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This can be done either in written, audio, or video format. To choose audio or video, click the + sign below to add new comment. Then click on the ... to choose a particular feature. Make sure to comment on one other person's post within this section.

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This can be done either in written, audio, or video format. To choose audio or video, click the + sign below to add new comment. Then click on the ... to choose a particular feature. Make sure to comment on one other person's post within this section.

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This can be done either in written, audio, or video format. To choose audio or video, click the + sign below to add new comment. Then click on the ... to choose a particular feature. Make sure to comment on one other person's post within this section.

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Feasibility of ABA therapy via telehealth

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Feasibility of ABA therapy via telehealth

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During the period of lockdowns due to the COVID 19 pandemic, many of the services including healthcare services were offered exclusively through online or web (telehealth). ASD related interventions through caregivers too were offered over the web. Therefore, this research article explores the feasibility/usability of the telehealth modalities of EBP such as ABA therapy as a long-term adoption of services. The purpose of the study is to find more on the following main themes:

1.       The compounded stress on caregiver (parent/guardian)

2.       The challenge in scheduling of sessions

3.       The adequacy of dosage or the frequency of sessions

4.       The choice of telehealth programs delivery

The result of the study indicates that services such as ABA therapy over the web (telehealth) is usable, feasible, and acceptable by caregivers.  Overall, the compounded stress on caregivers seems to decrease due to increased sense of efficacy and therefore more satisfaction. One of the key challenges include scheduling of therapy sessions. The caregivers are indifferent regarding the choice of telehealth delivery and dosage. Their choice rather is on the focused programs which could be both direct coaching and module-based learning.

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Treatment of problem behaviors, teaching communication skills, teaching early social skills, skill acquisition, and development of transition and employment are five chosen topic areas as a part of telehealth intervention. All these areas come under the applied behavior analysis or ABA therapy which is widely accepted EBP. Although the study is mainly focused on the delivery of the EBP services via telehealth, if the caregivers are empowered with tools to intervene, direct impact could be transmitted towards their family member with ASD. Since individuals with ASD are with their caregivers most of the time, it can help them on a daily basis in all the above-mentioned areas.

The study suggests that there is an increased sense of competency among the caregivers. This means the interventions learned through telehealth are working and helping their family members with ASD. Probably this is the same reason, the caregivers feel an increased sense of efficacy and satisfaction in caregiving.

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Joint attention intervention as an EBP

https://www.youtube.com/watch?v=hlMyr7nR02o

There are many ways to help develop a child’s joint attention. The above link demonstrates one way to help develop joint attention in individuals with ASD. In the video, a blue flashlight is used. When flashed upon a target, visual stimulation is evoked. This calls for an engagement into the activity in expectation for joint attention.

When two individuals focus on the same thing, it could be called a joint attention. Joint attention is one of the key skills to achieve the developmental milestones of a child such as bases of language, communication, and social interaction. Often individuals with autism lack joint attention skills and hence face difficulty in language development, delay in communication and challenges in social interactions with others. In fact, lack of joint attention is also considered one of the diagnostic criteria for ASD.

Similarly, joint attention is the basic learning skill to acquire any new skills in life. When one can communicate, use language, and socialize, the problem behaviors could be decreased. Acquiring life skills through learning can be beneficial to self-regulate and navigate about regular settings where social cues are typically followed.

Modeling as an EBP

https://www.youtube.com/watch?v=-fYuMzA9Js8

The above link is a video that demonstrates a step-by-step process on how to brush teeth. The video is attempting to model other children to follow the child in the video.

Modeling could be showing anything to teach them how to perform an activity. The activities of daily living (ADL) are an important part of getting by on a daily basis with one’s life. Similarly, hygiene on a regular basis such as washing your hands and brushing teeth are very important. Caregivers (parents) are usually the first person to model. This is a direct modeling. Other direct modeling can be performed by peers, teachers, therapists, and practitioners.

Video modeling is also becoming popular because many of the times caregivers (parents) run out of ideas and search on the web. Modeling on the web comes in the form of videos. Since individuals with ASD usually like screen time, it creates opportunities for modeling. Moreover, videos can be repeated as many times as it takes unlike a real person.

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This article discussed 2 studies utilizing telehealth therapy sessions to determine how caregivers find session most useful. During COVID, parents took the role of hands on therapist while being guided through programming. The adjustment to technology and new scheduling had its challenges.
The purpose of the study was to focus on priority skills during session for the student. As parents are guided to run programs, their knowledge of ABA increases, and the stress of dealing with maladaptive behaviors decrease.

