Telehealth Success Story: A Family Change Process
Read how ABA Telehealth helped a family revitalize their relationship and bridge communication gaps.
Sam’s father tried hard to connect with his energetic 7-year-old son. They went to soccer together every Sunday and picked up a special treat on their way back home. Once home, his father helped Sam to hang up his coat and then asked him to wash his hands for lunch. The struggle began.
Sam walked away and looked back blankly at his dad. Sam’s father insisted, yelled, cajoled and finally physically forced Sam to wash his hands and sit down, something Sam did daily at school with little fuss. By the time Sam’s mother returned home, Sam was in tears on the floor and his father was red in the face and feeling hopeless about the future Sam had in store for him. His dad had literally tried everything he could think of to get Sam to listen; sheer force was not an acceptable solution. And, Sam’s mother was no further along in getting Sam to listen to her.
His parents began to wonder if Sam needed a residential school to learn how to live with others. They knew that Sam had been diagnosed with ASD when he was 2 years old, but they always hoped that he would “snap out of it” like his older cousin with the same condition. Finally, one day Sam’s parents contacted ABA Telehealth Project to ask for help. “He won’t listen to us at all - and all we are asking him to do is sit down for his favorite snack,” Sam’s father complained during his first telehealth session. “We don’t know what else to do,” they said in unison. After spending some time getting to know Sam and his family, including observing Sam in the natural home environment via telehealth eating meals, playing with the family cat, and playing a board game with his brother, we agreed on a behavior intervention plan to improve Sam’s ability to follow his parents’ directions.
Over the next 10-weeks, during Nerf basketball gameplay, Sam’s father learned to use ABA strategies to help his son listen to and follow directions. With a BCBA observing each session and coaching Sam’s dad on how to respond to Sam’s behavior in real-time via telehealth sessions, Sam began to respond differently. He thought of this special playtime with Dad only as fun. Highly motivated to keep the play going, Sam was more responsive to his father’s efforts to engage him. His dad asked, “Who goes first, Sam?” Without hesitating, Sam replied, Me!” “Okay,” his dad replied, “pick up the ball and shoot.” Like a bullet, Sam retrieved the ball and threw it across the room missing the side of the room where the basket was affixed. “Good listening, Sam,” his father emphasized. “I think you could get the ball in the basket if you stand a little closer,” Dad told Sam. “Stand here,” he said as he gently directed Sam closer to the basket. “What a good listener I have here,” exclaimed Sam’s father at the BCBA’s suggestion.
Through a gradual and individualized process involving careful modification of expectations, demands and strategies - not always picture perfect on challenging days when Sam had a runny nose, hadn’t slept well or just woke on the wrong side of the bed - Sam’s father learned to use positive reinforcement, establish instructional control, increase Sam’s motivation, shape his behavior, and provide corrective feedback more consistently, clearly and in supportive ways. Over time, Sam and his dad were able to take his new “good listening” skills beyond Nerf basketball and apply them to turn-taking, praising the other player, snack time, getting dressed, clearing the plate from the table as well as other social skills and activities of daily living.
This composite vignette (actual identity concealed) is a real-life example of how telehealth can be used as an invaluable tool in the behavior analyst’s intervention toolbox. Meeting in an office or even visiting their home may not have afforded Sam and his father the same “special playtime” and opportunities to shift the dynamics in their relationship, improve father and son interaction skills, and set them on a better path toward improved interactions generalized to other settings through ABA telehealth services.
Want to see how ABA Telehealth Project services might be helpful for you and your loved one?