This study provides preliminary information about the efficacy of a telehealth applied behavior analytic (ABA) program. The intervention consisted of coaching caregivers (e.g., parents), via telehealth, to use ABA strategies to address three caregiver-selected goals. We evaluated the efficacy of the intervention using a pilot randomized controlled trial design, with an intervention and waitlist-control group. Nineteen children diagnosed with autism spectrum disorder (ASD), age 3 to 12 years old, and their caregivers participated in all phases of the study. We used five pre- and post-test measures to understand program efficacy. We did not find statistically significant differences on four of these measures, including the confirmatory measure (the Goal Attainment Scale). We did however find statistically significant improvements on the Vineland-3, favoring the intervention group. Single-case effect sizes from time series data suggested most individualized goals showed improvement. Furthermore, high caregiver intervention fidelity, the short duration of the program (i.e., 8 weeks), and the social validity data indicate the intervention may be feasible and acceptable in many contexts. Further research, including larger-scale evaluation of this type of program is warranted.

Children with developmental delays are more likely to experience difficulties in social-emotional skills and challenging behavior, which can lead to poor long-term outcomes if left untreated. The purpose of this literature review was to synthesize the literature related to home-based interventions to address social–emotional skills and challenging behavior. A systematic review of the literature resulted in the identification of 26 single-case design studies and 31 group design studies that evaluated a home-based intervention to improve social–emotional skills or challenging behavior for young children with a disability or delay. The most common interventions implemented were differential reinforcement, functional communication training, and antecedent-based interventions. Data based on the quality of experiment, characteristics of participants, and characteristics of interventions were analyzed. Fewer than half of the studies (41%) met design standards with or without reservations. However, the majority of studies that met design standards demonstrated strong or moderate evidence for the efficacy of the intervention (67%). Overall, the literature indicates caregivers can accurately implement established evidence-based practices with their young children to improve social–emotional skills and challenging behavior. Implications for practice and future research directions are discussed.

Schedule thinning following functional communication training is an important element of behavior analytic interventions targeting the reduction of challenging behavior. We systematically searched the literature for all applications of schedule thinning following functional communication training and identified three primary thinning techniques. These schedule thinning techniques include multiple schedules, chained schedules, and delay-to-reinforcement. We further analyzed the highly effective applications, meaning only those with a 90

Functional communication training (FCT) is an effective intervention to decrease challenging behavior. However, the continuous reinforcement of mands commonly implemented within FCT is difficult to implement in natural settings. Schedule thinning using a multiple schedule arrangement addresses this barrier, yet most studies evaluating this approach have been conducted in clinical environments and using implementer-arranged stimuli to signal reinforcer availability. The purposes of the current study are to (a) evaluate the effectiveness of caregiver-implemented multiple schedules in the home setting with caregiver coaching via telehealth and (b) evaluate the effectiveness of transferring stimulus control from caregiver-arranged to naturally occurring stimuli to signal reinforcer availability within a multiple schedule arrangement. The results indicated FCT was effective in reducing challenging behavior and increasing manding. For one participant, discriminated manding was established with caregiver-arranged stimuli within 7 sessions and transferred to naturally occurring stimuli with a three-step fading procedure across 33 sessions. For the other participant, discriminated manding was established with the caregiver-arranged stimuli within 21 sessions and transferred to naturally occurring stimuli with a three-step fading procedure across 23 sessions. Both caregivers implemented FCT and multiple schedules with fidelity. Given the preliminary nature of the results, more research is needed to determine if this strategy is effective and if there is a more efficient approach to teach discrimination of naturally occurring stimuli.

The trial-based functional analysis (TBFA) offers several advantages in natural settings, such as time efficiency and ecological validity. Previous studies have successfully trained or coached a variety of professionals and parents to conduct a TBFA utilizing in-person training procedures; however, no study has evaluated the effectiveness of telehealth coach or train others to implement a TBFA. Utilizing telehealth coaching, we coached three mothers of children with autism to conduct a TBFA in their home. The TBFA identified consequences maintaining challenging behavior for all three participants. Based on the results of the TBFA, we developed a functional communication training (FCT) intervention. Experimenters coached the mothers to implement the FCT intervention in their home. All interventions resulted in decreased challenging behavior and increased communication. The results suggest parents are capable of conducting a valid TBFA with telehealth coaching and support.

