Erin Mayberry, BCBA, LBA
Director of Customer Success
Kaitlin Doyle, MBA, OTR/L
TheraWe Clinical Director
There have been many questions about the effectiveness of telehealth and applied behavior analysis (ABA therapy). Telehealth is a fairly recent trend that’s becoming more popular due to social distancing restrictions.
It’s more convenient than in-person therapy in many ways. There are several ways to meet with a certified therapist through video conferencing and messaging.
Telehealth can help ABA therapy reach out to more people. For more information on the topic, here is an ABA Therapy & Telehealth FAQ.
How can telehealth help ABA therapy providers expand their practice and reach more people?
With telehealth services, ABA therapy providers are able to expand the scope of their practice. In the past therapy was mainly offered in the patient’s home, or otherwise a clinic or healthcare center.
Now, these services are able to be provided remotely.
ABA therapy providers can reach out to more people, without being restricted by the geographical area. This is a big benefit for customers. People in need of a therapist have more access to one without time or distance restrictions.
Often people can’t travel to see a therapist because of work, family, or other responsibilities. Telehealth provides an opportunity for these kinds of people who can’t get to a therapist’s office as easily.
Certain patients actually prefer remote therapy because along with being convenient, they don’t want to go see a therapist in person. Telehealth allows ABA therapy providers to reach out to these people and expand their practice.
Is telehealth approved by insurance?
This is a common question in an ABA Therapy & Telehealth FAQ. Telehealth is approved by insurance.
It will, however, depend on your payor and it can vary from state to state. It might not necessarily be approved for everyone, so it depends on each case.
Clinicians can contact the insurance company and ask whether or not telehealth is covered by their client’s specific policy.
You should ideally check with your insurer to find out how telehealth is covered by your policy.
How can you increase parent engagement when providing telehealth services?
One way to increase parent engagement when providing telehealth services is by setting appropriate expectations with the family and making accommodations based on the needs of the family.
First, find out information about the home environment from the parent. This will allow you to identify how he or she will be most successful.
Next, streamline communication to decrease channel fog. If you are using multiple channels of communication, for example messaging or video chat in one place, sharing parent training resources and the child’s data is in another place, and then there is a third-place for non-therapeutic communication and clinic updates, your parents may be at risk for channel fog. Condense all parent communication into one place.
In addition, consider the device the parent uses most often, whether this is a computer, tablet, or smartphone. Communication is most successful when delivered on the device he/she is using most often. This will help with engagement, as well.
Gamification and positive reinforcement are also great ways to improve parent engagement. Setting up a daily task list or specific focus for the parent will help the parent digest the information being provided and have actionable steps.
With positive reinforcement and encouragement, the parent will feel success. As the parent feels success, he/she will gain more confidence and be more engaged in the process.
How are clinicians running assessments via telehealth?
Different assessments have been made via telehealth, although more research is to be done in this area.
In previous research, David P. Wacker and colleagues in 2013 conducted functional assessments (FAs) via telehealth with 20 young children with autism spectrum disorders.
They trained parents to implement procedures at home while there was a clinician observing via online video conferencing.
FAs completed within a multielement design identified environmental variables that maintained problem behavior in 18 out of 20 individuals studied.
The results suggest that behavior analysts can effectively and efficiently conduct FAs via telehealth.
There have been other articles published in 2020 that look at preliminary findings on telehealth effectiveness.
Kelly M. Schieltz & Wacker also reviewed previous research in telehealth and provided a comprehensive summary of what is known regarding assessment and function-based delivery with remote services.
Emily Unholz-Bowden and colleagues also did a literature review on telehealth, specifically regarding the effectiveness of caregiver training and training packages that can be effective.
From a BCBA’s perspective, how can we make telehealth more comfortable?
From a BCBA’s perspective, you can make telehealth more comfortable in different ways. Certain professionals prefer to set up a typical home office environment.
