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Addressing provider shortages through parent training: Parent Implemented Training for Autism through Telemedicine . Lashanna Brunson, M.S., BCBA West Virginia University Center for Excellence in Disabilities. Purpose of PITA-T.
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Addressing provider shortages through parent training: Parent Implemented Training for Autism through Telemedicine Lashanna Brunson, M.S., BCBA West Virginia University Center for Excellence in Disabilities
Purpose of PITA-T • Provide access to Applied Behavior Analysis (ABA) therapy to families of children with Autism Spectrum Disorders in rural Appalachia
ABA and Autism • Evidence based best practice • Structured learning environment • Break large skills into small components • Individualized programming based on needs • Data-based decision making
27 Board Certified Behavior Analysts 1 15 2 1 2 2 4
12 Potential Practitioners 1 14 2 1 1 2 2 4
Barriers to Service Delivery • Technological Barriers • Less computer access in rural areas • Relatively poor internet connectivity • 45% of West Virginians use internet connections with speeds below federal minimum broadband standards (Speed Matters Report, 2010)
Barriers to Service Delivery • Economic Barriers • 17.5% of WV residents live in poverty • Extremely expensive
Overcoming Barriers • Teach parents to implement discrete trial training (DTT) techniques • Behavior analysts can reach a larger geographical area • Use asynchronous telecommunication to provide instructions and feedback • Eliminates need for high-speed internet
Our Families • Children under 5 years old with an Autism Spectrum Disorder • Live in: • West Virginia • Kentucky • Pennsylvania • Ohio • Virginia • Maryland
The Process • Phone screening • Intake • Assessments • Materials • Video camera • Tripod • Memory cards • Postage paid envelopes
The Process • Mail training materials • Parents record sessions and mail to staff • Staff review sessions and mail feedback • Exit assessments
Challenges to Implementation • Many children not diagnosed early • Expand eligibility age • Share autism fact sheet • Parental adherence to taping procedure • Create weekly schedule • Reminder phone calls • Monthly drawing
Preliminary Findings • Parents learning to implement DTT • Feedback is necessary • Potential for child improvements not enough to maintain treatment efforts • Greater adherence when video instructions and feedback were provided
THANK YOU! • This study is supported by grant R40MC20444 from the Maternal and Child Health Bureau (Combating Autism Act of 2006), Health Resources and Services Administration, Department of Health and Human Services • Collaboration between Center for Excellence in Disabilities & WVU Department of Psychology