Examining the effectiveness of telehealth as a model of training parents of children with ASD in behaviour analytic interventions

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by difficulties in social communication behaviour and restrictive patterns of behaviour. ASD is a complex diagnosis and various levels of support may be required, as such individualised provisions are recommended, which should be based upon high quality research. Provisions grounded in Applied Behaviour Analysis (ABA) have a strong evidence base of being able to successfully provide this support. ABA in the applied branch of the science of behaviour analysis. Tactics based upon ABA have been shown to create socially significant behaviour change and greatly improve the lives of people diagnosed with ASD and their families. Unfortunately, a potential increase in prevalence of ASD and a lack of available expertise has often meant such provision is not available. These shortages are particularly felt globally and in remote areas of well served countries. A potential solution to fill the gap between service need and availability is telehealth. Telehealth uses communication technology to provide remote training and intervention services. There is a growing body of evidence supporting its use to provide ABA-based provision to individuals diagnosed with ASD. This thesis aimed to investigate this delivery platform further. Firstly, a systematic literature review was conducted to identify the status of research in this area, primarily focusing on research outcomes, aims, procedures, participants and quality. This review allowed for the identification of gaps in the literature surrounding international research, which led to the formulation of the main applied project. This project used a telehealth training platform to provide training in naturalistic teaching strategies to five parent/child dyads. Utilising a multiple probe design across participants measures of parent fidelity and child communication behaviour were collected and displayed to demonstrate a functional relation between the training provided and changes in targeted behaviours. Additionally, parent feedback and child affect were measured to provide indications of both parent and child social validity. The research provided a unique contribution to the field by demonstrating the successes of an international training project where both trainer and participants were located outside of the US. The second applied study presented in this thesis provided an extension to the main applied study. Two sets of parent/child dyads participated, both parents resided in a different country from the trainer. The project was extended to include parents who had undertaken theory-based training in ABA and the training was extended to incorporate mand, tact and intraverbal verbal operants. This was a unique contribution to the field, as previous research had only focused on reporting the mand operant in isolation.