This is better if you prefer to sit down and focus and complete your daily tasks in a distraction-free setting. Others prefer to move around and have more flexibility and mobility. It depends on the person.
For BCBAs, you can be quite flexible in the way you choose to work. It’s up to the individual to build a routine in a setting that works for them. There are also ways to make the situation more comfortable for families and children.
Explain the setting to the family before you start. Even things like if your cat could walk past in the background or if you need to move to get new materials.
It depends on the nature of your practice. It’s a good idea to explain what the sessions will be like and what the patients are likely to see or hear through your camera.
For a BCBA, it’s especially important to set up an ergonomic workspace.
This might mean investing in an ergonomic chair, desk, and electronic equipment. This is important for your health and wellbeing. It’s as important from home as any other workplace.
How can telehealth provide more care and more billable opportunities?
Telehealth can be used in several ways to provide more care and more billable opportunities for the ABA therapy provider.
Telehealth can be embedded in the way we traditionally provide services, as an additional way to increase access to parents. It can also help reduce barriers to services that may include travel, illness exposure, and career responsibilities.
BCBAs can also increase attended parent training hours through the use of telehealth, and can increase supervision opportunities.
You may even be able to recover some of the costs of reviewing videos and providing written advice to families through asynchronous teleheatlh.
How does TheraWe decrease screen time while optimizing times on-screen?
TheraWe is an HIPAA compliant mobile video platform that bridges the gap between the clinic and families at home.
The platform allows parents to take and upload videos any time during the week from his/her mobile device. Videos are then uploaded to a secure location so that they can be reviewed by the BCBA.
The BCBA can also share the video that has been provided by the parent, as part of the next parent training session, decreasing the time the child has to be on the screen.
With this approach, the BCBA can discuss feedback on home implementation, what is working, and any areas for improvement. This is particularly useful for children who have difficulty with attention to the screen.
Should telehealth always be an option, even after the pandemic?
Many people will continue with some new habits formed during the pandemic. Telehealth isn´t an exception.
It can be combined with in-person therapy based in clinics or at home, and is a means to continue to provide services to people in rural areas or who have difficulties with scheduling or distance from providers.
Telehealth is a great alternative to in-person services for those who wouldn’t otherwise have access to them.
For example, if a parent is struggling with novel challenging behaviors, it could be convenient to do a parent training telehealth session for the day. This might be easier to fit into the parent’s busy schedule rather than arranging an appointment in person.
Should providers and business owners invest in better technology to improve telehealth, and why?
One thing that can make telehealth less convenient is, of course, technical issues.
Without proper technology and a strong Wi-Fi connection, it can be more difficult to carry out telehealth sessions. In order to provide the best services, you need better technology.
Providers and business owners should, therefore, invest in technology to help improve telehealth services. It’s important to have an effective, user-friendly interface to deliver these services through.
As far as hardware goes, a good camera, microphone, and computer are essential.
What are some top tips for parents, therapists, and etiquette for setting expectations for sessions?
It’s a good idea to be clear about expectations from both the ABA therapy provider and the parent. Give the parent a clear indication of their role. Thorough preparation will help improve the process.
It’s also important to be understanding that this is a new platform and many parents might be unfamiliar with it. Therefore, it’s necessary to be flexible with telehealth services and parent engagement.
Parents will need to get used to the platform and how it works. The best thing to do is to give them a thorough explanation of all expectations beforehand.
Sitting in front of a screen for a long time isn’t healthy, so it’s vital to work in proper conditions. Ergonomic settings are essential and the lighting and positioning of furniture and equipment need to be controlled. It’s also a good idea to take regular breaks.
Telehealth is the part of the future of providing care. It’s a new way to provide therapy services to those who wouldn’t normally be able to receive them.
ABA therapy providers are also able to broaden their client base and increase billable opportunities. For more information on ABA Therapy & Telehealth FAQs, contact us for all your questions answered.