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Iterative Development of Caregiver-Implemented Behavioral Intervention via Telehealth (Summary and Purpose)

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Iterative Development of Caregiver-Implemented Behavioral Intervention via Telehealth (Summary and Purpose)

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The study was focused on the overall feasibility of telehealth interventions with ABA Therapy Services.  It consisted of two studies with the first one looking at the usability of caregiver-ran telehealth intervention as rate using questionnaires by in-service BCBAs and caregivers.  It also looked at the effect of measurable stress on the caregivers when dealing with behavior intervention after trainings via tele-health.  The second study focused on  what choice of tele-health programs the families preferred when given the option.  The results from study one showed that the tele-health option for interventions proved to feasible with families with having some barriers such as scheduling as well as technological problems when trying to conduct said interventions. When looking at study 2, the results showed that caregivers preferred the method of tele-health interventions via a more focused programs  over what was considered a more extensive modulated program due to time as well as detailed learning that the focused module offered.

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The EBPs used in this study consisted of ABA Therapy via Telehealth as whole in regards to a form of intervention for individuals with autism, but more specifically the use of behavior intervention skills by caregivers, functional communication training, teaching social skills as well as transitional procedures for those with ASD moving into “real-world” situations.  The impact that these all have on individuals with ASD is that it directly impacts the rate in which they gain skills and are shown correct replacement behavior interventions from their respected caregivers.  This also impacts caregivers in that it is giving them the necessary tools to implement specific behaviors interventions safely and effectively which automatically affects the child or individual with ASD.

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https://www.youtube.com/watch?v=QagYZsX5dwY

This first resource is a mock ABA Parent Training via telehealth (without the client present).  This resource helps show and give ideas about what a telehealth parent training should look like for behavior intervention planning and follow through.  This would in my work with individuals with ASD by not only giving me ideas on how to conduct a parent training via telehealth but also it helps support the positivity and feasibility of telehealth sessions with and without clients present.  It supports that parents can learn behavior interventions to implement with their children over telehealth in times of COVID but also if that works best for their schedule.

https://www.youtube.com/watch?v=xnLuUp33Yys

This resource is a video of a BCBA talking about what telehealth is, how it benefits clients, parents and clinicians as well as the ethics it keeps and can promote even though it is conducted online.  This video is also helpful as it produces additional back-up resources and articles to support the demand and feasibility of telehealth. The most interesting part of the video in my opinion was learning about the ethics behind conducting a telehealth sessions as I feel this might be overlooked in that we use computers and tablets in our every-day lives with rarely having to get consent.  This resource helps promote client dignity for our clients with ASD receiving services which aids in our work in all aspects of programming, running trials, collecting behavior data, as well as conducting telehealth sessions.

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The purpose of this study was to investigate the feasibility of behavioral interventions done via telehealth. The study focused on 3 aspects; usability and feasibility of the program, effect on stress of the caregiver and a choice in the telehealth program in regards to dosage.

The results of the study indicated that the telehealth program was usable and feasible for the participants. However, both the participants and the BCBA's that were coaching the caregivers rated the practicality of the program lower due to time and scheduling. The results also suggested that after completing the program caregivers had a reduction in stress and frustrations which led to an increase in overall motivation.
The study also indicated that when given the options to choose the program, the majority of the participants chose a "focused" group that was similar to the original group but had condensed content and a maximum of two videoconferencing meetings with a BCBA that totaled 5 hours.

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The study gave the participants five intervention topics that included; treating problematic behavior, teaching communication, teaching early social skills, skill acquisition and the development of transition and employment plans. All of the intervention topics used Applied Behavioral Analysis or ABA as the core EBP. ABA is a widely used EBP today for individuals with autism.
Although the study did not go into depth about what those interventions looked like, the study talked extensively on the impacts and outcomes that the overall program had on the caregivers of those individuals.
Caregivers were given resources and provided with videoconferencing with BCBAs that would assist in the implementation of the given interventions. The majority of the caregivers reported decrease in stress and an overall increase in efficacy and satisfaction with their caregiving after the program. The caregivers were able to learn and implement the behavioral interventions which helped not only the individuals with autism but also their families as a whole. Parental involvement in the implementation of the interventions is a great opportunity not only for the caregivers to become educated but to also provide an opportunity for the interventions to be used more in the home rather than just in a school or clinical setting.

