Rapid Conversion from Clinic to Telehealth Behavioral Services During the COVID-19 Pandemic
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TECHNICAL AND TUTORIALS
Rapid Conversion from Clinic to Telehealth Behavioral Services During the COVID-19 Pandemic Jennifer L. Crockett 1,2 & Jessica L. Becraft 1,2
&
Sharon T. Phillips 1 & Marguerite Wakeman 1 & Michael F. Cataldo 1,2,3
Accepted: 4 September 2020 # Association for Behavior Analysis International 2020
Abstract Survival often depends on behavior that can adapt to rapid changes in contingencies, which should be particularly well suited to a contingency-sensitive and data-based discipline such as applied behavior analysis (ABA). The speed and scale with which contingencies shifted in early March 2020 due to the effects of COVID-19 represent a textbook case for rapid adaptation with a direct impact on the survival of many types of enterprises. We describe here the impact, changes, and outcomes achieved by a large, multifaceted ABA clinical program that has (a) ongoing data that forecasted and tracked changes, (b) staff well practiced with data-based shifts in operations (behavior), and (c) up-to-date information (data) on policy and regulations. The results showed rapid shifts in client and staff behavior on a daily basis, shifts in services from in-person services to telehealth, and increases in volumes, revenue, and margins. We detail regulations and provide actionable steps that clinical organizations can take pertinent to this shift now and in the future. The challenges of the COVID-19 pandemic underscore the importance of maintaining robust coordination and communication across our field in order to address crises that affect our field. Keywords Applied behavior analysis . Child problem behavior . Coronavirus . Service delivery . Telehealth
The novel coronavirus and illness caused by the virus (i.e., COVID-19) were first discovered in late 2019. By late January 2020, the United States had confirmed cases of COVID-19. Community spread was reported on the West Coast of the United States in late February. Subsequently in March, a nationwide effort was initiated to slow the spread of COVID-19, primarily through social-distancing measures. Over the past few months, states across the United States have
Editor’s Note This manuscript is being published as part of a series of emergency publications designed to help practitioners of applied behavior analysis take immediate action to adjust to and mitigate the COVID-19 crisis. The journal would like to especially thank Drs. Janice Doney and Valerie Rogers for their expeditious review of the manuscript. The views and strategies suggested by the articles in this series do not represent the positions of the Association for Behavior Analysis International or Springer Nature. * Michael F. Cataldo [email protected] 1
Kennedy Krieger Institute, Baltimore, MD, USA
2
Johns Hopkins University School of Medicine, Baltimore, MD, USA
3
Department of Behavioral Psychology, Kennedy Krieger Institute, 707 N. Broadway, Suite 200L, Baltimore, MD 21205, USA
declared a state of emergency and/or issued stay-at-home orders. Schools closed their doors and in
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