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Field Testing the Family Behavior Support Mobile Application (FBSApp) during a Global Pandemic

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Title: Field Testing the Family Behavior Support Mobile Application (FBSApp) during a Global Pandemic
Language: English
Authors: Erin E. Barton (ORCID 0000-0002-5575-5713), Claire Winchester (ORCID 0000-0001-9125-2593), Marina S. Velez (ORCID 0000-0002-6879-8392), Mollie Todt (ORCID 0000-0002-9407-3969), Brandy M. Locchetta (ORCID 0000-0003-3940-1023), Emma Skiba
Source: Journal of Autism and Developmental Disorders. 2025 55(8):2680-2695.
Availability: Springer. Available from: Springer Nature. One New York Plaza, Suite 4600, New York, NY 10004. Tel: 800-777-4643; Tel: 212-460-1500; Fax: 212-460-1700; e-mail: customerservice@springernature.com; Web site: https://link.springer.com/
Peer Reviewed: Y
Page Count: 16
Publication Date: 2025
Sponsoring Agency: Institute of Education Sciences (ED)
Contract Number: R324A160086
Document Type: Journal Articles
Reports - Research
Education Level: Adult Education
Descriptors: Field Tests, Evidence Based Practice, Handheld Devices, Computer Oriented Programs, Functional Behavioral Assessment, Young Children, Disabilities, Family Involvement, Child Behavior, Behavior Problems, Intervention, Parent Education, Coaching (Performance), Family Attitudes
DOI: 10.1007/s10803-024-06373-8
ISSN: 0162-3257
1573-3432
Abstract: We developed and tested an evidence-based mobile application designed to support families in using functional assessment-based intervention strategies with their young children with disabilities and challenging behaviors in home settings. Five families participated in the study. We utilized a multiple-probe across participants design to examine the effects of the FBSApp on parents' use of intervention strategies and childrens' use of challenging behaviors and replacement behaviors. We adapted our procedures to include individualized coaching to provide meaningful and effective support after the onset of the COVID-19 pandemic. A functional relation was not identified between access to FBSApp and caregiver use of strategies; however, the addition of coaching did lead to increased strategy use for two of four caregivers. A functional relation was identified between the use of the FBSApp plus coaching and CB. Families reported the app and coaching procedures favorably. We found that responsive, family-centered research CAN be conducted in spite of significant history events, and that mobile apps and virtual meeting platforms can be an accessible and efficient method for supporting families. The use of single case design allowed for flexible, yet methodologically sound procedures. More work is needed examining effective and efficient virtual supports for families.
Abstractor: As Provided
Notes: https://doi.org/10.17605/OSF.IO/69DSC
IES Funded: Yes
Entry Date: 2025
Accession Number: EJ1478438
Database: ERIC
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  Value: <anid>AN0186910022;aut01aug.25;2025Jul29.02:32;v2.2.500</anid> <title id="AN0186910022-1">Field Testing the Family Behavior Support Mobile Application (FBSApp) During a Global Pandemic </title> <p>We developed and tested an evidence-based mobile application designed to support families in using functional assessment-based intervention strategies with their young children with disabilities and challenging behaviors in home settings. Five families participated in the study. We utilized a multiple-probe across participants design to examine the effects of the FBSApp on parents' use of intervention strategies and childrens' use of challenging behaviors and replacement behaviors. We adapted our procedures to include individualized coaching to provide meaningful and effective support after the onset of the COVID-19 pandemic. A functional relation was not identified between access to FBSApp and caregiver use of strategies; however, the addition of coaching did lead to increased strategy use for two of four caregivers. A functional relation was identified between the use of the FBSApp plus coaching and CB. Families reported the app and coaching procedures favorably. We found that responsive, family-centered research CAN be conducted in spite of significant history events, and that mobile apps and virtual meeting platforms can be an accessible and efficient method for supporting families. The use of single case design allowed for flexible, yet methodologically sound procedures. More work is needed examining effective and efficient virtual supports for families.</p> <p>Keywords: Early childhood; Challenging behavior; Parent coaching; Telehealth; Autism spectrum disorder; Medical and Health Sciences Public Health and Health Services</p> <p>Copyright comment Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</p> <p>Challenging behaviors (CB) have been identified as a primary concern facing schools (Fox & Hemmeter, [<reflink idref="bib11" id="ref1">11</reflink>]). Studies have found increasingly high rates of children who present with CB entering kindergarten (Lee & Bierman, [<reflink idref="bib18" id="ref2">18</reflink>]); CB is especially prevalent among young children with disabilities, with clinically significant forms of CB occurring in 48–60% of children with intellectual disabilities and up to 90% of children with autism spectrum disorder (ASD; Simó-Pinatella et al., [<reflink idref="bib29" id="ref3">29</reflink>]). The high prevalence of CB is especially troubling given CB in the preschool years are predictive of later adjustment difficulties and negative long-term outcomes (Frey et al., [<reflink idref="bib13" id="ref4">13</reflink>]). The relation between social development and school readiness highlights a critical need to address CB as early as possible (Frey et al., [<reflink idref="bib13" id="ref5">13</reflink>]; Lee & Bierman, [<reflink idref="bib18" id="ref6">18</reflink>]).