Dissemination of Applied Behavior Analysis through Global Telepractice

Transcription

1 Dissemination of Applied Behavior Analysis through Global Telepractice Leslie Neely, Ph.D., BCBA-D, The University of Texas at San Antonio Ee Rea Hong, Ph.D., BCBA-D, The University of Tsukuba, Japan Sawako Kawaminami, The University of Tsukuba, Japan, Ileana Umaña, M. A., The University of Texas at San Antonio* 1

2 Japan and the BCBAs Early intensive intervention, founded on the principles of Applied Behavior Analysis (ABA), can mediate some of the deficits autism spectrum disorder and lead to greater independence, higher employment rates, and improved overall performance (Kuppens & Onghena, 2012; Makrygianni & Reed, 2010) There are 16 BCBA s in Japan (BACB.org) There is a need to disseminate the practice 2

3 Telepractice Telepractice includes the use of technology to enable specialists to provide services to clients when not in the same location, using the internet and other technologies. Cost effective method to provide training to multiple individuals, maximizing resources. Can be used to teach and provide feedback for the application of different skills (Heitzman-Powell et al., 2014; Hay-Hansson & Eldevik, 2013; Suess et al., 2014; Machalicek et al., 2009; Machalicek et al., 2010; Wacker et al., 2013; Vismara et al., 2009). Allows for the dissemination of training regardless of location (Wainer & Ingersoll, 2013). 3

4 Pyramidal Training Involves an expert training a small group of coaches to teach subsequent individuals (Pence et al., 2014 ). It has been effective for training staff in various settings (Jones, Fremouw, & Carples, 1977; Page et al., 1982; Pence et al., 2012; Pence et al., 2014). Can be used to teach a variety of skills (Parsons & Reid, 1995; Pence et al., 2014; and Haberlin et al. 2012). Is a cost effective method of training staff (Pence et al., 2012; Pence et al., 2014). 4

5 Purpose of this study Pilot a telepractice training package where the expert was located in the United States and the practitioners were in Japan. The skill targeted was incidental teaching 5

6 Core Elements (Kaiser, Ostrosky, & Alpert, 1993): Incidental Teaching Characterized by an interventionist capitalizing on a child s interest to construct learning opportunities within the natural context Environmental arrangement to promote learning opportunities Teaching occurs in response to child initiations Natural consequences are provided 6

7 Research Questions Research Questions: What is the effect of preparing interventionists to implement incidental teaching via pyramidal training on their implementation of incidental teaching strategies? What is the distal effect of preparing interventionists to implement incidental teaching via pyramidal training on child requesting behavior? 7

8 Methods 8

9 Methods- Participants One BCBA-D Supervisor in the United States One bilingual coach in Japan Three therapists in Japan who worked in a community-based autism clinic 9

10 Dependent Variable Therapist Fidelity Implementing Incidental Teaching Number of Communication Opportunities Offered Frequency of Child Mands 10

11 Fidelity Checklist for Incidental Teaching Instructions: This checklist includes each step of the process of utilizing incidental learning. Within the table, record a + under the description of how you think you performed the step during your 5-minute session Step Interventionist follows the learner s lead Interventionist restricts access to the stimulus Interventionist waits for learner to initiate the request for 3s before initial prompting Interventionist presents a prompt for communication (model, mand-model, gestural/physical prompt depending on the learner s needs) Interventionist delivers prompts only if the learner demonstrates interest in an item If the learner emits the targeted response, Interventionist provides access to item for at least 20s (or provides one edible if using edibles) If the learner does not emit the targeted response, Interventionist provides another model of the correct response Interventionist waits at least 3s between prompts If the learner does not emit the targeted response after the second prompt, Interventionist provides a final model of the correct response and provides access to the item Interventionist adds a final model of mand and expands model to one level above learner s current level of communication (i.e., says Can I have milk? if current performance is I have milk? All of the time Sometimes Never Not Applicable 11

12 Phase I BCBA-D supervisor worked with the bilingual coach Technologies Used Skype for videoconferencing Dropbox plus Sookasa (encrypts videos) to ensure HIPPA compliance to transfer videos between Japan and US 12

13 Procedures PowerPoint Presentation Self-evaluation and feedback session Met Criterion? Yes Move to Coaching No 13

14 Phase 2 BCBA-D supervisor trained the coach in the training procedures via skype The Coach used the same procedures to train the therapists 14