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The first resources that I am sharing is the EBP of Incidental Teaching.
Incidental teaching is a strategy that uses ABA to provide learning opportunities that the individual is interested in.  This article explains what incidental teaching should look like and how to implement it.
In the autistic support classroom that I am currently working in we are conducting incidental teaching with a new kindergartener in our classroom. He is extremely reluctant to sit and complete anything that is in front of him! When he does find interest in a toy or book we usually are counting or naming colors that are associated with what he is interested in.
https://www.fau.edu/education/centersandprograms/card/documents/incidentalteaching.pdf

The second resource that I am sharing is an instructional and informational video on implementing task analysis.
Task analysis is when teaching a task is broken down into smaller steps so that the individual can learn more easily.
Task analysis is used more commonly to teach life skills such as brushing your teeth, washing your hands and putting on clothes.
Task analysis could assist students complete many different tasks in the classroom such as toileting and learning new procedures for the classroom and school in general.

https://www.youtube.com/watch?v=HHb-B_7h_c4

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The purpose of this article is to discuss the development if behavioral intervention delivered vis telehealth. There are 2 studies included in this article. Study 1 investigate the feasibility and usability of the intervention delivered via telehealth and study 2 evaluate which program caregivers would choose when given different options and combination of program structure.

Study 1 evaluate the behavior intervention via telehealth based on three feasibility aspect which are usability and feasibility of the program, effect of the program on caregiver stress, and choice of telehealth dosage. The results of this study are analysed from survey , The Parenting Sense of Competence completed by the caregiver, coach. The results suggest that behavior intervention via telehealth is usable and feasible for caregivers, increase sense of efficacy and caregiving satisfaction while decreasing the caregiver’s stress.

Study 2 investigate how caregivers would choose when given three different program consists of online modules, videoconferencing with BCBA-Ds and different hours of training. Based on the choices selected by the caregiver, it can conclude that direct coaching via telehealth may be an indispensable part of behavioral intervention via telehealth which more resources or teaching are required in training interventionist via telehealth.

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The EBP mentioned in this article is Applied Behavior Analysis (ABA). ABA has been considered as the most effective, evidence based treatment option for individual with ASD. In this article, ABA intervention and teaching strategies including prompting, shaping, chaining are taught to caregivers via telehealth. By teaching caregivers ABA strategies, they could apply to their child who has ASD whenever appropriate such as at home, park, supermarket, etc. This increase the opportunities for the child to practice and apply learned skills and enhance generalization. Also, it helps reduce caregiver’s stress and frustration when facing challenging behavior, especially during this pandemic period of COVID-19. Moreover, it may be difficult to send child to receive direct ABA service. ABA intervention via telehealth would be a good choice to keep the child learning with the cooperation of both caregivers and the interventionist.

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1.  "Telehealth and Autism: Treating Challenging Behavior at Lower Cost"

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4727312/

This research investigate whether it is feasible and effective to train parents to implement ABA via telehealth.The result suggests that caregiver can successfully implement functional analysis and functional communication training via remote video coaching and there are no significantly difference between in person or via telehealth. I see another possibility in my work which is to implement intervention or teaching via telehealth since the result in this research showed the effectiveness and accountability of telehealth in delivering ABA service. Also, using telehealth is a lower cost intervention that may be suitable for some families who consider the financial aspect.

2.

https://www.youtube.com/watch?v=4HKHQaSPoKo

This is a video of ABA telehealth parent training recorded during real training session. In this video, there are two scenarios with  the same family and the BCBA. The BCBA are teaching the parent to teach her kid to follow commands. The function of the problem behavior in the first and second part of the video are escape from demand and attention seeking respectively. From this video, I have an idea on the steps to do ABA telehealth parent training such as giving clear instruction of what the parent could do at that moment. For example, when the little boy left his seat when given the coloring task. The BCBA would ask mum to physically hold the boy and guide him back to the seat, restate the command and tell the boy he could have his reinforcer after coloring. Also, the BCBA keeps giving praise and feedback to the child’s mum to reinforcer her for engaging in this parents training.

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The article describes the telehealth interventions focused on one specific topic selected by the caregiver. As these programs are guided by a BCBA, parents receive direct strategies to practice with their child during session and within the household.
Treating problem behavior is vital for anyone that may need to de-escalate a tantrum or have proactive strategies in place before maladaptive behaviors reach their peak. Teaching communication skills builds a repertoire of phrases/sign language for students to practice and utilize on the daily basis. Once a consistent form of communication is developed, it s expected that maladaptive behaviors will decrease. I find skill acquisition to be an ongoing teaching process that will change as the need for new activities and adapting to new environments.

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This resource is an example of how parents can be used to prompt and reinforce their child while involved in session. The child is in a seat, in close proximity to parent, and focused on the activity. The therapist primes the mother to assist with finding the correct answer, and praises her verbally when she finds the correct answer.

I would use a style of programming similar to the video and have pre-made slideshows with the stimuli. Running programs for students on the spectrum is difficult on telehealth if the flow of session is paused often. The reinforcement used is usually a tangible but if the therapist can only give verbal praise, planning with the rewards/breaks with the parents prior would be vital to skill acquisition.

https://www.abaparenttraining.com/home/2022/2/8/why-is-parent-training-important-in-aba-applied-behavior-analysis
This resource details the importance of parents involvement in sessions. Building professional relationships with teachers and BCBAs to feel confident about practicing new skills is most important. Nurturing the parent-child relationship can strengthen maintenance and generalization of skills learned within sessions.

