavior analysis. Journal of Applied Behavior Analysis, 1(1), 91–97. https://doi.org/10.1901/jaba.1968.1-91

Bellini

Akullian

(2007). A meta-analysis of video-modeling and video self-modeling interventions for children and adolescents with autism spectrum disorders. Exceptional Children, 73(3), 265–287. https://doi.org/10.1177/001440290707300301

Blackwell

Stockall

(2021). Incidental teaching of conversational skills for students with autism spectrum disorder. Teaching Exceptional Children, 54(2), 116–123. https://doi.org/10.1177/0040059921990405

Cihon

J. H.

Ferguson

J. L.

Lee

Leaf

J. B.

Leaf

McEachin

(2022). Evaluating the cool versus not cool procedure via telehealth. Behavior Analysis in Practice, 15(1), 260–268. https://doi.org/10.1007/s40617-021-00553-z

Colombo

R. A.

Wallace

Taylor

(2020). An essential service decision model for ABA providers during crisis. Behavior Analysis in Practice, 13(2), 306–311. https://doi.org/10.1007/s40617-020-00432-z

Conallen

Reed

(2016). A teaching procedure to help children with autistic spectrum disorder to label emotions. Research in Autism Spectrum Disorders, 23, 63–72. https://doi.org/10.1016/j.rasd.2015.11.006

Council of Autism Service Providers. (2021). Practice parameters for telehealth-implementation of applied behavior analysis (2nd ed.). Author.

10.

Cox

D. J.

Plavnick

J. B.

Brodhead

M. T.

(2020). A proposed process for risk mitigation during the COVID-19 pandemic. Behavior Analysis in Practice, 13(2), 299–305.

11.

DiGennaro Reed

F. D.

Reed

D. D.

Baez

C. N.

Maguire

. (2011). A parametric analysis of errors of commission during discrete-trial training. Journal of Applied Behavior Analysis, 44(3), 611–615. https://doi.org/10.1901/jaba.2011.44-611

12.

Dunn

D. M.

(2018). Peabody picture vocabulary test (5th ed.). Pearson.

13.

Ferguson

Craig

E. A.

Dounavi

(2019). Telehealth as a model for providing behaviour analytic interventions to individuals with autism spectrum disorder: A systematic review. Journal of Autism and Developmental Disorders, 49(2), 582–616.

14.

Ferguson

J. L.

Majeski

M. J.

McEachin

Leaf

Cihon

J. H.

Leaf

J. B.

(2020). Evaluating discrete trial teaching with instructive feedback delivered in a dyad arrangement via telehealth. Journal of Applied Behavior Analysis, 53(4), 1876–1888. https://doi.org/10.1002/jaba,773

15.

Leaf

J. B.

Cihon

J. H.

Ferguson

J. L.

Milne

C. M.

Leaf

McEachin

(2020). Comparing error correction to errorless learning: A randomized clinical trial. The Analysis of Verbal Behavior, 36(1), 1–20. https://doi.org/10.1007/s40616-019-00124-y

16.

Leaf

J. B.

Leaf

J. A.

Milne

Taubman

Oppenheim-Leaf

Torres

Townley-Cochran

Leaf

McEachin

Yoder

(2017). An evaluation of a behaviorally based social skills group for individuals diagnosed with autism spectrum disorder. Journal of Autism and Developmental Disorders, 47(2), 243–259. https://doi.org/10.1007/s01803-016-2949-4

17.

LeBlanc

L. A.

Lerman

D. C.

Normand

M. P.

(2020). Behavior analytic contributions to public health and telehealth. Journal of Applied Behavior Analysis, 53(3), 1208–1218.

18.

Lerman

D. C.

Valentino

A. L.

LeBlanc

L. A.

(2016). Discrete trial training. In Lang

Hancock

Singh

(Eds.), Early intervention for young children with autism spectrum disorder: Evidence-based practice in behavioral health (pp. 47–83). Springer. https://doi.org/10.1007/978-3-319-30925-5_3

19.

Lovaas

O. I.

(1987). Behavioral treatment and normal educational and intellectual functioning in young autistic children. Journal of Consulting and Clinical Psychology, 55(1), 3–9.

20.

Martin

N. A.

Brownell

(2011). Expressive one-word picture vocabulary test (4th ed.). Pro-Ed.

