Welcome to Behaviorbabe
Ethical Advocate for Accurate Application & Dissemination of Behavior Analysis

Welcome to Behaviorbabe

Ethical Advocate for Accurate Application & Dissemination of Behavior Analysis

Applied Behavior Analysis and Telehealth

"Telemedicine seeks to improve a patient's health by permitting two-way, real time interactive communication between the patient, and the physician or practitioner at the distant site. This electronic communication means the use of interactive telecommunications equipment that includes, at a minimum, audio and video equipment" (Medicaid).

Sample ABA Telehealth Sessions

Parent Training no Client

Parent Training w/Client

ABA Direct via Telehealth

ABA Direct with Parent Facilitator

ABA, Telehealth, and COVID-19

Things to keep in mind when consulting esp. during a crisis (Dr. Rachel Taylor)

  1. Reference previous session recommendations
  2. Emphasize the importance of prioritization and compartmentalization
  3. Take every opportunity to “normalize” things as much as possible
  4. Highlight the value associated w/structure
  5. Encourage NET for previously more structured programs to protect against further potential regression
  6. Tie current recs to anticipated future benefits
  7. Adjust delivery format (TH session frequency and length) based on caregiver needs (and clarify related funding provider constraints but explain that it’s your job to worry about this part)
  8. Identify potential for both direct TH client interactions and separated caregiver training sessions (with any member of the household in need)
  9. Provide tips to capitalize on individual strengths
  10. Decrease caregiver and child response effort whenever possible
  11. Compare to other service disruptions (e.g. holiday breaks) to provide some perspective regarding having success before, yet acknowledge what now needs to be adjusted
  12. Reference caregiver provided data and videos
  13. Clearly define your communication turn around times (less than 1 day) and continued opportunities for increased support (eg have caregiver send video clips of any new concerns to review before next scheduled session)
  14. Include personal examples demonstrating that the caregiver has been heard before (eg specifically refer to activities that have changed for the caregiver in crisis and may be further contributing to their current well being)
  15. Validate.

These checklists are offered courtesy of Kristen Koba-Burdt with BAYADA. 


Kristen Koba-Burdt

Dr. Carla Schmidt

Dr. Johanna Higgins

Dr. Amand N. Kelly

Topics discussed: Coding and billing for telehealth sessions, how to structure telehealth sessions, obtaining parent buy-in, direct implementation via telehealth and the role of RBTs, running group social skills sessions online, how to conduct intake assessments via telehealth, resources, research, references and much more.

Recent Publications - Telehealth & COVID-19

Council of Autism Service Providers (CASP) Telehealth Resources

APBA Webinar: Telehealth and COVID-19

Association of Professional Behavior Analysts Webinar

Presenters: Gina Green, APBA; Jenna Minton, Minton Healthcare Strategies; Michele Silcox, ABA Therapy Billing and Insurance Services

The COVID-19 emergency is prompting many ABA healthcare providers to consider delivering services remotely for the first time or in an expanded way. That necessitates communicating with payers regarding authorizations or approvals, amended policies, billing codes and modifiers, documentation, and perhaps changes in client treatment targets, goals, and procedures. Laws, regulations, and ethical standards pertaining to remote delivery of ABA services must also be taken into account; some of those are changing rapidly in response to the pandemic. This 1.5-hour webinar (recorded on March 28, 2020) addresses those topics and offers suggestions based on the best information available to the presenters at the time.

Additional Resources & Related Articles

American Telemedicine Association.  (n.d.). States with parity laws for private insurance coverage of telemedicine (2018).  Retrieved from http://www.americantelemed.org/policy-page/state-policy-resource-center

Barkaia, A., Stokes, T. F., & Mikiashvili, T.  (2017). Intercontinental telehealth coaching of therapists to improve verbalizations by children with autism. Journal of Applied Behavior Analysis, 50, 582-589.

Barretto, A., Wacker, D. P., Harding, J., Lee, J., & Berg, W. K.  (2006). Using telemedicine to conduct behavioral assessments. Journal of Applied Behavior Analysis, 39, 333-340.

Blackman, K.  (2016). Covering and reimbursing telehealth services. Retrieved from http://www.ncsl.org/documents/health/lb_2404.pdf

Boisvert, M., Lang, R., Andrianopoulos, M., & Boscardin, M. L. (2010). Telepractice in the assessment and treatment of individuals with autism spectrum disorders: A systematic review. Developmental Neurorehabilitation, 13, 423-432.

Griswold, B. (n.d.). Will insurance cover video and phone sessions? Retrieved from https://pro.psychcentral.com/will-insurance-cover-video-and-phone-sessions/

Higbee, T. S., Aporta, A. P., Resende, A., Nogueira, M., Goyos, C., & Pollard, J. S.  (2016). Interactive computer training to teach discrete-trial instruction to undergraduates and special educators in Brazil: A replication and extension. Journal of Applied Behavior Analysis, 49, 780-793.

Higgins, W. J., Luczynski, K. C., Carroll, R. A., Fisher, W. W., & Mudford, O. C.  (2017). Evaluation of a telehealth training package to remotely train staff to conduct a preference assessment. Journal of Applied Behavior Analysis, 50, 238-251.

Lunney, K.  (2016). FEHBP insurance carriers must cover autism treatment beginning in 2017. Retrieved from http://www.govexec.com/pay-benefits/2016/02/fehbp-insurance-carriers-must-cover-autism-treatment-beginning-2017/126275/

Medicaid.gov.  (n.d.). Telemedicine. Retrieved from https://www.medicaid.gov/medicaid/benefits/telemed/index.html

Suess, A. N., Wacker, D. P., Schwartz, J. E., Lustig, N., & Detrick, J.  (2016). Preliminary evidence on the use of telehealth in an outpatient behavior clinic.  Journal of Applied Behavior Analysis, 49, 686-692.

​Quigley, S., Blevins, P., Cox, D., Brodhead, M. T., & *Kim, S. Y. (accepted with revisions). An evaluation of the ethical implications of telehealth research with individuals with autism spectrum disorder. Behavior Analysis: Research and Practice.

U.S. Census Bureau. (2011). Computer and Internet Use. Retrieved December, 17, 2013 from https://www.census.gov/.

U.S. Department of Health and Human ServicesHealth Resources and Services Administration.  (2013). Increasing access to behavioral health care through technology. Retrieved from https://www.hrsa.gov/sites/default/files/publichealth/guidelines/BehavioralHealth/behavioralhealthcareaccess.pdf

Wacker, D. P., Lee, J. F., Padilla Dalmau, Y. C., Kopelman, T. G., Lindren, S. D., Kuhle, J., Pelzel, K. E., & Waldron, D. B.  (2013). Conducting functional analyses of problem behavior via telehealth. Journal of Applied Behavior Analysis, 46, 31-46.

Ward, T. A.  (2015a, July 16). Virtual autism treatment. Retrieved from https://www.bsci21.org/virtual-autism-treatment/

Ward, T. A.  (2015b, July 21). Building children’s communication skills via telehealth. Retrieved from https://www.bsci21.org/building-childrens-communication-skills-via-telehealth/

Ward, T. A.  (2016, October 18). Social skills and staff training in a limousine: Using telehealth to implement OBM.  Retrieved from https://www.bsci21.org/social-skills-and-staff-training-in-a-limousine-using-telehealth-to-implement-obm/