</p> <p>While research shows that CB is a significant barrier to effective teaching in classrooms, similar challenges also occur in home settings (Doubet & Ostrosky, [<reflink idref="bib7" id="ref7">7</reflink>]). Parents of young children with persistent CB face stressful demands, and CB can affect a family's ability to participate in home and community activities (Lucyshyn et al., [<reflink idref="bib19" id="ref8">19</reflink>]). CB is a significant source of parental stress, can negatively impact the quality of life for children and their families, and can be associated with embarrassment, isolation, and discomfort (Fox et al., [<reflink idref="bib12" id="ref9">12</reflink>]). In fact, parents of children with disabilities cited CB among their greatest concerns (Bromley et al., [<reflink idref="bib5" id="ref10">5</reflink>]).</p> <p>Extensive research has shown that functional assessment (FA)-based interventions are an effective approach for reducing CB and increasing pro-social behaviors (Reeves et al., [<reflink idref="bib27" id="ref11">27</reflink>]; Wood et al., [<reflink idref="bib38" id="ref12">38</reflink>]). FA-based interventions are collaborative, assessment-based approaches to developing effective, individualized interventions for children who demonstrate CB (Lucyshyn et al., [<reflink idref="bib20" id="ref13">20</reflink>]). Such interventions are centered on the principle that CB serves a specific function for the individual, such as gaining attention, escaping a demand, or getting access to an item or activity. A recent review of parent implemented FA-based interventions found that 11 of the 13 identified studies included follow-up support for families (Fettig & Barton, [<reflink idref="bib8" id="ref14">8</reflink>]). Follow-up support included a variety of practices (e.g., practice opportunities, performance-based feedback). Effectiveness of parent interventions is highly associated with the implementation supports families receive in authentic settings (Forgatch et al., [<reflink idref="bib10" id="ref15">10</reflink>]). When interventions move from the training to natural implementation settings, intervention fidelity might be negatively impacted without appropriate supports (Dickinson, [<reflink idref="bib6" id="ref16">6</reflink>]; Marulis & Neuman, [<reflink idref="bib21" id="ref17">21</reflink>]). The supports parents receive are crucial for yielding positive child outcomes (Powell et al., [<reflink idref="bib26" id="ref18">26</reflink>]), given that the effectiveness of any intervention is directly related to the level of intervention fidelity (Barton & Fettig, [<reflink idref="bib2" id="ref19">2</reflink>]; Fettig et al., [<reflink idref="bib9" id="ref20">9</reflink>]).</p> <p>Given the challenges faced in supporting families with children exhibiting challenging behaviors, there is a significant demand for innovative and accessible interventions. While FA-based interventions have proven effective, the delivery and sustainability of these interventions in home settings remain a concern (Strain & Bovey, [<reflink idref="bib34" id="ref21">34</reflink>]). Recognizing these gaps, we developed the Family Behavior Support application (FBSApp; AUTHORS, [<reflink idref="bib1" id="ref22">1</reflink>]) as a potential solution. This app responds to the need for flexible, family-centered interventions that can adapt to varied family dynamics, a gap identified in recent research (Smith et al., [<reflink idref="bib31" id="ref23">31</reflink>]). Its accessibility may also enhance intervention fidelity, as consistent and convenient access to intervention tools is a critical factor in maintaining effective implementation (Neely et al., [<reflink idref="bib24" id="ref24">24</reflink>]). The FBSApp thus serves as a practical extension of existing methodologies, providing evidence-based strategies through a platform that is both accessible and customizable, aiming to mitigate some of the common constraints associated with conventional interventions.</p> <p>The FBSApp provides a structured and intuitive platform that supports parents in the application of FA-based interventions within home environments. It includes features designed to facilitate the identification and application of behavioral strategies, such as a system for personalizing strategy recommendations based on user input and modules for interactive learning. The app processes information input by parents related to antecedent–behavior–consequence (ABC) patterns to inform the development of a behavior support plan (BSP) that is tailored to the child's needs. Furthermore, it offers resources for education and feedback to assist parents in the effective application and monitoring of these strategies. The app is also designed to facilitate ongoing engagement and support collaborative interactions between families and early intervention professionals, which may contribute to more effective management of challenging behaviors.