21.

Monlux

K. D.

Pollard

J. S.

Bujanda Rodriguez

A. Y.

Hall

S. S.

(2019). Telehealth delivery of function-based behavioral treatment for problem behaviors exhibited by boys with fragile x syndrome. Journal of Autism and Developmental Disorders, 49(6), 2461–2475. https://doi-org.libproxy.library.unt.edu/10.1007/s10803-019-03963-9

22.

Nohelty

Bradford

C. B.

Hirschfeld

Miyake

C. J.

Novack

M. N.

(2021). Effectiveness of telehealth direct therapy for individuals with autism spectrum disorder. Behavior Analysis in Practice. Advanced online publication. https://doi.org/10.1007/s40617-021-00603-6

23.

Nuernberger

J. E.

Ringdahl

J. E.

Vargo

K. K.

Crumpecker

A. C.

Gunnarsson

K. F.

(2013). Using a behavioral skills training package to teach conversational skills to young adults with autism spectrum disorders. Research in Autism Spectrum Disorders, 7(2), 411–417. https://doi.org/10/1016/j.rasd.2012.09.004

24.

Oblak

M. K.

(2021). An analysis of a system under pandemic conditions. Journal of Applied Behavior Analysis, 54(2), 530–546. https://doi.org/10.1002/jaba.836

25.

Pellegrino

A. J.

DiGennaro Reed

F. D.

(2020). Using telehealth to teach valued skills to adults with intellectual and developmental disabilities. Journal of Applied Behavior Analysis, 53(3), 1276–1289. https://doi.org/10.10.1002/jaba.734

26.

Peters

Tullis

C. A.

Gallagher

P. A.

(2016). Effects of a group teaching interaction procedure on the social skills of students with autism spectrum disorder. Education and Training in Autism and Developmental Disorders, 51(4), 421–433.

27.

Plavnick

J. B.

Vitale

F. A.

(2016). A comparison of vocal mand training strategies for children with autism spectrum disorders. Journal of Positive Behavior Interventions, 18(1), 52–62. https://doi.org/10.1177/1098300714548800

28.

Pollard

J. S.

LeBlanc

L. A.

Griffin

C. A.

Baker

J. M.

(2021). The effects of transition to technician-delivered telehealth ABA treatment during the COVID-19 crisis: A preliminary analysis. Journal of Applied Behavior Analysis, 54(1), 87–102. https://doi.org/10.1002/jaba.803

29.

Rodriguez

K. A.

(2020). Maintaining treatment integrity in the face of crisis: A treatment selection model for transitioning direct ABA services to telehealth. Behavior Analysis in Practice, 13(2), 291–298.

30.

Shillingsburg

M. A.

Bowen

C. N.

Shapiro

S. K.

(2014). Increasing social approach and decreasing social avoidance in children with autism spectrum disorder during discrete trial training. Research in Autism Spectrum Disorders, 8(11), 1443–1453. https://doi.org/10.1016/j.rasd.2014.07.013

31.

Sindelar

P. T.

Rosenberg

M. S.

Wilson

R. J.

(1985). An adapted alternating treatment design for instructional research. Education and Treatment of Children, 8(1), 67–76.

32.

Smith

(2001). Discrete trial training in the treatment of autism. Focus on Autism and Other Developmental Disabilities, 16(2), 86–92. https://doi.org/10.1177/108835760101600204

33.

Sparrow

S. S.

Cicchetti

D. V.

Saulnier

C. A.

(2016). Vineland adaptive behavior scales (3rd ed.). Pearson.

34.

Wacker

D. P.

Lee

J. F.

Padilla Dalmau

Y. C.

Kopelman

T. G.

Lindgren

S. D.

Kuhle

Pelzel

K. E.

Dyson

Schieltz

K. M.

Waldron

D. B.

(2013). Conducting functional communication training via telehealth to reduce problem behavior in children with autism. Journal of Developmental and Physical Disabilities, 25(1), 35–48.

35.

Weiss

M. J.

Hilton

Russo

(2017). Discrete trial teaching and social skill training: Don’t throw the baby out with the bath water. In Leaf

J. B.

(Ed.), Handbook of social skills and autism spectrum disorder (pp. 155–169). Springer.