Technology has played a tremendous role in the growth of teletherapy as a method for delivering high-quality, medically-necessary services to individuals and their families when accessibility presents as a barrier. There are a variety of behavioral health services that can be delivered via teletherapy, a technology that can be useful when delivering services such as Applied Behavior Analysis (ABA) therapy to children with Autism Spectrum Disorders (ASD) and their families.
More recently, technology has proven to be a vital instrument in the delivery of parent and caregiver training. In fact, parent training expands beyond the parents/caregivers to community providers within the patient’s macrosystem. The ongoing COVID-19 pandemic has served as a catalyst for the use of technology as a method to deliver parent training services with ease. As a result of the increase in technological options, parent training services have not only become more accessible to families, but practitioners have experienced an increase in parent participation, in addition to the development of a safe and comfortable space for both parents and providers to communicate openly. With the rapid advancements of technology, practitioners will likely have software at their disposal that will help to support the clinician-client relationship and enhance the delivery of evidence-based services via videoconferencing to individuals across the globe.
The stay-at-home orders issued across the country in response to the COVID-19 pandemic have increased the demands of ABA service delivery to patient and their families in the home setting via teletherapy. By offering teletherapy services to clients and families, medically-necessary services are made available while continuing to keep families safe.
There are benefits to delivering services outside of clinic or office setting. Through teletherapy, providers are able to observe and gain a better understanding of both the patient’s and family’s needs in the home and provide guidance and support to the parents as they work with their child in-vivo. Parent training isn’t, however, limited to providing parents/caregivers with direct instruction. It can also incorporate education specific to evidence-based strategies and how these interventions can be used with their child on a daily basis or as problems arise. With easier accessibility of parent education services via teletherapy modalities, parents/caregivers can participate in many different environments, including at home, during breaks at work, or even while waiting in the car while their child receives therapy services.
Providers have observed that parents/caregivers appear to be more willing to communicate and participate during trainings. This is most likely related to parents and caregivers receiving therapy in a safe and more relaxed environment such as sitting in their favorite chair at home with their favorite cup of coffee or tea. Teletherapy has become a stimulus to help create a safe and comfortable space for both parents and providers to communicate more freely and openly.
As providers we know that accessibility to parent education can sometimes be difficult due to having to schedule time that is best for both the clinician and the parent/caregiver. As a part of ABA therapy services, parent education is an essential part of the child’s treatment plan with specific parent goals targeted. Often this involves in-vivo training, where parents/caregivers go into therapy settings or providers go into the child’s home to work jointly in the implementation of these strategies with the child in order to increase independent skills and decrease maladaptive behaviors in the home and community settings.
The COVID-19 pandemic caused significant restrictions to be placed on nonessential businesses, including all educational settings, and ultimately resulted in families having to comply with stay-at-home orders. This produced a major disruption in the daily lives of families and particularly those with children diagnosed with autism since all in-person ABA services, including parent training, had to be halted.
One might think that requiring the parent/caregiver to set more time aside to participate in parent training might cause an increase in cancellations; however, providers started to experience an increase in parent participation as the parents needed more help navigating the changes at home and helping their child to be more successful and independent with daily living skills. Providers were able to model and instruct on how to complete daily living skills and routines through videoconferencing and the use of various technologies. Due to the increased support during the pandemic via teletherapy modalities, parents are more eager to attend parent training sessions, even when in-person sessions were reestablished. Providers have ultimately seen lower cancellation rates and even when a schedule conflict arises, parents/caregivers and providers have been able to reschedule appointments due to the flexibility of the delivery model.
There is no doubt that technology advancements have increased accessibility and adherence to treatment for many families across the globe. Individuals and their families living in remote areas of the United States have experienced a greater sense of connection with their communities and have likely made long-lasting relationships. Resources that were not an option in the past are now attainable. Therapies that historically were delivered in-person are now equally effective when delivered via teletherapy. The footprint of teletherapy is significant enough to ensure that it remains available to all individuals; therefore, it is important to legislate for the continuation of teletherapy as a modality of delivering evidence-based practices.
Dr. Solandy Forte is a licensed social worker and doctoral-level behavior analyst, Jenna Cornwall is a behavior analyst, and Janelle Vilitski is a behavior analyst for Milestones Family Services at Milestones Behavioral Services in Manatee County, Florida. To view more information about their services, you may visit www.mbs-inc.org. You may contact Dr. Forte at sforte@mbs-inc.org and Jenna Cornwall at jcornwall@mbs-inc.org or call them at (203) 306-0821. You may contact Janelle Vilitski at jvlitski@mbs-inc.org or (484) 868-8976.