</p> <p>We conducted the current study to examine the utility of the FBSApp for efficiently supporting parents' implementation of FA-based interventions to address their child's CB. The following research questions guided our study: (<reflink idref="bib1" id="ref25">1</reflink>) Does family use of the FBSApp with professional coaching increase parent use of function-based strategies? (<reflink idref="bib2" id="ref26">2</reflink>) Does family use of the FBSApp with professional coaching decrease child challenging behavior? (<reflink idref="bib3" id="ref27">3</reflink>) Does family use of the FBSApp with professional coaching increase child replacement behaviors? (<reflink idref="bib4" id="ref28">4</reflink>) Do families perceive the FBSApp to be useful and effective? (<reflink idref="bib5" id="ref29">5</reflink>) Do families perceive the professional coaching paired with the use of the FBSApp to be useful and effective?</p> <hd id="AN0186910022-2">Method</hd> <p></p> <hd id="AN0186910022-3">Participants</hd> <p></p> <hd id="AN0186910022-4">Families</hd> <p>We began recruitment procedures after obtaining approval from the Institutional Review Board. Recruitment included distribution of flyers both in-person and via e-mail to relevant childcare, service provision, and educational agencies in the area, and via social media. Interested families were screened using these inclusion criteria: (a) child between the ages of 24 and 61 months; (b) child demonstrated a consistent pattern (i.e., 3 or more times per week) of CB in the home setting, according to parent report; (c) child had a diagnosed disability, or was at-risk for a disability according to the Ages and Stages Questionnaire: Social–Emotional, 2nd edition (ASQ-SE-2; Squires et al., [<reflink idref="bib32" id="ref30">32</reflink>]); (d) family primarily spoke English at home.</p> <p>Five parent–child dyads were recruited and consented for participation in the study. All families were located around a large metropolitan area in a southeastern state. Family 1 consisted of a 45-month-old White male with diagnoses of ASD, significant language delay (SLD), and developmental delay (DD) and his mother, a 36-year-old White female. His CB included elopement and tantrums. Family 2 consisted of a 39-month-old, Black/Hispanic female with sensory processing disorder and her mother, a 39-year-old White female. Her CB included verbal refusal and screaming. Family 3 consisted of a 42-month-old White/Hispanic male with ASD and his mother, a 37-year-old White female. His CB consisted of throwing objects and kicking. Family 4 consisted of a 39-month-old White female with ASD, SLD, and DD and her mother, a 42-year-old White female. Her CB included hitting and throwing objects. Family 5 consisted of a 56-month-old White male with ASD and his mother, a 36-year-old White female. His CB included screaming and elopement. Family 5 withdrew from the study during baseline when a tornado damaged their home. Their data are not included in the graphs and are available by request from the first author.</p> <hd id="AN0186910022-5">Professional Support</hd> <p></p> <hd id="AN0186910022-6">Community Professionals</hd> <p>Educational and service professionals from within the families' community (e.g., behavior analysts, occupational therapists) were consented for participation in the study. These professionals already served in a support role for the families and were recruited to support them as coaches throughout the study. Following the onset of the pandemic, many families discontinued in-person services or lost contact entirely with these professionals. To adapt, graduate students within the research lab (hereafter, coaches) filled the coaching role originally intended for the community professionals.</p> <hd id="AN0186910022-7">Coaches</hd> <p>The participating coaches who assumed the family support role were graduate students enrolled in an early childhood special education (ECSE) program and working toward certification in behavior analysis. The coach for Family 1 was a 25-year-old White female; the coach for Families 2 and 3 was a 22-year-old White female; the coach for Family 4 was a 24-year-old White female. All coaches had a Bachelor's degree in psychology and previous experience working with young children.</p> <hd id="AN0186910022-8">Research Assistants (RA)</hd> <p>Graduate students who were working as RAs within the primary author's research lab conducted all other study procedures, including video recording observation sessions and coding for caregiver and child behavior data. All RAs were first- or second-year master's students enrolled in an ECSE program.</p> <hd id="AN0186910022-9">Setting</hd> <p>All study procedures took place in individual families' homes. During intake, each family chose a specific routine during which CB regularly occurred to be targeted for intervention. The target routine for Family 1 was bath time; the target routine for Family 2 was free play with a sibling; the target routine for Family 3 was free play with the sibling while the parent was occupied (e.g., preparing dinner); the target routine for Family 4 was free play with mother.