Background:
The application of technology is changing the way in which medical and clinical services are delivered today. Select telehealth technologies can revolutionize clinical care, integrating providers across many systems of care (schools, outpatient treatment centers, and hospitals), and provide new methods for data acquisition and longitudinal follow-up. As part of a national Operational Assessment project for the U.S. Air Force, Intermountain Center For Autism and Child Development (ICACD) and four other autism service agencies used Behavior Imaging, a store and forward telehealth technology for behavior treatment, in order to show benefit in terms of remote consultation for families with children and adolescents with autism spectrum disorders.
Objectives:
Assess if remote supervision of behavior treatment with Behavior Imaging can enhance the delivery of ABA services, and evaluate system utility, usage, perceived effectiveness, strengths, and limitations.
Methods:
Thirty-three families were recruited for this study. Each had at least one child with autism who was a TRICARE beneficiary (TCB), and was receiving applied behavior analysis (ABA) services at home or in a clinical environment. The family and tutors were provided a novel Behavior Imaging technology to use in their homes free of charge. Families, ABA tutors, and ABA therapy supervisors from 5 sites could use live (synchronous) web-conferencing and / or an asynchronous approach that allowed them to record, annotate, tag, and share video clips of sessions via Behavior Connect, a secure online consultation and collaboration platform. Supervision was provided to designated tutors as well as family members who delivered ABA therapy when tutors were not available. Pre-study and post-study questionnaires were administered to clients and therapists in order to evaluate system utility, usage, perceived effectiveness, strengths, and limitations.
Results:
Results from the national assessment indicated that remote supervision of treatment delivered in the home setting with Behavior Imaging can enhance the delivery of ABA services, and can enable service providers to modify their clinical protocol to be effective without as frequent in-person visits.
Conclusions:
More meaningful and as needed frequent contact with patients and their family allows providers to better understand their patient and meet the needs of the family. More control of patient flow in a clinic allows for more patients to be seen. The use of Behavior Imaging requires comfort with these technologies and recognition of what is beneficial during remote consultation.