Pilot Test of a Model for Remote Provision of Evidence-Based Services for Rural Families of Children with Autism Spectrum Disorder
Early Intensive Behavioral Intervention (EIBI) is recommended as an intervention of choice for young children with Autism Spectrum Disorder (ASD), but services can be challenging for many families to access. Research suggests that Caregivers have the ability to acquire and implement intervention strategies with their children with ASD. Video-teleconferencing can be used to teach Caregivers to use a naturalistic language intervention and remote technology can also be used to train Early Interventionists (EIs) on Caregiver coaching strategies.
The objectives of this pilot study are to evaluate the feasibility and impact of using a remote consultation model to train Caregivers and EIs in non-rural and rural areas on evidence-based strategies.
Approximately 90 families will be provided with services following participation in a psychological evaluation for ASD. Families of children under three who are referred by Tennessee Early Intervention System (TEIS) to Vanderbilt Kennedy Center’s Treatment and Research Institute for Autism Spectrum Disorders (TRIAD) for a psychological evaluation and are living in any county within the Greater Nashville and South Central districts of Middle TN are eligible. All participating families receive two home-based evaluation support sessions led by a professional in the field of applied behavior analysis which include focused consultation and training on evidence-based practices for children with ASD.
Families residing in select counties are eligible for expanded services, including two additional home visits. These families are already receiving services from an EI through TEIS. Participation of the EI in these two sessions is required to ensure the training of the EI in evidence based behavior analytic strategies is adequate. During these sessions, the Consultant will work with the Caregiver and EI to implement strategies recommended previously. The service will also include two bi-weekly clinic visits that will include the EI, Caregiver and remote attendance of the TRIAD Consultant. Remote clinic visits are held at a community clinic closer to participants’ homes than the TRIAD clinic. During these two visits, the TRIAD Consultant will remotely observe interactions while providing feedback and recommendations in real-time for EI and Caregiver. The EI will continue to serve the family throughout the TRIAD service and consult with the TRIAD Consultant remotely. Following the completion of the service, remote consultation will be provided to the EI for up to two hours per month for six months or until the child turns three years old.
Behavioral and social validity data will be collected on skill acquisition by the child, skill acquisition by Caregivers and EI’s, and Caregiver and EI satisfaction with services.
Preliminary results indicate that Caregivers and EIs are satisfied with the services that they receive. In addition, Caregivers are able to implement interventions to promote skill acquisition. Finally, EIs implement strategies learned with 75-100% of their other clients.
See attached preliminary data for additional information.
Preliminary data is not complete enough to allow conclusions to be drawn. Data will continue to be collected through April 2016. We anticipate a total of twelve participants in this pilot study by that date.