</p> <hd id="AN0186910022-10">Experimental Design</hd> <p>We tested the efficacy of the FBSApp using a single case research multiple probe design (Gast & Ledford, [<reflink idref="bib14" id="ref31">14</reflink>]). Caregiver use of function-based strategies was the primary dependent variable and was used to make all condition change decisions. Data were collected across all families simultaneously during baseline; the first dyad to demonstrate stability in child CB was given a manual for downloading the FBSApp, including linking their community professional. When the onset of the global pandemic required revision of our procedures, we added coaching support as part of the intervention (introduced in a staggered manner consistent with multiple probe design logic) while maintaining experimental control. Additional details are provided in the procedures section. We used visual analysis formatively to make experimental decisions throughout the study, and at conclusion of the study to evaluate experimental control and the presence of a functional relation, using procedures consistent with Barton et al. recommendations ([<reflink idref="bib4" id="ref32">4</reflink>]).</p> <hd id="AN0186910022-11">Dependent Variables and Coding Procedures</hd> <p></p> <hd id="AN0186910022-12">Caregiver Behaviors</hd> <p>The coders collected data on four caregiver behaviors: (<reflink idref="bib1" id="ref33">1</reflink>) prevent strategies, (<reflink idref="bib2" id="ref34">2</reflink>) teach trials, (<reflink idref="bib3" id="ref35">3</reflink>) response to CB, and (<reflink idref="bib4" id="ref36">4</reflink>) reinforcement of replacement behavior. Data were collected only on the participating caregiver's behaviors, even if other caregivers were present during the routine. Caregiver statements were always considered to be directed towards the target child unless the caregiver used a vocal or gestural attentional cue to another person (e.g., calling by name or tapping person on shoulder). Coding manuals, operational definitions of each behavior, and raw data for each participant are available via OpenScience Framework.</p> <hd id="AN0186910022-13">Prevent Strategies</hd> <p>A prevent strategy was defined as a vocal statement involving a change in the antecedents typically occurring before CB to make CB less likely. The strategy could not occur within 5 s of CB. Coders categorized each instance under one of six categories: first/then statements, positive descriptive feedback, transition warnings, behavior expectations, predictable schedules, and choices.</p> <hd id="AN0186910022-14">Teach Trials</hd> <p>A teach trial was defined as the vocal presentation of opportunity for the child to use an appropriate replacement behavior. This included an establishing statement (i.e., a vocal statement that increased the value of a reinforcer) or discriminative stimulus (i.e., a vocal statement that indicated a particular behavior would be reinforced). The onset of the teach trial could not occur within 5 s of the offset of CB. Next, a trial was considered complete if the caregiver provided a prompt (i.e., assistance to promote child replacement behavior that differed from the initial establishing statement/discriminative stimulus), or the child engaged in a replacement behavior and the caregiver provided a functional reinforcer. If the child engaged in a replacement behavior that was consistent with the function of the behavior in that trial, the caregiver then had to provide reinforcement within 5 s of the offset of the child's behavior. Trials containing CB and trials missing at least one of these elements were marked as incomplete.</p> <hd id="AN0186910022-15">Response to CB</hd> <p>A response strategy was defined as a caregiver behavior that was incompatible with reinforcement of the child's CB, thus reducing the likelihood that the CB would occur again in the future. Each instance of response strategy occurred in the presence of CB. An opportunity for a response strategy started at the onset of the CB and continued until 5 s after the offset of CB. Coders recorded the caregiver use of response strategies that were specifically included on their child's BSP (see Table 1). A nonexample of a response strategy was a caregiver response that reinforced the child's CB.</p> <p>Table 1 BSP strategies generated for each family</p> <p> <ephtml> <table frame="hsides" rules="groups"><thead><tr><th align="left" /><th align="left"><p>Function</p></th><th align="left"><p>Prevent</p></th><th align="left"><p>Teach</p></th><th align="left"><p>Response</p></th></tr></thead><tbody><tr><td align="left"><p>Family 1</p></td><td align="left"><p>Escape demand</p></td><td align="left"><p>Positive descriptive feedback</p></td><td align="left"><p>Say "no thank you" or "all done"</p></td><td align="left"><p>Prompt-follow through</p></td></tr><tr><td align="left" /><td align="left"><p>Gain attention<sup>a</sup></p></td><td align="left" /><td align="left"><p>Make choices</p></td><td align="left"><p>Avoid attending to CB<sup>a</sup></p></td></tr><tr><td align="left" /><td align="left" /><td align="left" /><td align="left"><p>Ask for attention<sup>a</sup></p></td><td align="left" /></tr><tr><td align="left"><p>Family 2</p></td><td align="left"><p>Gain attention</p></td><td align="left"><p>Predictable schedules</p></td><td align="left"><p>Ask for attention</p></td><td align="left"><p>Avoid attending to CB</p></td></tr><tr><td align="left" /><td align="left"><p>Escape demand</p></td><td align="left" /><td align="left"><p>Say "no thank you" or "all done"</p></td><td align="left"><p>Prompt-follow through</p></td></tr><tr><td align="left" /><td align="left" /><td align="left" /><td align="left"><p>Follow directions</p></td><td align="left" /></tr><tr><td align="left"><p>Family 3</p></td><td align="left"><p>Gain attention</p></td><td align="left"><p>Transition warnings</p></td><td align="left"><p>Ask for attention</p></td><td align="left"><p>Avoid attending to CB</p></td></tr><tr><td