I believe that within my in home therapy I can have more empathy for parents and focus on the skills they find most important. I find it most difficult to have full parent participation without hesitation when services are introduced.

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ABA Direct Session with Parent Facilitator (Behaviorbabe)

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Purpose: To explore the practicality of ABA interventions through telehealth, and the benefits it lends to both the individual with as ASD as well as their caregiver, in order to develop an acceptable and effective tele-health model. There were 2 separate studies done over a 2 year period. Study 1 focused on the feasibility of caregiver coaching via tele-health in a particular skill by focusing on 3 main areas which included the overall usability and feasibility of the program, how the program effects the caregiver’s stress, and the choice of tele-health dosage. Study 2 focused on the caregiver’s choice out of 3 different tele-health programs offered.

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The EBP focused in this study was ABA therapy. In this study, ABA resources were provided through tele-health. The caregivers were able to choose one specific intervention area and learn effective implementation skills. This enabled caregivers to use the strategies they learned and apply them in their everyday life of caring for their individual with ASD. The technology of tele-health educational delivery allows caregivers to gain a stronger sense of confidence in their own care-giving abilities. By receiving the ABA therapy guidance in the comfort of the caregiver’s home, it adds another level of capability, as well as adding a sense of contentment to the individual with ASD. Both the individual as well as the caregiver benefit greatly from this particular EBP. It’s also important to note another positive impact this EBP (more importantly the delivery of it) was that the caregiver’s stress was found to be reduced after completing the program. The overall patient care always takes priority, and so ABA therapy proves to deliver yet again.

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https://www.youtube.com/watch?v=CsDtdMhcWJ8

This webinar video conducted by a BCBA provides some tips and tricks for ABA tele-health sessions, and what to expect. Specifically this focuses on how to prepare for them, and why it is so important for parents to be trained in ABA.

Though I am not currently working with any individuals with ASD, I am better equipped with why these sessions are vital for caregivers to gain competency in practicing ABA therapy with their individual with ASD. This video only further demonstrates how practical telehealth sessions are.

https://www.youtube.com/watch?v=c23GwTuUeqo

This video discusses parent training in applied behavior analysis. The benefit of using distance education models (tele-health) are mentioned. Online training has proven to be very effective. Power points, parent training curriculums, video models, and video conferencing can all be used. It explains how to use an online training platform, and also provides a checklist for creating a platform.

This was a clear outline on parent training. I can better explain why parent involvement is so important, and provide information on distance education as a source of how to lead parent training.

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When there is limited access to services in an area, telehealth calls have been means to facilitate therapy or treatments for individuals with ASD. With COVID outbreaks, there was an increase in using telehealth calls to facilitate therapy. There were two studies conducted. In the first study, the purpose was to evaluate the feasibility of telehealth programs when it comes to content and targeted skills. Study one results state that the program was overall usable and feasible. The second study indicates caregivers choice of programs. Those program options include 10 hour training with online modules and video conferencing, focused program counting 5 hour training of modules and video conferencing, and online modules only contains 5 hours of training. The study two results state that about 76% of caregivers chose the focused module.

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The study used EBP’s when coaching the caregivers in targeted skills. There were several cohorts that data was taken from to provide accurate data. The impact of the evidence based practices allowed for the caregivers to be provided the best coaching experiences. Caregivers gaining this experience allows for a higher success rate in the studies.

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I found this study very interesting because of the need for telehealth services due to client/paraprofessional cancellation. Telehealth is now a much more feasible means of therapy when there are constraints on schedules. This study discusses the "quality and feasibility for delivering training

to caregivers of children with ASD.”

The purpose of the study was to assess the effectiveness of telehealth as a modality for delivering services. The goal of services is for a learner to become self-sufficient and capable in all areas of life. The paraprofessional delivers evidence based practices with the goal of the learner being able to achieve success without a paraprofessional present. The same goes for providing EBP and training to the caregivers of learners with ASD. The study discussed how it is hard to determine "what portion of knowledge gain came from the precession video modules and which came from the more time- and personnel-intensive sessions with BCBAs."

The goal of the study is for caregivers to have access to training on EBP that increases their caregiving ability. The studies in this article showed that delivering training via telehealth was effective however it was hard to work around schedules to deliver training to the caregiver.

