Evaluating Practical Functional Assessment and Skill-Based Treatment for Severe Challenging Behavior via Telehealth with Novice Dual Parent Implementers: A Pilot Investigation

Practical functional assessment and skill-based treatment (PFA/SBT) is increasingly recognized as a safe and efficient behavioral assessment and treatment approach for severe challenging behaviors commonly exhibited by children with autism spectrum disorder (ASD). Few studies, however, have evaluated the safety, efficiency and acceptability of implementing PFA/SBT procedures by coaching caregivers via telehealth, particularly for caregivers with no prior experience and training. In this pilot single-case investigation, the mother and father of a 6-year-old autistic girl who exhibited severe challenging behaviors were individually coached in weekly one-hour sessions via telehealth to implement PFA/SBT procedures with their child over 12 weeks in their home. The child’s father was subsequently coached to implement a treatment extension with the child in weekly one-hour telehealth sessions conducted over an additional 12-week period. Neither parent had prior training or experience implementing behavioral interventions with their child. Results showed that both parents implemented the intervention with high fidelity and that dangerous forms of challenging behavior rarely occurred during the treatment period. Both parents rated the intervention as highly acceptable. These results demonstrate that parents with limited knowledge and experience of behavioral principles can be successfully coached to implement PFA/SBT procedures via telehealth safely, efficiently, and with high fidelity.