align="left" /><td align="left"><p>Gain item</p></td><td align="left" /><td align="left"><p>Ask for item</p></td><td align="left"><p>Withhold item</p></td></tr><tr><td align="left"><p>Family 4</p></td><td align="left"><p>Gain attention</p></td><td align="left"><p>First/then statements</p></td><td align="left"><p>Ask for attention</p></td><td align="left"><p>Avoid attending to CB</p></td></tr><tr><td align="left" /><td align="left"><p>Gain item</p></td><td align="left"><p>Choices</p></td><td align="left"><p>Ask for item</p></td><td align="left"><p>Withhold item</p></td></tr><tr><td align="left" /><td align="left" /><td align="left"><p>Behavior expectations</p></td><td align="left"><p>Take turns</p></td><td align="left" /></tr></tbody></table> </ephtml> </p> <p> <sups>a</sups>Function/strategy that was added to the BSP later in the study due to a shift in the contingencies surrounding the child's behavior. All families were coached on the use of all six prevent strategies</p> <hd id="AN0186910022-16">Reinforcement of Replacement Behavior</hd> <p>Reinforcement of a replacement behavior was defined as caregiver provision of the functional reinforcer contingent on the child's use of a replacement behavior. For each instance of child replacement behavior, coders indicated whether the caregiver provided a functional reinforcer within 5 s. Only reinforcers consistent with the function of the child's replacement behavior were recorded. Nonexamples included the caregiver providing reinforcement after 5 s or not responding.</p> <hd id="AN0186910022-17">Child Behaviors</hd> <p></p> <hd id="AN0186910022-18">Challenging Behavior (CB)</hd> <p>CB was defined as any repeated pattern of behavior that interfered with or was at risk of interfering with optimal learning or engagement with peers or adults (Smith & Fox, [<reflink idref="bib30" id="ref37">30</reflink>], p. 6). Repetitive or self-stimulatory behaviors that did not meet any other criteria (e.g., hand-flapping) were not considered CB. When collecting antecedent and consequence data in pre-baseline observations, coders identified the common topographies of CB for each child. Parent input during screening and intake was also taken into account. Individualized operational definitions of each child's CB, examples, and non-examples were then developed (available via OpenScience Framework).</p> <hd id="AN0186910022-19">Replacement Behaviors</hd> <p>Replacement behavior was defined as a child's vocal statement that served as a request for functionally equivalent reinforcement from the target caregiver. Replacement behaviors could occur spontaneously or within a teach trial. Replacement behaviors for the families in this study included: (a) ask for attention, (b) ask for help, (c) say "no thank you," or, "all done," and (d) ask for an item or object. Given the variable language ability in participants, child-specific examples and non-examples were also developed (available via OpenScience Framework).</p> <hd id="AN0186910022-20">Measurement System</hd> <p>Coders used ProCoder for Digital Video (ProcoderDV; Tapp, [<reflink idref="bib35" id="ref38">35</reflink>]) to code all variables. The frequency of prevent strategies, the frequency of teach strategies, and the onset and offset of each instance of child CB was coded using timed-event recording. A new onset of behavior began with a 5 s latency from previously coded behavior of the same topography. CB data were converted to rate by dividing the number of onsets by the total video length. Two coders independently coded each session and then met to come to a consensus on all disagreements prior to subsequent steps. If disagreements were not easily resolved, the third author was consulted for a decision. Coders recorded frequency of child replacement behaviors using timed-event recording. Child replacement behaviors were recorded categorically as either reinforced or not reinforced. Coders also categorized each teach trial in regard to presence of child replacement behavior and presence of caregiver reinforcement. Finally, each instance of CB was categorized by the presence of the caregiver's use of response strategy or reinforcement.</p> <hd id="AN0186910022-21">Coding Training</hd> <p>RAs were trained by two doctoral students enrolled in an ECSE program (the third and fifth authors) to code all variables. First, RAs were given a coding manual describing the dependent variables, including operational definitions, rules, examples, and non-examples. Next, trainers and RAs met to review the manual and code a practice video. RAs then coded non-study videos until reaching at least 80% agreement with the trainers on two videos for each dependent variable. Weekly meetings were conducted throughout to discuss formative agreement.</p> <hd id="AN0186910022-22">Interobserver Agreement</hd> <p>To assess interobserver agreement (IOA), two RAs independently coded 100% of baseline and intervention sessions for all participants on all variables. For timed-event recording variables, IOA was estimated using point-by-point agreement (Ledford et al., [<reflink idref="bib17" id="ref39">17</reflink>]) with a 3 s agreement time-window. Occurrence and nonoccurrence percent agreement was calculated by dividing all agreements by agreements plus disagreements and multiplying the quotient by 100 (Yoder et al., [<reflink idref="bib39" id="ref40">39</reflink>]). For categorical variables, IOA was estimated using an agreement method with each behavior marked as an agreement or disagreement.