This study is designed to improve access to appropriate behavioral services for young children (ages 1 to 6 years) with autism spectrum disorders. The major research goal is to evaluate the effectiveness and efficiency of conducting behavioral treatment for autism through a telehealth network to reach underserved areas of a rural state. Our prior research has demonstrated that parents can be successfully trained to conduct functional behavior analysis (FA) and functional communication training (FCT) to reduce the disruptive behavior of young children with autism and other developmental disabilities. The current proposal evaluates a service delivery model in which telehealth is used by behavioral specialists to """"""""coach"""""""" staff and parents at regional health centers across a rural state to assess and treat the disruptive behaviors displayed by young children with autism.
The specific aims of this study focus on testing whether functional analysis and functional communication training, conducted through telehealth coaching, is effective in reducing disruptive behavior and increasing positive social behaviors in young children with autism spectrum disorders. Providing greater local access to behavioral procedures with expert consultation from a remote site should increase families'opportunities to obtain behavioral services in a cost-effective and timely manner, which is an urgent public health need in rural states that face a scarcity of trained behavioral specialists. The current project thus represents an investment in the statewide infrastructure needed to more effectively serve children with autism and their families.

Public Health Relevance

Autism is a neurodevelopmental disorder that results in marked difficulties in social interaction, communication, and repetitive behavior. With a prevalence as high as 1 in 150 children (Centers for Disease Control and Prevention, 2007), autism spectrum disorders represent a serious public health challenge. The proposed research will study the effectiveness of delivering behavioral treatment for autism through telehealth methodology, which has the potential to overcome barriers that limit access to care in rural and other underserved areas. The results of the proposed study should provide an evidence base on which to expand behavioral treatment options for families of children with autism spectrum disorders.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Research Project (R01)
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Special Emphasis Panel (ZMH1-ERB-B (A1))
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Juliano-Bult, Denise M
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University of Iowa
Schools of Medicine
Iowa City
United States
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Romani, Patrick W; Schieltz, Kelly M (2017) Ethical Considerations When Delivering Behavior Analytic Services for Problem Behavior via Telehealth. Behav Anal (Wash D C) 17:312-324
Lindgren, Scott; Wacker, David; Suess, Alyssa et al. (2016) Telehealth and Autism: Treating Challenging Behavior at Lower Cost. Pediatrics 137 Suppl 2:S167-75
Wacker, David P; Lee, John F; Padilla Dalmau, Yaniz C et al. (2013) Conducting Functional Communication Training via Telehealth to Reduce the Problem Behavior of Young Children with Autism. J Dev Phys Disabil 25:35-48
Wacker, David P; Lee, John F; Dalmau, Yaniz C Padilla et al. (2013) Conducting functional analyses of problem behavior via telehealth. J Appl Behav Anal 46:31-46