Neely, Leslie C., et al. “Iterative Development of Caregiver-Implemented Behavioral Intervention via Telehealth: A Focus on Feasibility.” Perspectives of the ASHA Special Interest Groups, vol. 7, no. 2, 2022, pp. 295–309., https://doi.org/10.1044/2022_persp-21-00219.

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https://ascendautism.com/autism-treatment-programs/telehealth-autism-treatment/

This is a link to an autism group's page and provides a basic overview of tele-health and ABA. I really like how straight-forward the information about tele-health is. The agency also did a breakdown of what is beneficial about tele-health ABA and what is needed for it to be completed. This would be beneficial to me because I can direct caregivers, staff, and even individuals if needed to the page so they can review how tele-health would work or can be beneficial. With my job, many clients that I work with are older so the idea of tele-health visits is sometimes scary to them and their caregivers as an alternative to the in-person methods most are familiar with.

https://www.verywellhealth.com/telemedicine-for-autism-5214013

This is another informative article that I found that can be beneficial for both the caregiver and the client. It breaks down what tele-health is and why it can be beneficial to those receiving services through this method. I liked how the article did go over some drawbacks as well but overall explained that there are more positives than negatives for most individuals. It also went a bit in-depth of what services work well with tele-health for autism and what ones an in-person method may be best. This would aid in my work with individuals with ASD because it is a great resource that can be used to explain tele-health to supports, caregivers, parents, or the individual themselves. I like how the article provides links to other relevant information at the end and the ease of use of the site.

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Behavioral therapy utilizing the principles of Applied Behavior Analysis (ABA) as a scientifically proven, evidence-based treatment for those diagnosed with autism spectrum disorder (ASD) has been heavily researched and proven to be effective across a number of service delivery models, including telehealth.

With the advances and greater access to video communication technology, it's easier than ever before to communicate across great distances at any time of day.

Here at Ascend Autism, we dedicate ourselves to providing the highest quality of care and treatment and making it accessible to all.

Telehealth or telemedicine for autism treatment can shorten waiting lists, overcome geographic issues, and provide more schedule flexibility for families. Parents and children can turn to our telehealth services and receive the same quality of care while accessing therapy remotely.

What Is Telehealth Treatment for Autism?

With the rise of stay-at-home orders in light of the COVID-19 pandemic, one positive aspect to arise has been the wider use of information technology to connect individuals. Sometimes called telemedicine, telehealth uses video-conferencing and streaming communication technologies through computer web cameras, tablets, or smartphones so individuals can access health care services remotely.

Telehealth is not a distinct treatment but rather a service or means to deliver treatment and support just as in-person care does. By using HIPAA-compliant video conferencing systems, telehealth guarantees privacy as we at Ascend Autism provide remote services to the child with ASD, their parents, and caregivers.

One of the primary treatment modalities utilized at Ascend Autism is Applied Behavioral Analysis or ABA. ABA focuses on teaching skills and modifying behaviors under the direction of a Master's level behaviorist. The practice asserts that desired behaviors can be taught through a system of incentives and disincentives. By using positive reinforcement, ABA applies behavioral principles to behavioral goals and then carefully measures results to adjust treatment as necessary.

How Telehealth Treatment Works

Telehealth treatment involves the use of technology to connect patients and healthcare providers. Platforms like Zoom, Skype, and FaceTime allow individuals to connect through video, while online chats might be used for brief discussions. During the COVID-19 pandemic, as people are encouraged to socially distance from one another, telehealth has proven to be an effective way of connecting people with their doctors and therapists.

Telehealth treatment for autism has also become popular this year, both for parents and for their children. Children with ASD can attend virtual sessions with their therapist, and parents can receive support and training from their own homes.

Benefits of Telehealth Autism Treatment

Without question, the primary benefit of using telehealth in behavior therapy and ABA, in particular, is enhanced access. Whether it is due to geography, availability of therapists, or barriers that inhibit a therapist from entering your home, telehealth treatment removes all of these obstacles and opens the door to the same quality of interactive, behavior therapy sessions focused on communication, social skills, and daily living skills.

Other benefits of telehealth treatment include:

Increased supervision and communication: Telehealth treatment provides therapists the opportunity for additional supervision hours to supplement their time providing in-home supervision.

Schedule flexibility: Children with ASD may require more schedule flexibility according to their needs. Telehealth treatment allows for adaptability with treatment.

Improved patient outcomes and satisfaction: By increasing the frequency of supervision and communication with patients and caregivers, therapists can modify treatment plans and interventions more frequently, as well as regularly conduct training with direct-support professionals.

At Ascend Autism, our experts walk parents and caregivers through best practices as part of our standard parent training program and provide a foundation for further telehealth sessions.

Requirements for Telehealth for Autism Treatment

For telehealth to be effective, individuals need to meet only a few practical requirements:

Online or live video streaming requires a secure and reliable internet connection.