</p> <p>For CB, prevent strategies, and complete teach trials, we conducted consensus coding for 100% of sessions because we anticipated caregiver behaviors would occur at low frequency in baseline, and child behaviors would occur at low frequency in intervention. Low base-rate behavior can lead to IOA averages below quality standards (Velez et al., [<reflink idref="bib36" id="ref41">36</reflink>]; Yoder et al., [<reflink idref="bib39" id="ref42">39</reflink>]). Consensus coding increases the confidence in the validity of the data, given that two coders reviewed each video and came to agreement prior to subsequent steps in coding. Due to resource constraints, consensus coding did not occur for response strategies, replacement behaviors, and reinforcement of replacement behaviors.</p> <hd id="AN0186910022-23">Procedural Fidelity (PF)</hd> <p>A self-report fidelity checklist was created to ensure the proper video recording procedures took place throughout the study. The checklist consisted of yes/no items and was designed to be completed by each RA during and after each session.</p> <hd id="AN0186910022-24">Social Validity</hd> <p>A post-study survey was emailed to each family after their final observation to complete independently via REDCap (Harris et al., [<reflink idref="bib15" id="ref43">15</reflink>]). The survey contained 18 items regarding usability and feasibility of the FBSApp, as well as questions about parent's confidence addressing their child's CB, and family quality of life. Families were encouraged to give additional feedback about the study to their coach or project coordinator via email.</p> <hd id="AN0186910022-25">Procedures and Intervention</hd> <p></p> <hd id="AN0186910022-26">Video Recording</hd> <p></p> <hd id="AN0186910022-27">Initial Procedures</hd> <p>RAs conducted in-person recordings of the targeted routines for each family 2–3 times per week. The RA arrived at the home, greeted the family, answered any caregiver questions, and moved to the periphery of the room to record the routine, after which the RA did not interact with the parent or child. Once the routine ended, or after a maximum of 15 min had elapsed, the RA stopped recording, signaled to the parent that they were done, and left the home.</p> <hd id="AN0186910022-28">Adapted Procedures</hd> <p>In March 2020 (i.e., 3 weeks into data collection), all in-person research paused due to state-issued stay-at-home orders and university-mandated safety protocols in response to the COVID-19 pandemic, resulting in adaptations to the study procedures. Instead of recording observations in-person in families' homes, observations were conducted and recorded via Zoom™ video conferencing software. Families were issued recording equipment (i.e., tripod, iPad) and instructed to set the equipment up prior to each observation. The RA sent the family a Zoom™ link on the day of the observation. The RA then recorded the observation via Zoom™ and uploaded the video to a secure online hard drive. The RA muted themselves and turned their video off during observations. If obstructions occurred (e.g., the iPad fell), the RA unmuted themselves and alerted the parent, or sent the parent a text message. After the routine ended, or after a maximum time of 15 min, the RA ended the recording.</p> <hd id="AN0186910022-29">Baseline</hd> <p>During baseline, families were instructed to engage in the target routine as they typically would. The only added variable was the presence of an unfamiliar person (i.e., the RA; initial procedures) or video-recording device (i.e., iPad; adapted procedures). Baseline observations continued until data were stable.</p> <hd id="AN0186910022-30">Intervention</hd> <p>Immediately prior to intervention, families received a manual with instructions for downloading and creating an account within the FBSApp. How-to videos and instructional graphics within the app guided families through the process of collecting and logging ABC data to create a BSP and utilizing the recommended strategies within the BSP. The manual also contained instructions for adding a professional to download and jointly access the BSP created in the app. Families were encouraged to visit the app regularly (i.e., 3–4 times per week) to access the informational resources and to communicate with their coach if they had questions or concerns about their BSP. After the family accessed the FBSApp, intervention observations began, which followed baseline procedures.</p> <hd id="AN0186910022-31">Adapted Intervention</hd> <p>Due to inconsistent involvement of community professionals after the onset of the pandemic, each family received support from a coach surrounding use of strategies in the BSP. The coach scheduled an introductory meeting to discuss the family's preferred form of contact and level of confidence in understanding and using the strategies listed on their child's BSP. This information was used to determine the initial content, format, and intensity of the coaches' support. The coaching procedures were adapted throughout intervention according to families' needs and feedback. During this period, observations continued according to the same procedures as intervention. After the caregiver and child data showed therapeutic change, coaching was gradually faded. Family-specific procedures are detailed below.