Function-Based Intervention with E-Coaching in Reducing Challenging Behaviors during Home Visits

Background:

Challenging behaviors present a significant barrier to learning for children with disabilities and are a source of stress for families and practitioners. Extensive research has shown that function based interventions (FBI) are effective for reducing challenging behaviors and increasing pro-social behaviors in young children with disabilities, including Autism Spectrum Disorder (Duda et al, 2008; Fettig, Schultz, & Sreckovic, 2014). Studies that compared FBI to non-function based interventions have noted distinct advantages of this approach (Ingram, Lewis-Palmer, & Sugai, 2005). Research also demonstrated that follow-up coaching and support were necessary for ensuring high fidelity implementation (Barton & Fettig, 2013). Across this literature, coaching of FBI generally involved face-to-face meetings and multiple home visits. This is costly and time and resource intensive, which might limit the amount of support practitioners receive. Few have examined the use of web-based technology (videoconferencing, texting, emails) to support practitioners (Ludlow & Duff, 2002), and this might be a feasible approach. To date, no FBI studies have examined effects of videoconferencing to support interventionists to implement intervention during home visits. Given the need for cost effective and accessible approaches, a logical next step is to investigate effectiveness of e-coaching for supporting implementation of FBI with children with disabilities and challenging behaviors.

Objectives:

This study explored the effects of an e-coaching approach within FBI for an early interventionist working with a toddler with ASD and challenging behaviors. The research questions were: was e-coaching functionally related to the interventionist’s implementation of FBI and was high fidelity of implementation of FBI related to a decrease in the child’s challenging behaviors.

Methods:

The target behaviors for this study were: interventionist’s implementation of FBI, missed opportunities for use of strategies and child challenging behaviors. The FBI was derived from the individualized behavior support plan (BSP) created with the parents and the interventionist. The BSP included strategies that supported interventionist in preventing challenging behaviors (e.g. visual cues for transition), teaching the child new skills (e.g., prompt child to ask for help) and responding to challenging and appropriate behaviors (e.g., redirection and praise).

Single subject, multiple baseline across behaviors design (Kazdin, 2011) was used to examine changes in the interventionist’s use of FBI with the introduction of e-coaching. E-coaching via Facetime^TM was introduced with the first set of FBI strategies (prevention) demonstrating baseline stability following the training sessions. Once the first behavior demonstrated stability with e-coaching, e-coaching commenced with the next set of strategies (teaching new skills and then responses to behaviors) to demonstrate baseline stability.

Results:

The results indicated that e-coaching was effective in supporting early interventionist’s implementation of FBI and high fidelity of implementation resulted in reduced child challenging behaviors. Social validity data as well as research and practice implementations will also be shared.

Conclusions:

Given the study results and the need for cost effective and accessible approaches, educators should consider using e-coaching to support the implementation of FBI with children with ASD and challenging behaviors.