Communication intervention for children with severe neurodevelopmental disabilities: An application of telehealth as a service delivery mechanism

Abstract

The current study examined the efficacy of a parent-implemented communication assessment and intervention package with coaching via telehealth (i.e., video conferencing) on the acquisition of early communication skills for three young children (3- 4 years old) with severe neurodevelopmental disabilities. Assessment included a structured descriptive assessment (3 participants) and functional analysis (2 participants) to identify communicative contexts and idiosyncratic/potentially communicative responses for the participants. Following assessment, three communicative contexts with high levels of idiosyncratic responses were embedded with Functional Communication Training (FCT). To investigate the efficacy of FCT, participants’ use of aided augmentative and alternative communication (AAC) responses and idiosyncratic responses were measured in an adapted multiple probe design across contexts. All three participants acquired the targeted AAC responses; whereas, prior to intervention, none of the participants engaged in easily recognizable communication forms. Idiosyncratic responses were functionally related to the reinforcers in the communicative contexts, as demonstrated by changes to response patterns during differential reinforcement. Parents implemented the interventions with a high level of fidelity to the coached procedures. At the conclusion of the study, parents rated the interventions as ‘highly acceptable.’ These results provide empirical evidence to telehealth-coached, parent-implemented FCT as an intervention to improve early communication skills for young children with severe neurodevelopmental disabilities. Implications are considered in regards to telehealth as a mechanism to improve access to communication intervention.