</p> <hd id="AN0186910022-32">Family 1</hd> <p></p> <hd id="AN0186910022-33">Adapted Intervention</hd> <p>The initial format of coaching for Family 1 was weekly check-in via text in which the coach provided supportive and corrective feedback, citing specific examples from observations during the previous week. After 20 sessions with no behavior change, the coach conducted a 30-min booster training on the BSP strategies using behavior skills training (BST; Miltenberger, [<reflink idref="bib23" id="ref44">23</reflink>]). The coach then began providing post-session feedback at a higher intensity (i.e., following each observation rather than weekly) until data stabilized.</p> <hd id="AN0186910022-34">Fading</hd> <p>Support was faded in two phases. In phase one, the coach discontinued live feedback. In the second phase, the coach discontinued corrective feedback. The coach and family then met for a final review session.</p> <hd id="AN0186910022-35">Family 2</hd> <p></p> <hd id="AN0186910022-36">Adapted Intervention</hd> <p>The family began receiving coaching after eight intervention sessions with no behavior change. Per family preference, the coach provided initial support through biweekly phone meetings. During these meetings, the coach gave supportive and corrective feedback, reviewed key strategies from the BSP, and set goals or reviewed progress on previous goals. After eight sessions with no significant change in behavior, the coach added pre-session reminders and post-session feedback (e.g., supporting and corrective).</p> <hd id="AN0186910022-37">Fading</hd> <p>Support was faded in two phases. In phase one, pre-session reminders were removed. In phase two, the coach only provided weekly check-ins via text. The coach and family then met for a final review session.</p> <hd id="AN0186910022-38">Family 3</hd> <p></p> <hd id="AN0186910022-39">Adapted Intervention</hd> <p>The family started receiving coaching after eight intervention sessions with no behavior change. Per family preference, the coach provided initial support through biweekly phone meetings during which they reviewed strategies and delivered supportive and corrective feedback. Email communication occurred in between meetings as needed. After receiving coaching for seven sessions, the family requested to exit the study due to extenuating circumstances. Fading procedures were not implemented.</p> <hd id="AN0186910022-40">Family 4</hd> <p></p> <hd id="AN0186910022-41">Adapted Intervention</hd> <p>The family started receiving coaching after seven sessions with no behavior change. The coach provided initial support through weekly Zoom meetings, during which the coach provided supportive and corrective feedback and reviewed key strategies from the BSP. Emails were sent within 24 h of an observation and contained both supportive and corrective feedback and goal-setting. After five sessions with no change in behavior, the coach began sending pre-session text reminders of the current goal.</p> <hd id="AN0186910022-42">Fading</hd> <p>Coaching was faded in two phases. During phase one, the coach replaced corrective feedback with reflective questions. In phase two, post-session email feedback was discontinued. The coach and family then met for a final review session.</p> <hd id="AN0186910022-43">Results</hd> <p>A functional relation was not identified between access to FBSApp and caregiver use of prevent or teach strategies; however, the addition of coaching did lead to increased strategy use for two out of four caregivers. A functional relation was identified between the use of the FBSApp plus coaching and reductions in CB, with three demonstrations of effect. Data are displayed in Figs. 1, 2, 3, and 4.</p> <p>Graph: Fig. 1 Frequency of caregiver use of prevent strategies. Dashed line during baseline phase indicates the onset of adapted procedures due to the pandemic lockdown</p> <p>Graph: Fig. 2 Frequency of caregiver engagement in complete teach trials (i.e., trials that contained a prompt or reinforcement for a replacement behavior)</p> <p>Graph: Fig. 3 Frequency of child challenging behavior (CB; closed circles) and caregiver use of new response strategies (NR; open circles)</p> <p>Graph: Fig. 4 Frequency of child engagement in replacement behaviors within and outside of trials</p> <hd id="AN0186910022-44">Caregiver Prevent Strategies</hd> <p>The frequency of caregiver use of prevent strategies is displayed in Fig. 1. Use of prevent strategies increased largely for one family. Small gains, including more consistent usage, were seen for two of the four families. No covariation was detected across tiers, thus demonstrating experimental control.</p> <p>For Family 1, baseline data were low and stable (<emph>range</emph> = 0–2) with one outlier at six. With the addition of FBSApp, data increased in variability and level (<emph>range</emph> = 1–6). When coaching was added, data increased in level with high variability (<emph>range</emph> = 1–32). When coaching was faded, data remained higher than baseline levels with high variability (<emph>range</emph> = 6–27). For Family 2, baseline data were variable (<emph>range</emph> = 1–9). With the addition of FBSApp, data increased slightly and remained variable (<emph>range</emph> = 4–10). When coaching was added, data remained consistent (<emph>range</emph> = 1–16). Once coaching was faded, data remained slightly higher with less variability compared to baseline (<emph>range</emph> = 4–12). For Family 3, baseline data were low with slight variability (<emph>range</emph> = 1–5). With the addition of FBSApp, data remained variable at the same level as baseline with one outlier at 11 (<emph>range</emph> = 1–6). With the addition of coaching, data remained consistent with the previous conditions (<emph>range</emph> = 2–11). For Family 4, baseline data were low with slight variability (<emph>range</emph> = 0–5), which continued with the addition of the FBSApp (<emph>range</emph> = 0–5). When coaching was added, data increased slightly with continued variability (<emph>range</emph> = 0–7). Once coaching was faded, data were variable at levels higher than previous conditions (<emph>range</emph> = 1–9).