15 Procedures PowerPoint Presentation Self-evaluation and feedback session Met Criterion? Yes Finish Project No 15

16 Results & Discussion 16

17 17

18 18

19 19

20 20

21 Discussion The telepractice program was associated with increased fidelity in implementing incidental teaching for the Therapists. Results demonstrate that all of the children increased their requesting skills during intervention phase. These results suggest that delayed feedback provided via videoconferencing might be effective in training Future research might investigate this procedure with more complicated skills 21

22 Questions? Leslie Neely at 22

23 References Hay-Hansson, A. W., & Eldevik, S. (2013). Training discrete trials teaching skills using videoconference. Research in Autism Spectrum Disorders, 7, doi: /j.rasd Heitzman-Powell, L. S., Buzhardt, J., Rusinko, L. C., & Miller, T. M. (2014). Formative evaluation of an ABA outreach training program for parents of children with autism in remote areas. Focus on Autism and Other Developmental Disabilities, 29(1), doi: / Kaiser, A. P., Ostrosky, M. M., & Alpert, C. L. (1993). Training Teachers to Use Environmental Arrangement and Milieu Teaching with Nonvocal Preschool Children. Journal of the Association for Persons with Severe Handicaps, 18(3), Kuppens, S. P. E., & Onghena, P. (2012;2011;). Sequential meta-analysis to determine the sufficiency of cumulative knowledge: The case of early intensive behavioral intervention for children with autism spectrum disorders. Research in Autism Spectrum Disorders, 6(1), doi: /j.rasd Ingersoll, B. R., & Wainer, A. L. (2013). Pilot study of a school-based parent training program for preschoolers with ASD. Autism, 17(4), doi: / Jones, F. H., Fremouw, W., & Carples, S. (1977). Pyramidal training of elementary school teachers to use a classroom management skill package. Journal of Applied Behavior Analysis, 10, doi: /jaba Machalicek, W., O'Reilly, M., Chan, J., Rispoli, M., Lang, R., Davis, T., et al. (2009). Using videoconferencing to support teachers to conduct preference assessments with students with autism and developmental disabilities. Research in Autism Spectrum Disorders, 3, doi: /j.rasd Machalicek, W., O Reilly, M. F., Rispoli, M., Davis, T., Lang, R., Hetlinger-Franco, J., & Chan, J. (2010). Training teachers to assess the challenging behaviors of students with autism using video tele-conferencing. Education and Training in Developmental Disabilities, 45,

24 References Makrygianni, M. K., & Reed, P. (2010). A meta-analytic review of the effectiveness of behavioural early intervention programs for children with autistic spectrum disorders. Research in Autism Spectrum Disorders, 4(4), doi: /j.rasd Page, T. J., Iwata, B. A., & Reid, D. H. (1982). Pyramidal training: A large-scale application with institutional staff. Journal of Applied Behavior Analysis, 15, doi: /jaba Pence, S. T., St. Peter, C. C., & Tetreault, A. S. (2012). Increasing accurate preference assessment implementation through pyramidal training. Journal of Applied Behavior Analysis, 45, doi: /jaba Pence, S. T., St. Peter, C. C., & Tetreault, A. S. (2012). Increasing accurate preference assessment implementation through pyramidal training. Journal of Applied Behavior Analysis, 45, doi: /jaba Suess, A. N., Romaini, P. W., Wacker, D. P., Dyson, S. M., Kuhle, J. L., Lee, J. F., et al. (2014). Evaluating the treatment fidelity of parents who conduct in-home functional communication training with coaching via telehealth. Journal of Behavioral Education, 23, doi: /s Wacker, D. P., Lee, J. F., Padilla Dalmau, Y. C., Kopelman, T. G., Lindgren, S. D., Kuhle, J., et al. (2013). Conducting functional analyses of problem behavior via telehealth. Journal of Applied Behavior Analysis, 46, doi: /jaba.29 Wainer, A. L., & Ingersoll, B. R. (2013). Disseminating ASD interventions: A pilot study of a distance learning program for parents and professionals. Journal of Autism and Developmental Disorders, 43, doi: /s Vismara, L. A., Young, G. S., & Rogers, S. J. (2012). Telehealth for expanding the reach of early autism training to parents. Autism Research and Treatment, doi: /2012/