Telehealth Guidelines and Instructions

How to Run a Telehealth Direct Care Session

Outlining the Responsibilities of the BCBA, RBT and Parent

This is a guideline created to help BCBAs who need help managing telehealth implementation of direct services. It should be noted that this is not a requirement of how to run telehealth sessions, but more so a guide as to how one could run a telehealth direct care session. Below is the table of contents of this document:

  1. General Overview of RBT Direct Care Telehealth Sessions

  2. Overview of BCBA Responsibilities

Stages of Implementation with RBT & Parent responsibilities

General Overview

  • Therapy sessions can be run for the full hour consecutively or throughout the day in intervals

  • RBT and parents will decide on scheduled times

BCBA will send materials to client’s & therapist’s home’s

Overview of BCBA Responsibilities

  • Rewriting behavior guidelines to show for telehealth implementation (if needed)

  • Rewriting programs for parent implementation

  • Rewriting programs for telehealth implementation

  • Changing prompting procedures to match for parents

  • Creating and sending the same materials to both the therapist and family

    • First…then board

    • Token Board

    • Any stimuli for programs

  • Going over programs with parents during parent training

  • Creating video models for programs

Stages of Implementation with RBT & Parent Responsibilities

Stage One: BCBA Trains RBT

  • BCBAs and RBTs should find a time prior to the beginning of telehealth sessions to go over how to deliver service and this document.

  • BCBA will use Behavioral Skills Training to train the RBT on how to provide feedback for programs

  • BCBA will go over the new guidelines for program implementation with the RBT

Stage Two: BCBA Trains Parents

  • BCBA will train the parents on programs prior to implementation with the therapist as if the parents are the therapist

  • BCBA will use Behavioral Skills Training to train the parents on the programs

  • BCBA will go over the new guidelines for program implementation with the parent

Stage Three: Pairing the RBT w/ Client Virtually

RBT Behavior

  • The RBT is going to need to pair with the student again via the telehealth platform

  • RBT should take the first few sessions of telehealth to pair with the client and gain instructional control again virtually.

  • RBT should play to the reinforcers of the client to gain their attention virtually.

    • Example: Client likes singing so therapy sings songs for the first few sessions with the client and plays videos.

  • Deliver parents feedback for how they delivered consequences for challenging behavior should they occur

  • Data collection of observed behaviors and programming

  • Track delivery of tokens and reinforcer intervals

Parent Behavior

  • Play along and build rapport with the therapist and child during repairing

  • Keeping client in general area and bring attention to the screen

  • Utilize first…then board with child saying “first computer time with [therapist] then…[reinforcer]

  • Deliver consequences for challenging behavior how they are outlined should they occur

  • Follow through with therapist feedback

  • Deliver tokens & reinforcers

Stage Four: Program Implementation Virtually

RBT Behavior

  • Introduce programs slowly, one at a time

  • Run programs how they are written by the BCBA

  • Modeling programs using stimuli given by the BCBA for each program when applicable

  • Data collection of observed behaviors and programming

  • Delivering feedback to parents

Parent Behavior

  • Run programs how they are written by the BCBA

  • Follows the model if necessary

  • Delivering prompts as written

  • Follow through with therapist feedback

Here are some creative ideas for how to make a telehealth session be effective and productive!

  • Read a book (if you have a session later in the day, make it a bed-time story :)

  • Have the parent prepare a set of art supplies & create a craft simultaneously. (Tip: find out first what the parent has available, and then plan your project )

  • Turn your prompts into a song! 

  • Be creative,  use rhymes & familiar tunes 

  • Arrange with Mom for an incentive- system, using whatever treats she has available (candy, screen-time, coins, sticker-chart toward a larger prize, etc.)

  • Get active! Have your student follow your lead while you jump, stretch and jog in place together !

  • Draw pictures and share them with each other 

  • Guide your student in drawing a specific image, step-by-step. 

  • Play a guessing game....doesn't require any materials!

  • Make a puppet show for your student!

  • Don't have puppets? Make them from old socks, folded paper, etc

  • Look online for ideas

  • Use this unique opportunity! Learn what your student likes best to play at home ....make small instructive requests,  work on direction-following

  • (If level- appropriate): have your student practice reading....either from a book they own, or pages which you can send in a picture to Mommy, or a book/words which you can display on the screen.

  • Play music & dance !

  • Does Mom have play-do available? Can she make some (plenty of recipes online)....guide your student as they make a play-do craft, or just chat while they play