Parent Implemented Training for Autism through Telemedicine


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Presentation by Lashanna Brunson, MS, BCBA, Research Coordinator, Parent Implemented Training for Autism through Telemedicine, Center for Excellence in Disabilities, West Virginia University

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  • Introduction – Research Coordinator for the Parent Implemented Training for Autism through Telemedicine study
  • Early and intensive intervention can:Result in significant improvements in:Core symptoms & functional skills of individuals with autism (Green, 1996; Lovaas 1987; McEachin, Smith, & Lovaas, 1993)Decrease problem behavior
  • Over 50 years of researchEvidence based best practice by US Surgeon GeneralPositive reinforcementRepetition
  • Provider ShortagesLimited number of Board Certified Behavior Analysts (BCBAs)Geographic BarriersDistribution of behavior analysts uneven across the stateMountainous terrainPoor roads and infrastructure
  • Gray are BCBA’s working at university –training up new BCBAs or doing other things – not practitioners working with children with autismLeaves 12 possible practitioners, but no guarantee all are working with children with autism
  • Communications Workers of America
  • Economic barriersTravel to and from training centerAssistance with passage of Autism Insurance Reform, but not all families are covered by this and still a lack of personnel
  • Through written instructions & feedback or video instructions and feedbackAsynchronous because all of state does not have high speed internetAllows for regular parent-professional contact without high-speed internetFree to parents
  • Will diagnosis if don’t have a diagnosis
  • Intake completed onsite in MG or CharlestonADOS, DP3, PSI – provide parents with camera, tripod, memory card, postage paid envelopes
  • Write individualized programs and mail training materialsContent same, format differentCycle continues until parents reach 80% criteria level on DTTEF or have been in study for a yearAll the training and materials the parents receive are provided free of charge
  • survey parents for suggestions
  • Parent Implemented Training for Autism through Telemedicine

    1. 1. Lashanna Brunson, M.S., BCBA West Virginia University Center for Excellence in Disabilities
    2. 2. Purpose of PITA-T • Provide access to Applied Behavior Analysis (ABA) therapy to families of children with Autism Spectrum Disorders in rural Appalachia
    3. 3. ABA and Autism • Evidence based best practice • Structured learning environment • Break large skills into small components • Individualized programming based on needs • Data-based decision making
    4. 4. 27 Board Certified Behavior Analysts 1 15 1 2 4 2 2
    5. 5. 12 Potential Practitioners 1 14 1 1 2 4 2 2
    6. 6. Barriers to Service Delivery • Technological Barriers • Less computer access in rural areas • Relatively poor internet connectivity • 45% of West Virginians use internet connections with speeds below federal minimum broadband standards (Speed Matters Report, 2010)
    7. 7. Barriers to Service Delivery • Economic Barriers • 17.5% of WV residents live in poverty • Extremely expensive
    8. 8. Overcoming Barriers • Teach parents to implement discrete trial training (DTT) techniques • Behavior analysts can reach a larger geographical area • Use asynchronous telecommunication to provide instructions and feedback • Eliminates need for high-speed internet
    9. 9. Our Families • Children under 5 years old with an Autism Spectrum Disorder • Live in: • • • • • • West Virginia Kentucky Pennsylvania Ohio Virginia Maryland
    10. 10. The Process • Phone screening • Intake • Assessments • Materials • • • • Video camera Tripod Memory cards Postage paid envelopes
    11. 11. The Process • Mail training materials • Parents record sessions and mail to staff • Staff review sessions and mail feedback • Exit assessments
    12. 12. Challenges to Implementation • Many children not diagnosed early • Expand eligibility age • Share autism fact sheet • Parental adherence to taping procedure • Create weekly schedule • Reminder phone calls • Monthly drawing
    13. 13. Preliminary Findings • Parents learning to implement DTT • Feedback is necessary • Potential for child improvements not enough to maintain treatment efforts • Greater adherence when video instructions and feedback were provided
    14. 14. THANK YOU!   This study is supported by grant R40MC20444 from the Maternal and Child Health Bureau (Combating Autism Act of 2006), Health Resources and Services Administration, Department of Health and Human Services Collaboration between Center for Excellence in Disabilities & WVU Department of Psychology