Coaching parents to assess and treat self-injurious behaviour via telehealth.
S S Benson, A F Dimian, M Elmquist and 3 others
PMID 29205605WHAT IT FOUND
With live video coaching, parents of two boys with self-injury implemented functional assessment and taught a communication response.
Each boy's self-injury decreased while switch or picture card requests increased. This shows a possible home method, not proof it works.
Key findings
01The functional analyses identified different functions: adult attention for Connor and tangible access for Nick.
02During telehealth-coached parent-implemented functional communication training, Connor's self-injury decreased to near-zero rates in the last five sessions, and switch presses occurred at higher rates than self-injury after the second intervention session.
03During telehealth-coached parent-implemented functional communication training, Nick's self-injury was zero for all five sessions when the intervention was reintroduced, and picture card use returned to stable elevated levels.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study included only two children, so it cannot show what will happen for other children. There was no control group or random allocation; each child served as his own comparison across baseline and intervention phases. No baseline sessions with the microswitch present were conducted for Connor, and his second baseline data were variable, which limits inferences about the effect of functional communication training. Parent implementation fidelity was evaluated after the study, so no conclusions can be made about the effect of fidelity on self-injury. The authors did not systematically collect social validity data. Connor had special education services, protective helmet and arm limiting devices, and previous medical interventions for tissue damage; Nick had in-home applied behaviour analysis 35 to 40 hours per week plus occupational and physical therapy. The study cannot separate the contribution of any single component.
Declared interests
The article is listed as research supported by NIH extramural funding. The supplied text does not include an author conflict-of-interest declaration.
The easy way to misread this
Do not conclude that telehealth coaching reliably reduces self-injury. The study included only two children. Connor also had special education services, a protective helmet and arm limiting devices, and previous medical interventions for tissue damage; Nick also had in-home applied behaviour analysis 35 to 40 hours per week plus occupational and physical therapy. The contribution of any single component cannot be separated.