Telehealth and Autism: Treating Challenging Behavior at Lower Cost

TLDR

The study aimed to assess whether telehealth training of parents to deliver ABA can effectively reduce challenging behavior in young children with autism and other developmental disabilities at lower cost. The authors compared outcomes and costs of ABA delivered via in‑home therapy, clinic‑based telehealth, and home‑based telehealth to 94 children with autism or other neurodevelopmental disorders. All three delivery models achieved over 90% reduction in problem behavior with high parent acceptability, and home‑based telehealth was the least costly, demonstrating that parent‑led ABA via telehealth can effectively treat behavior problems in autism at lower cost and reduce geographic barriers.

Abstract

OBJECTIVE: To determine whether challenging behavior in young children with autism and other developmental disabilities can be treated successfully at lower cost by using telehealth to train parents to implement applied behavior analysis (ABA). METHODS: We compared data on the outcomes and costs for implementing evidence-based ABA procedures to reduce problem behavior by using 3 service delivery models: in-home therapy, clinic-based telehealth, and home-based telehealth. Participants were 107 young children diagnosed with autism or other neurodevelopmental disorders, and data analysis focused on the 94 children who completed treatment. RESULTS: All 3 service delivery models demonstrated successful reduction of problem behavior by training parents to conduct functional analysis and functional communication training. The mean percentage reduction in problem behavior was >90% in all 3 groups after treatment, and treatment acceptability based on parent ratings was high for all groups. Total costs for implementing treatment were lowest for home telehealth, but both telehealth models were significantly less costly than in-home therapy. CONCLUSIONS: This research demonstrated that parents can use ABA procedures to successfully treat behavior problems associated with autism spectrum disorders regardless of whether treatment is directed by behavior consultants in person or via remote video coaching. Because ABA telehealth can achieve similar outcomes at lower cost compared with in-home therapy, geographic barriers to providing access to ABA for treating problem behavior can be minimized. These findings support the potential for using telehealth to provide research-based behavioral treatment to any family that has access to the Internet.