Project helps transition autism therapy to telehealth services

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JANUARY 1, 2021 — Editor’s note: This project furthers experiential learning efforts in the community by training therapists who will go on to train other behavior professionals, including UTSA clinical students. [Originally published April 20, 2020.]

COVID-19 has significantly impacted society with drastic changes to everyday life. These changes have been especially difficult for children with autism in the San Antonio as the current shelter-in-home order has forced many services, therapies and support programs to be canceled or suspended. 

However, with the development of telehealth services and a new project spearheaded by Leslie Neely, assistant professor of educational psychology at UTSA and coordinator of the applied behavior analysis program, the much-needed services will continue in a virtual setting. 

“We are starting a new project that looks at how to use videoconferencing software to teach behavior therapists to conduct sessions virtually,” Neely said. 

Started in early April, the project is funded by a grant from the COVID-19 Response Fund, a community fund jointly managed by the San Antonio Area Foundation and the United Way of San Antonio. The fund is comprised of nearly 30 caring businesses, donor advised funds, philanthropic foundations and government entities. It will train existing behavior analysts at the Autism Treatment Center. Those therapists will graduate to training other behavior professionals, including UTSA clinical students, in the same skills. 

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“Without it, many children are likely to relapse and engage in potentially life threatening self-injurious behavior.”

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The San Antonio Applied Behavior Analysis, a consortium of researchers and clinicians from UTSA, the Autism Treatment Center, and the Children’s Hospital of San Antonio, operates an applied behavior analysis clinic on site at the Children’s Hospital of San Antonio. 

Prior to the pandemic, the SAABA consortium served about 50 clients between the ages of 3 and 16 years old in the San Antonio area. With the shelter-in-home directive many of those clients no longer have access to the services. 

“Applied behavior analysis is a medically necessary therapy that treats severe behavior and teaches communication, social and adaptive skills,” Neely said. “Without it, many children are likely to relapse and engage in potentially life threatening self-injurious behavior.” 

The goal of this telehealth model is to train a maximum number of therapists and reestablish ABA services via telehealth for clients as quickly as possible.

As a leading researcher in the telehealth ABA field, Neely is well versed in applications of the telehealth model.

“It’s been a niche topic in ABA research for the last five to 10 years but has really gained popularity and recognition since the pandemic,” Neely said.

The telehealth model is very different from typical services, since the therapist is not there to model or intervene with the client. Instead, their role is to support the caregivers to interact with their child in a therapeutic way.

“When you’re doing behavior therapy via video conferencing your goals change and you focus on supporting the caregiver and family as a unit,” Neely said.

This requires interactive caregiver training typically in the home setting.

“While this is certainly a shift for ABA, training caregivers via telehealth will ultimately lead to a much stronger therapy,” Neely said. “Board certified behavior analysts will get to see children in the natural setting where dogs are barking, siblings are crying and life is happening. I think the telehealth model will challenge behavior analysts to think through and apply our science in a very precise way so that we can be effective in that natural environment.”

The long-term goal of this project is to establish telehealth as an effective alternative to in-person services, even after COVID-19 has passed. 

Neely believes that this modality has the potential to extend services to rural areas and to those families without the resources to access a typical clinic setting. It can also be used to generalize the skills a client learns to the home environment by training the caregiver to implement the interventions. 

“Telehealth has already proved to be effective for so many families. While I have been working to research the telehealth ABA over the past five years, the pandemic has accelerated this work,” Neely said. “I am hopeful we can train our therapists and students to immediately reestablish these essential services for our community.

— Valerie Bustamante

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