1. Treating Severe Behavior Problems via Telehealth
David P. Wacker and Alyssa N. Suess
The University of Iowa Children’s Hospital

2. Acknowledgements
R40 HD from the Health Resources and Services Administration of the U.S. Department of Health and Human Services
R01 HD from the National Institute of children Health and Human Development of the National Institutes of Health.
R01 MH from the National Institute of Mental Health of the National Institutes of Health
R01 MH from the National Institute of Mental
Health of the National Institutes of Health

3. The Evolution of Telehealth at UICH
Regional Clinic Telehealth Project
Outpatient Clinic Telehealth Project
2014-Present
In-Home Telehealth Project (Multi-Site)
In-Home Telehealth Project

4. I. Regional Clinic Telehealth Project
Wacker, D. P. , Lee, J. F., Padilla Dalmau, Y. C., Kopelman, T. G., Lindgren, S. D., Kuhle, J., Pelzel, K. E., & Waldron, D. B. (2013). Conducting functional analyses of problem behavior via telehealth. Journal of Behavior Analysis, 46, 1-16.
Wacker, D. P., Lee, J. F., Padilla Dalmau, Y. C., Kopelman, T. G., Lindgren, S. D., Kuhle, J., …Waldron, D. B. (2013). Conducting functional communication training via telehealth to reduce the problem behavior of young children with autism. Journal of Developmental and Physical Disabilities, 25,

5. The Evolution of Telehealth at UICH
Regional Clinic Telehealth Project
Outpatient Clinic Telehealth Project
2014-Present
In-Home Telehealth Project (Multi-Site)
In-Home Telehealth Project

6. II. In-Home Telehealth Project
Purpose
Evaluate and treat problem behavior of young children with autism via telehealth directly in their homes
Randomized clinical trial of FCT
Immediate treatment and wait-control
Sites
Parents and children were in their homes
Behavior analysts at the telehealth center at UICH
Procedures
FA and matched FCT program
Parents implemented all of the procedures with coaching provided via telehealth
Weekly 1-hr visits

7. Site Locations

8. Technology
Home
Telehealth Center

9. Escape Session of FA

10. Initial FCT Session

11. Later FCT Session

12. FA and FCT Results
40 children completed FA with identified social function
– Avg. number of sessions to complete FA =
21.2 (range, 12 to 38)
34 out of 36 completed FCT
– Average reduction in problem behavior was %

13. The Evolution of Telehealth at UICH
Regional Clinic Telehealth Project
Outpatient Clinic Telehealth Project
2014-Present
In-Home Telehealth Project (Multi-Site)
In-Home Telehealth Project

14. III. Outpatient Clinic Telehealth Project
Purpose
Provide brief behavioral consultation via telehealth to those families waiting for an in-vivo evaluation
Integrate telehealth services into our existing caseload for our
outpatient clinic
Sites
Parents and children traveled to a regional autism center
Behavior analysts at the telehealth center at UICH
Procedures
FA and matched FCT program
Parents implemented all of the procedures with coaching provided via telehealth
1-hr FA visit; 3 15-min FCT visits

15. Site Locations
Telehealth Center
Regional Autism Center

16. FA Results
Suess, A. N., Wacker, D. P., Schwartz, J. E., Lustig, N., & Detrick, J. (accepted). Preliminary evidence on the use of telehealth in an outpatient behavior clinic. Journal of Applied Behavior Analysis.

17. FCT Results

18. The Evolution of Telehealth at UICH
Regional Clinic Telehealth Project
Outpatient Clinic Telehealth Project
2014-Present
In-Home Telehealth Project (Multi-Site)
In-Home Telehealth Project

19. IV. In-Home Telehealth Project (Multi-Site)
Purpose
Evaluate and treat problem behavior of young children with autism via telehealth directly in their homes
Randomized clinical trial of FA
Evaluate the effectiveness of a pragmatic version of telehealth
Procedures
FA and matched FCT program
Parents implemented all of the procedures with coaching provided via telehealth
1-hr weekly visits

20. Collaboration Across Three Sites