Presentation by Lashanna Brunson, MS, BCBA, Research Coordinator, Parent Implemented Training for Autism through Telemedicine, Center for Excellence in Disabilities, West Virginia University
2. Purpose of PITA-T
• Provide access to Applied Behavior
Analysis (ABA) therapy to families of
children with Autism Spectrum
Disorders in rural Appalachia
3. ABA and Autism
• Evidence based best practice
• Structured learning environment
• Break large skills into small
components
• Individualized programming based on
needs
• Data-based decision making
6. Barriers to Service Delivery
• Technological Barriers
• Less computer access in rural areas
• Relatively poor internet connectivity
• 45% of West Virginians use internet
connections with speeds below federal
minimum broadband standards (Speed Matters
Report, 2010)
7. Barriers to Service Delivery
• Economic Barriers
• 17.5% of WV residents live in poverty
• Extremely expensive
8. Overcoming Barriers
• Teach parents to implement discrete
trial training (DTT) techniques
• Behavior analysts can reach a larger
geographical area
• Use asynchronous telecommunication
to provide instructions and feedback
• Eliminates need for high-speed internet
9. Our Families
• Children under 5 years old with an
Autism Spectrum Disorder
• Live in:
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West Virginia
Kentucky
Pennsylvania
Ohio
Virginia
Maryland
10. The Process
• Phone screening
• Intake
• Assessments
• Materials
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Video camera
Tripod
Memory cards
Postage paid envelopes
11. The Process
• Mail training materials
• Parents record sessions and mail to
staff
• Staff review sessions and mail
feedback
• Exit assessments
12. Challenges to Implementation
• Many children not diagnosed early
• Expand eligibility age
• Share autism fact sheet
• Parental adherence to taping
procedure
• Create weekly schedule
• Reminder phone calls
• Monthly drawing
13. Preliminary Findings
• Parents learning to implement DTT
• Feedback is necessary
• Potential for child improvements not
enough to maintain treatment efforts
• Greater adherence when video
instructions and feedback were provided
14. THANK YOU!
This study is supported by grant R40MC20444
from the Maternal and Child Health Bureau
(Combating Autism Act of 2006), Health Resources
and Services Administration, Department of Health
and Human Services
Collaboration between Center for Excellence in
Disabilities & WVU Department of Psychology
Editor's Notes
Introduction – Research Coordinator for the Parent Implemented Training for Autism through Telemedicine study
Early and intensive intervention can:Result in significant improvements in:Core symptoms & functional skills of individuals with autism (Green, 1996; Lovaas 1987; McEachin, Smith, & Lovaas, 1993)Decrease problem behavior
Over 50 years of researchEvidence based best practice by US Surgeon GeneralPositive reinforcementRepetition
Provider ShortagesLimited number of Board Certified Behavior Analysts (BCBAs)Geographic BarriersDistribution of behavior analysts uneven across the stateMountainous terrainPoor roads and infrastructure
Gray are BCBA’s working at university –training up new BCBAs or doing other things – not practitioners working with children with autismLeaves 12 possible practitioners, but no guarantee all are working with children with autism
Communications Workers of America
Economic barriersTravel to and from training centerAssistance with passage of Autism Insurance Reform, but not all families are covered by this and still a lack of personnel
Through written instructions & feedback or video instructions and feedbackAsynchronous because all of state does not have high speed internetAllows for regular parent-professional contact without high-speed internetFree to parents
Will diagnosis if don’t have a diagnosis
Intake completed onsite in MG or CharlestonADOS, DP3, PSI – provide parents with camera, tripod, memory card, postage paid envelopes
Write individualized programs and mail training materialsContent same, format differentCycle continues until parents reach 80% criteria level on DTTEF or have been in study for a yearAll the training and materials the parents receive are provided free of charge