Video activity schedules are a type of video-based instruction that combines video modeling with activity schedules. To the authors’ knowledge, there has not been a comprehensive synthesis of this intervention for teaching autistic people. The purpose of this review was to synthesize the current single-case research and evaluate the methodological quality and rigor, and the outcomes, using the Single Case Analysis Review and Framework (SCARF; Ledford et al. http://ebip.vkcsites.org/scarfv2 , 2016). A systematic search of three databases was conducted for studies evaluating the intervention with autistic participants. A total of 76 studies with 199 participants met our inclusion criteria. Results of the review indicated that research is primarily conducted with adolescent and adult aged males who were taught daily living skills. Race/ethnicity information was not reported for over half of the studies. Most of the studies were conducted in a school setting, but implemented by the researcher. Overall, the results of the SCARF indicated that the studies were of high quality. Identified areas for future research are to include younger autistic participants, teaching academic or play/leisure skills, and the inclusion of race/ethnic information to further understand for whom this intervention is most effective for. Limitations and further implications for research are discussed.

Functional communication training (FCT) is a highly effective intervention to reduce challenging behavior. However, continuous reinforcement of the functional communicative response typically used during FCT cannot be maintained in natural settings. Reinforcement schedule thinning addresses this drawback. In order to better inform practice and future research, we conducted a systematic review of all peer-reviewed studies published between the years 1985 and 2022 that implemented schedule thinning following FCT. We identified 82 articles with 296 participants and 401 applications of schedule thinning. We summarized each application according to characteristics of the participant, FCT, and schedule thinning procedure. We identified nine unique schedule thinning procedures. The four most prevalent were multiple schedules, chained schedules, delay-to-reinforcement, and response restriction with a correlation between the function of challenging behavior and the selected schedule thinning approach. Notably, there was great procedural variability across each procedure. Very few studies were conducted in natural settings or involved natural change agents in selecting the terminal schedule of reinforcement or as schedule thinning implementers. Although there is ample evidence supporting the efficacy of schedule thinning after FCT, more research is needed to determine the most effective procedures necessary to ensure that the benefits of FCT can be maintained via schedule thinning in natural settings.

Children with autism spectrum disorder (ASD) often experience skill deficits that can negatively affect long-term outcomes. Interventions based on applied behavior analysis (ABA) yield improvements in targeted skills. However, families often have difficulty accessing ABA services. The purpose of this study was to evaluate the efficacy of a caregiver coaching program delivered via telehealth. Thirty children with ASD and their caregivers (e.g., parents, grandparents) participated in all phases of the study. The program consisted of therapists providing coaching in English or Spanish to caregivers of children with ASD via synchronous video call telehealth visits, typically provided one to two times per week. Caregivers received coaching in interventions (e.g., functional communication training, discrete trial teaching, total task chaining, and naturalistic teaching) to address individualized goals. We collected data on caregiver treatment fidelity and child outcomes (i.e., Vineland-3, observation, and analysis of time series data). Caregivers implemented intervention procedures with 95% accuracy on average. The single-case effect sizes calculated based on the time series baseline and intervention data yielded medium, large, or very large improvements for 85% of goals addressed. Results indicated that the children improved on appropriate engagement (measured via observation), but there was no statistically significant improvement for the remaining pre-post measures. These results, along with the results of previous studies, provide preliminary support for the use of telehealth to provide ABA services. However, there is a need for additional research evaluating the efficacy of these types of programs.

Current research has identified poor post-school outcomes for individuals with intellectual and developmental disabilities; in fact, poorer than any other disability group. Employment support, such as vocational skill training can improve outcomes and increase opportunities for paid employment. With recent advances in technology, a myriad of technology devices and programs offer relatively inexpensive and portable forms of support to vocational training programs. Moreover, today's ubiquitous use of technology allows for the use of technology supports in a way that may not be as stigmatizing in the work setting relative to more traditional forms of support. The purpose of this review is to summarize the literature regarding the use of technology in vocational skills training programs. Articles identified via a systematic search of the literature are summarized according to (a) participant characteristics, (b) vocational skills, (c) intervention characteristics and (d) outcome measures. Sixty studies were identified as providing vocational skills training through the utilization of a technological device and are discussed. Additionally, trends in intervention components, considerations for practitioners, and areas for future research are discussed.