Parents or caregivers need to have a stable device through which they can see and speak with their therapist. This is typically a desktop computer, laptop, tablet, or smartphone.

Once you have met the hardware requirements, then it becomes necessary to turn your attention to the space around you.

An advantage of t elehealth for autism treatment is that the individual can receive therapy in the comfort of their home. This still means one has to be prepared and organized:

Try to set aside a clear block of time as you would for any appointment and establish a clear space within your home that is free from distractions.

As children become more familiar with the process, the various treatments and programs will become part of a more easily embraced routine.

Contact Us to Learn More About Telehealth for Autism Treatment

Telehealth for autism treatment has numerous benefits. It meets the challenge presented by limited access to care. It also provides families with the necessary flexibility to get the treatment needed.

Ascend Autism understands the need to have as many resources as possible to address the unique issues facing families and individuals with ASD. One way we do this is through our telehealth services. Using online live streaming and conferencing, we can equip and empower parents and caregivers. We can also provide the therapy, guidance, and treatment an individual needs even if they cannot leave their home.

Ascend Autism's experts are here to help parents sift through the information and find just what they need. We have an array of services for treating autism spectrum disorder and commit ourselves to help children and families. For instance, we offer the following:

Reach out to our knowledgeable and compassionate staff today by calling 877.323.8668 or completing our convenient online form. Learn more about the resources and treatment that we can provide to help support you and your family today.

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Behavioral therapy utilizing the principles of Applied Behavior Analysis (ABA) as a scientifically proven, evidence-based treatment for those diagnosed with autism spectrum disorder (ASD) has been heavily researched and proven to be effective across a number of service delivery models, including telehealth. With the advances and greater access to video communication technology, it's easier than...

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During the COVID-19 pandemic, many if not most individuals found themselves going from an in-person method of work, activities, meetings, appointments, etc. to one that was virtual. In the world of therapies this was no different. Caregivers, parents, and the individual with ASD often found that their typically in-person therapy session needed to be conducted virtually via tele-health to protect everyone from potential illness. Over the past two years, even though it is coming to a point where things are going back to being in-person, there has been a shift in some preferring the tele-health method of therapy and agencies being more comfortable with implementing this method of therapy. The purpose of this study was to look at two different studies that were conducted over two years within a host study with a goal of developing a usable tele-health model by focusing on different aspects of behavior intervention by tele-health. The three aspects of behavioral intervention that were looked at were usability and feasibility of the program as rated by caregivers and coaches, effect of the program on caregiver stress, and choice of telehealth dosage.

The results of the study did show that caregivers felt a sense of increased efficacy and satisfaction due to them feeling competent in what they were utilizing. They did feel a decrease in overall stress but there were concerns seen with some issues with scheduling the tele-health visits into a daily schedule and that caregivers did prefer that the tele-health visits be more focused or limited compared to more comprehensive. Tele-health visits are beneficial but it is important that the caregivers feel comfortable with becoming the in-person clinician since they are most often the one completing the tele-health visit with the client. There also needs to be a usable and feasible process for utilizing tele-health services.

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The article discusses the use of module training for caregivers on “a) treatment of problem behavior, (b) teaching communication skills, (c) teaching early social skills, (d) skill acquisition and (e) development of transition and employment plans.” The first EBP that deals with “treatment of problem behavior” would be the use of Antecedent-Based Interventions (ABI) and Differential Reinforcement of Alternative, Incompatible, or Other Behavior (DR). Antecedent based interventions are used to change what happens prior to the problem behavior to eliminate problem behavior. This can change a child with ASD’s life by looking at the ABC’s of a problem behavior. Antecedent based interventions help with altering the environment. For example a child who is sensitive to light may present problem behavior in the presence of bright lights. If it is possibly to change this, it can change how not only how the child reacts but how they are able to function the rest of the day.

Another EBP that can be used to teach communication skills is Functional Communication Training. FCT provides the child with a functional form of communication to get their needs met. If a child is used to screaming to get their needs met, the child can be taught to say “No I want ____” instead of screaming. This changes their life by giving them a means of communication that does not cause stress of caregiver and is a much more appropriate response. AAC’s are also another means of communication for nonverbal learners. This is a HUGE impact on the lives of learners because it gives them the ability to communicate functionally.

An EBP for skill acquisition would be direct instruction (DI) and DTT (discrete trial training.) Discrete trial training is a great tool to help learners acquire new skills.

An EBP for development of transition and employment plans would be video modeling and video supports. As learners reach high school age and transition to college and beyond they need explicit visual instruction to help them do their everyday tasks.

