For a study, it was determined that problem behaviors such as violence and self-injury are more common in children with fragile X syndrome (FXS). Due to the scarcity of treatment providers and the significant geographical dispersion of families with FXS across the country, many children with FXS have limited access to proven behavioral therapy. Telehealth could be a cost-effective and practical way to get through these major roadblocks. The researchers looked at the impact of telehealth delivery of a well-known behavior analytic intervention termed functional communication training (FCT) on levels of problem behaviors in boys with FXS. The researchers also looked at treatment acceptance and the effect on parenting stress levels. Over 12 weeks, boys with FXS, aged 3 to 10, who demonstrated daily problem behaviors were randomized to receive FCT via telehealth (n=30) or treatment as usual (n=27). Observations of problem behavior during sessions, the Aberrant Behavior Checklist—Community (ABC-C), the Treatment Acceptability Rating Form—Revised (TARF-R), and the Parenting Stress Index, the 4th edition, were used as outcome measures (PSI-4). Scores on the irritability subscale of the ABC-C, the major outcome measure, fell considerably for boys who got FCT via telehealth compared to boys who received treatment as usual (P<.001, Cohen’s d=0.65), according to intention-to-treat analyses. In-session observations of those who received therapy revealed a 91% reduction in problem behavior compared to baseline. Following FCT treatment, levels of parenting stress related to child behavioral problems were also decreased, and caregivers said the intervention was acceptable. These researches support the use of telehealth-enabled FCT as a framework for increasing access to behavioral interventions for children with FXS who had problem behaviors. Expanding the use of telehealth to deliver behavior-analytic treatment can save healthcare costs, improve child and family quality of life, and lead to advancements in the treatment of problem behavior in the broader community of people with neurodevelopmental disorders.
Link:link.springer.com/article/10.1186/s11689-020-09331-4
