Q&A: CABER's new telehealth model assists students with special needs during COVID-19

Kevin Ayres and Joel Ringdahl, professors in the department of communication sciences and special education at UGA's Mary Frances Early College of Education, manage the clinic services for the UGA Center for Autism and Behavioral Education Research (CABER). In addition, they and their team conduct research on skill acquisition and behavior reduction.

The bulk of Ayres' and Ringdahl's work focuses on using applied behavior analysis for improving educational and behavioral outcomes for individuals with developmental disabilities. CABER, which provides training for educators and therapists as well as services for individuals with autism spectrum disorders and other developmental disabilities, has continued to provide services to their clients during the COVID-19 pandemic. The clinic has developed a telehealth model geared toward educational opportunities for special education students.

"From a professional standpoint, our team is bound by an ethical code that obligates them to not abandon the client—even in exceptional circumstances like this, we try to identify ways to support those clients," Ayres said. "If you take a look at what's happening in special education across the country, the Department of Education is basically relaxing requirements. We didn't see that as an adequate response."

CABER has undertaken several initiatives to meet the needs of individuals with developmental disabilities and their families during the recent health crisis. These activities include designing and implementing educational opportunities for students with developmental disabilities via telehealth, transitioning in-person clinical services to a telehealth format, and developing a virtual program for parent enrichment.

What is the telehealth model for special education?

We operate three model classrooms within the Clarke County School District. When the schools closed, we figured out how to quickly provide service to those students who we are responsible for teaching. Our team—which includes master's and doctoral students, and full-time staff—got together and in about a week, developed a telehealth model that mirrored what we did in the classroom and connected with some of the families who had the ability and interest to do this with us.

We're planning to branch telehealth out into surrounding counties and across the state and are waiting to hear back from their special education programs to see which students they want to direct our way.

How many days a week do you provide telehealth services?

We take appointments on weekdays from 8 a.m. to 6 p.m.

What is the curriculum telehealth covers?

Most of our students have two appointments per week that last about an hour. These kids typically work on basic academic skills such as identifying pictures, identifying letter sounds, that sort of thing. We coordinate with the parent to get on Zoom with us and the child. The parent will have an outline of what we're going to learn that day. If the child is going to learn three letter sounds, they will need to be exposed to the pairing of that letter sound many times before they remember it. We'll spend about five minutes on a lesson and then take a break.

Many lessons involve our staff member sharing their computer screen so that the child can view what we need them to see. Our staff will ask a question, prompting the child to respond. The parents help to make sure that the child stays at the computer and determine if the response is correct or incorrect.

What challenges did you face creating this program?

While we were creating the program, a couple of other items became apparent to us—three big things actually. We offer telehealth services for educational advancement, and we serve clients in our clinic who engage in problem behavior, disruption, aggression, etc. who also have autism or intellectual disability. On Tuesdays and Thursdays, we work with those families on how to support their children.

We also realized how much support some of these parents need while doing telehealth. We've been conducting a parent training program over the past two years to help parents understand children's' behavior and how to respond to it. We decided to also turn that into a telehealth format, which we recently launched.

Lastly, in talking with several parents of children with developmental disabilities and hearing what's been going on, we realized many of the parents don't necessarily need telehealth meetings a couple of times a week to teach their kids, but they do need additional supports within their home. We launched a tip line that parents can reach out to if they're experiencing some challenges. Many of these parents have challenges getting their children into a new routine because they're going to be out of school for an extended period of time. Putting our therapist in a position to provide the parents some general support is now live. Under Ringdahl's leadership, that group shifted to offering all of those services via telehealth.

Is there a specific age group that telehealth is geared toward?

For telehealth clinical services, there is no age limit—we've seen kids up to high school. For our tip line, we didn't put any parameters on who can call in. We knew that we could be a resource in the community for people struggling to figure out how to be a teacher as well as how to juggle a job and parenting.

What's a day in the life like for the telehealth staff?

For every hour of instruction that the staff completes, they're putting in about two hours of instruction preparation or finishing up the previous lesson. They usually plan the lesson and meet with their team to deliver the lesson. After the lesson, they will review and respond to the data to determine what's going to go into the next session for that particular child.

Right now, we have the capacity to serve about 30 kids and we're only a third full. It's been interesting because when we first solicited parents to see if they were interested, we received a very limited response. What we're hearing from other organizations that have done something similar to this is that the longer it goes on, more parents are seeking support. We expect to see an increase in kids signing on in the future.