Using Telehealth to Deliver Behavioral Interventions for Children

As telehealth becomes a permanent fixture in the United States’ health care landscape, mental health clinicians are exploring new ways to apply the technology to remote care.

Psych Congress Network spoke with Daniel Bagner, PhD, professor psychology and directory of clinical training in Child and Adolescent Psychology at Florida International University about his recent study, “Telehealth Treatment of Behavior Problems in Young Children With Developmental Delay: A Randomized Clinical Trial,” recently published in JAMA Pediatrics.

In Part 2 of this video Q&A, Dr Bagner details which new avenues he and his colleagues are exploring for the application of behavioral interventions delivered via telehealth. He also explains why behavioral interventions are the preferred first-line treatment for children as well as how clinicians can further their understanding of the important role that behavior plays in pediatric patients’ healthcare plan.

Missed Part 1: Delivering Parent-Child Interaction Therapy Via Telehealth with Dr Bagner? Find it here.

Visit our Telehealth Excellence Forum for more expert insights on how to improve patient outcomes remotely.

Daniel Bagner, PhD, is Professor of Psychology and Director of Clinical Training and the Clinical Science Doctoral Program in Child and Adolescent Psychology at Florida International University (FIU). A licensed and board-certified clinical child psychologist, Dr Bagner studies interventions for at-risk infants and young children and their families and etiological models of early childhood behavior problems. He has published more than 90 scientific papers and chapters on these topics and has been continuously funded by the National Institutes of Health (NIH) for the past 19 years to conduct his research. Dr Bagner currently serves on the editorial board for five journals and was a member of the Psychosocial Development, Risk, and Prevention (PDRP) study section at the National Institutes of Health. He is involved in several professional and community organizations, including his role as the FIU representative to the board of directors for The Children’s Trust, an organization with a dedicated source of revenue to fund strategic investments that improve the lives of children and families in Miami-Dade County, Florida.

Read the transcript:

Daniel Bagner, PhD: I'm Dr. Daniel Bagner. I'm a professor of psychology at Florida International University and also at the Center for Children and Families. And I'm also the director of the Clinical Science Doctoral Training Program.

So currently we're actually testing a similar intervention for children even younger. So the children in this study were three. They did have developmental delays at the point where we recruited them for the study. What we're testing now is an adapted version of this intervention, a much shorter version to try to get at problems even before they're really problematic for a family.So we're trying to identify kids that are at risk for later problems with their behavior in kids as young as 12 to 18 months, and try to set in motion really positive interactions and play between the parent, other caregivers, and their child to try to prevent those behaviors from becoming more problematic later in life.

So there's actually pretty limited research on the effectiveness of pharmacological medications for very young children with developmental delay. That's not to say that they're not used with young kids with pretty significant behavior problems. What I think this type of study suggests is that trying to address the problems behaviorally with a psychosocial treatment can be an effective first line approach before resorting to or trying a medication to resolve problems.

That approach is actually consistent with newer guidelines around problems like ADHD, where in the field of developmental behavioral pediatrics, the approach is to first line of treatment, target the child's behavioral problems as a result of the ADHD in a psychosocial treatment before trying stimulant medication or other pharmacological meds.

I think it's very important for the entire healthcare team to understand and recognize the importance of behavior and how that can impact a lot of different areas of children's development and functioning. So behavior can affect children's sleep and eating, and can affect their later academic problems, can affect their physical health.And so by realizing the importance of that, providers should realize and understand that those are problems that really need to be addressed early in life to try to reduce later problems.