Cameron2020 Article TelehealthForFamilyGuidanceAcc 2
The paper presents a five‑stage telehealth protocol designed to help Board Certified Behavior Analysts (BCBAs) support families of children with autism spectrum disorder (ASD) during the COVID‑19 pandemic. The protocol combines Acceptance and Commitment Therapy (ACT) techniques, a parent‑focused preference assessment inspired by the Meaningful Activity Participation Assessment (MAPA), and activity‑based instruction (ABI) led by parents. Stage 1 uses the Valued Living Questionnaire and Bull’s‑Eye Values Survey to clarify caregiver values and identify value‑action gaps. Stage 2 conducts an indirect preference assessment to determine parents’ preferred, meaningful activities. Stage 3 aligns the child’s individualized goals with those preferred activities, creating a visual framework that links values, activities, materials, goals, timing, data collection, and outcomes. Stage 4 implements parent‑implemented ABI using behavioral skills training (BST) and video‑based data collection via the Marco Polo app, enabling coaching, feedback, and permanent‑product data capture. Stage 5 primes families for a comprehensive ACT model through educational materials, a matrix of defusion exercises, and behavioral rehearsal tailored to the parent’s stage of change (Transtheoretical Model). The authors also propose a minimum clinical data set, grounded in Berwick’s quality framework, to evaluate client‑level outcomes (programs, learning opportunities, skill mastery), microsystem (family adaptability, cohesion, parental locus of control), and organizational metrics (service utilization, staff satisfaction, claim accuracy). The paper argues that this integrated, stage‑based approach can sustain ABA services via telehealth, enhance caregiver engagement, and promote psychological flexibility, while calling for further empirical validation.
Topics
COVID‑19‑Driven Need for Telehealth in ABA Services
Explains how pandemic‑related restrictions disrupted in‑person ABA, prompting a shift to telehealth to maintain mandated services for children with ASD.
Five‑Stage Telehealth Protocol Overview
Introduces the sequential framework (ACT, preference assessment, goal alignment, parent‑implemented ABI, ACT priming) that structures telehealth sessions for BCBAs and families.
Stage 1 – Values Clarification & Committed Action via VLQ and BEVS
Details the use of the Valued Living Questionnaire and Bull’s‑Eye Values Survey to identify caregiver values, detect value‑action discrepancies, and link them to child‑focused interventions.
Stage 2 – Parent‑Focused Preference Assessment Inspired by MAPA
Describes an indirect, checklist‑driven survey administered via telehealth to capture parents’ activity frequency and personal meaningfulness, producing a list of preferred activities suitable for child inclusion.
Stage 3 – Goal Alignment & Parent‑Led Activity‑Based Instruction (ABI)
Presents a visual framework that yokes child goals to parent‑valued activities, specifying materials, timing, data collection methods, generalization strategies, and desired outcomes.
Stage 4 – Parent‑Implemented ABI with Behavioral Skills Training and Marco Polo Data Capture
Outlines a BST model (instruction, modeling, role‑play, feedback) combined with the Marco Polo video app for real‑time coaching, permanent‑product data, and family engagement.
Stage 5 – Priming for a Comprehensive ACT Model Using TTM and Behavioral Rehearsal
Integrates the Transtheoretical Model to match interventions to caregiver readiness, provides a matrix of ten defusion exercises, and employs behavioral rehearsal to practice ACT principles.
Minimum Clinical Data Set for Telehealth Evaluation
Proposes client‑level, microsystem, and organizational metrics (program counts, learning opportunities, skill mastery, family adaptability, staff satisfaction, utilization dashboards) to assess protocol efficacy.