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Resource 1:
https://www.fielding.edu/the-4-pillars-of-evidenced-based-coaching/
I found this resource to be interesting. "Evidence Based Coaching" talks about the 4 pillars, theory, coach, core competency, and client. It explains how EBP can be used when coaching someone using these pillars to ensure that the client is set up for success. I found that it related a lot to tele-health calls.
Resource 2:
https://www.youtube.com/watch?v=QNkTICCOp_w
I only had the opportunity to watch a few clips of this webinar, but it was a huge insight on how coaching as an evidence based practice benefits our clients.

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In 1995, Thomas Leonard started the International Coach Federation (ICF) as a nonprofit organization for the coaching community. In 1999, accredited coach training programs were formed and by 2018, there were over 25,000 credentialed coaches and just over 1,000 Master Certified Coaches. The profession continues to grow and with that growth, new distinctions continue to surface.

The term evidence-based coaching was introduced in 2003 to demonstrate how professional coaching is anchored in empirical and theoretical knowledge versus what others may describe as loosely constructed trends in pop psychology.

In 2005, Fielding Graduate University began its accredited coach training program and was one of the first to include the evidence-based theoretical underpinnings. Fielding believes four pillars support coaching evidence.

First, theories from multiple disciplines helped birth the profession, and their integration into coaching practice is essential.

Second, we subscribe to the ICF core competencies and believe that coaching development should be grounded in this knowledge.

Third, the coach is an instrument of change and knowledge. When coaches self-regulate with an awareness of self, they can be highly effective in creating growth and development in others.

Last, the client brings a great deal of knowledge to the coaching engagement and successful coaches' partner with their clients by understanding them in their full context.

Fielding Graduate University incorporates the pillars into the EBC curriculum in the following ways.

Pillar #1: Theory

Our fundamental role as a coach is to help create awareness with our clients. With awareness comes choice and a new mindset that help people realize they are not bound by either/or thinking or self-imposed limiting beliefs.

What distinguishes Evidence-Based Coaching from other types is the coach's knowledge of theories, models, and associated tools that underpin our professional work. Theories explain human behavior or phenomenon in ways that help people understand they are not alone. Models help determine courses of action or ways of thinking and tools equip us to do or decide as we face challenges in our adult development.

One of the reasons the EBC program includes so many different theories and approaches is that we want EBC graduates to create a large toolbox to draw from for specific situations that may arise in coaching engagements. Fielding does not believe there is just one theory, model, assessment, or set of tools that work in every situation. Studying theories provides coaching with solid underpinning that is academic and evidence-based.

Depending on the type of coaching you decide to pursue, you will create your own personal toolbox, starting with the materials that you learn during the EBC program. As you become more familiar with these tools and models, you will be able to draw on them during a coaching conversation to provide insight for yourself and the client. Articles, books, videos, handouts, and other materials can also serve as persuasive homework that you can give your clients for further self-reflection.

Over time, as you begin to integrate theory and models into your coaching practice, you will develop your own favorite tools. Your work as a coach is to keep learning, growing, and staying open to different ways of doing this work. You might even find yourself developing your own methods.

Pillar #2: Core Competency

The ICF defines coaching as partnering with clients in a thought-provoking and creative process that inspires them to maximize their personal and professional potential. Originally there were eleven core competencies grouped into four categories. The ICF Global Board has approved a revised competency model that will go into effect in early 2021. There are now eight core competencies, and Fielding Graduate University is incorporating these into the EBC curriculum to ensure graduates are grounded in the competencies that will help them gain ICF credentials.

1. Demonstrates Ethical Practice

2. Embodies a Coaching Mindset

3. Establishes and Maintains Agreements

4. Cultivates Trust and Safety

5. Maintains Presence

6. Listens Actively

7. Evokes Awareness

8. Facilitates Client Growth

A great deal of time in the EBC program is dedicated to learning and practicing the ICF core competencies. They serve as a foundation of your coaching practice that you will build on throughout your career. With practice, these eight will be so hard-wired in your coaching, you will demonstrate them without self-conscious effort. They will move from front of brain to the back of brain and will guide all your client interactions. Fielding Graduate University intends for you to know the competencies so well that down the road when you pause to give your client advice or interrupt to tell them something from a consulting perspective, you do it with full awareness. You will then consciously pivot back into your role as a coach, inviting your client to respond to your perspective. As is said, you must know the rules before you can break them.

Pillar #3: The Coach (use of self)

Skillful coaching starts with the coach's self-awareness and having a deep understanding of one's own personal identity, strengths, values, character, ethics, weaknesses, biases, and interests. One powerful way to do this is through personal reflection and feedback. The EBC program provides many opportunities for you to be a reflective practitioner and share your learning with others in a way that inspires everyone's growth. Over time, as you develop your professional identity as a coach, you will also get clarity on the type of clients you want to serve. Additionally, you will gain a better understanding of your personal interests in certain types of coaching, whether that be life coaching, executive coaching, business coaching, academic coaching, wellness coaching, or others. The use of self also includes being clear about what are your own issues versus the issues of your clients. This includes monitoring your reactions to what a client says or is trying to do. Knowing your triggers and hot buttons help separate your developmental work from your client's work.

Pillar #4: The Client

Coaching is inherently client-centered. This means the coach's agenda is always in service of the client's agenda. For this reason, developing a coaching agreement at the beginning of a coaching session is critical. The coach needs to empower the client to determine the topic and the desired outcomes of coaching. Our clients also have unique contexts and intersections. They are never dealing with just one issue because no one experiences one-issue lives. Coaches must respect the client's professional and personal settings and explore things from their perspective. This requires coaches to believe what the client says when they say they are struggling, not to question why they have a certain belief, but instead to explore how that belief serves them or blocks them from what they most want. Coaches also have to ensure they serve their clients in socially just ways. The core competencies will help coaches maintain presence and listen well to what the client needs.

In summary, the four pillars of Evidence-Based Coaching are critical for skillful coaching, and developing in these areas requires a lifelong journey. In time, you will determine your favorite theories and methods that align with your interests and your clients' needs. Remember, coaching above all else, is about growth and managing change. There is no shortage of clients who need professional coaches, and your education and commitment to evidence-based approaches will serve you well as you pursue your coaching career.

Resources:

International Coach Federation https://coachfederation.org/core-competencies
Stober, D.R., & Grant, A.M. (2006). Evidence Based Coaching Handbook: Putting Best Practices to Work for Your Clients. San Francisco, CA: Wiley.

Contributors:

Dr. Carrie Arnold
Dr. Terry Hildebrandt
Dr. Leni Wildflower

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The 4 Pillars of Evidenced-Based Coaching

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4 Pillars of EBC In 1995, Thomas Leonard started the International Coach Federation (ICF) as a nonprofit organization for the coaching community. In 1999, accredited coach training programs were formed and by 2018, there were over 25,000 credentialed coaches and just over 1,000 Master Certified

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EBP’S - Using ABA to find the Function of behavior

https://masteraba.com/functions-of-behavior/

This video discusses the functions of behavior including access and escape. Learners often want to gain access to something or to escape something. Knowing the function of a behavior would aid in my work with children with ASD in that I would be able to respond appropriately. A learner I worked with may have a behavior that starts out as a way of gaining access or attention and then over time is used to avoid or escape. For example, a nonverbal student may scream because they want access to something and then over time they notice that whenever they scream they are able to escape tasks they don’t want to do. So in this case it is important to identify what the function or the multiple functions of behavior are. To identify the antecedent, behavior and consequences of the behavior in different situations. As a result of identifying the function behavior, I can teach my learner an alternative way to either gain access or an alternative behavior to escape.

Functional Communication Training

https://www.youtube.com/watch?v=WQHypB48x3I

This video was created by Virginia Commonwealth University’s Autism Center for Excellence. In this video, Functional Communication Training is defined. FCT is a way to get your needs met and to advocate for yourself. The video also discusses how learners with ASD may use verbal speech to communicate and some may not. It’s important to know the different types of communication modes. In my career as a paraeducator I have used PECS (picture exchange communication system) and I am also learning how to use sign language. Communication is a critical foundational skill especially for the preschool age learners that I work with. A key detail of this video that I plan to use in my work is the use of a system based on the student’s strengths. It does not make sense to use PECS with a learner who does not understand visual picture symbols. They may understand sign language which is a more universal language. It’s important to let the learner lead in choosing a communication method. It’s also important to partner with other professionals including the SLP in implementing a communication method that is right for the learner.

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How To:  Intro to Functional Communication

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ABA therapy was the EBP of focus for this study. Resources were provided by the clinician via tele-health to the caregiver, parent, support, etc. to utilize with the client. There were different means of intervention that were available to work on the skill of interest such as mand training, video prompting, and person-centered care. By having the caregiver be the provider of the service by learning the skills needed to implement them, they were able to find ways to use them with the individual in different aspects of their life and environments.

The impacts of the EBPs on individuals with ASD would be that they can be selected to target a specific skill to acquire but once completed, can often be utilized in other aspects of the individual's life. Video modeling for example can be used in a home environment to show how to brush their hair and can also be used in a community environment of how to cross a street. Communication skills can be taught with the Functional Communication Training (FCT) which was in the article to provide them with a form of communication that is more appropriate to get their needs met. This form of communication can be used in different environments for the individual or can be adapted to fit the environment that they are in.