</p> <hd id="AN0186910022-45">Caregiver Teach Strategies</hd> <p>The frequency of caregiver use of teach trials is displayed in Fig. 2. There was a large increase in teach strategy use for two out of the four caregivers and small gains for one caregiver. There was no covariation across tiers, demonstrating experimental control.</p> <p>For Family 1, baseline data were low and stable (<emph>range</emph> = 0–1). With the addition of FBSApp, data immediately increased in level with high variability (<emph>range</emph> = 0–5). With the addition of coaching, data remained high and variable (<emph>range</emph> = 0–9). When coaching was faded, data decreased slightly but remained higher than baseline levels (<emph>range</emph> = 1–8). For Family 2, baseline data were stable at zero. With the addition of FBSApp, data remained low. With the addition of coaching, data remained low with 25% of sessions above baseline levels (<emph>range</emph> = 0–2). When coaching was faded, data remained low, but with five of six data points higher than baseline (<emph>range</emph> = 0–2). For Family 3, baseline data were low and stable. Data remained low with the addition of FBSApp, then coaching. For Family 4, baseline data were variable (<emph>range</emph> = 0–4). With the addition of FBSApp, data remained variable at lower levels (<emph>range</emph> = 0–2). When coaching was added, data were initially low and consistent with previous conditions; however, at session 30, data increased to three and remained at higher-than-baseline levels for 8 of 10 sessions (<emph>range</emph> = 3–5). When coaching was faded, data were highly variable (<emph>range</emph> = 0–8).</p> <hd id="AN0186910022-46">Child CB and Caregiver Response Strategies</hd> <p>The frequency of child CB (closed circles) is depicted in Fig. 3 alongside caregiver response to CB (open circles). CB decreased for three out of four families, demonstrating a functional relation. There was no covariation across tiers, demonstrating experimental control. No trends or functional relations were identified for response strategies.</p> <p>For Family 1, baseline CB data were high and variable (<emph>range</emph> = 4–16). With the addition of FBSApp, data were lower in level (<emph>range</emph> = 0–8), with one outlier at 16. With the addition of coaching, data were lower (<emph>range</emph> = 1–10) with a decreasing trend across the first 14 sessions. From sessions 33 to 47, data were highly variable (<emph>range</emph> = 0–20), after which data were low and stable for the remainder of intervention except for one outlier. When coaching was faded, data remained low and stable (<emph>range</emph> = 0–4) with one outlier at nine. Response strategies followed near identical patterns to CB throughout all conditions. For Family 2, baseline CB data were low and stable (<emph>range</emph> = 2–4) with two outlying data points. With FBSApp, data decreased slightly in level (<emph>range</emph> = 0–4) with 50% overlap with baseline. Once coaching was added, data immediately stabilized at near zero levels until session 42, after which variability increased (<emph>range</emph> = 0–6). Once coaching was faded, data returned to low and stable levels (<emph>range</emph> = 0–4). Response strategies were similar in trend and level to CB across all conditions. For Family 3, during baseline, CB data were highly variable (<emph>range</emph> = 0–17) with a slight decreasing trend. With the addition of FBSApp, data were highly variable, ranging from 0 to 11 with one outlier at 27. Data remained highly variable with coaching (<emph>range</emph> = 0–11). For Family 4, baseline CB data were highly variable (<emph>range</emph> = 0–20). Data remained variable when FBSApp was introduced (<emph>range</emph> = 5–21). With the addition of coaching, data stabilized around 12 and then decreased, with zero-level sessions at the end of the condition. When coaching was faded, data remained relatively low with increased variability from the end of the previous condition (<emph>range</emph> = 0–7). For Families 3 and 4, response strategies were low in comparison to CB during baseline. As CB decreased when coaching was introduced, response strategies increased in proportion, indicating that the parent responded to more instances of CB in a way that decreased the future likelihood of CB.</p> <hd id="AN0186910022-47">Child Replacement Behavior</hd> <p>The frequency of replacement behaviors is displayed in Fig. 4. Data were highly variable with no covariation across tiers. For Family 1, data were low during baseline, ranging from 0 to 3. Upon introduction of FBSApp, data were highly variable (<emph>range</emph> = 0–8). When coaching was added, data remained at similar levels (<emph>range</emph> = 2–9) across the first 10 sessions before decreasing slightly (<emph>range</emph> = 0–5), then returning to comparable levels in the final sessions. When coaching was faded, data remained variable at low to moderate levels (<emph>range</emph> = 1–7). For Family 2, data were variable during baseline, ranging from 0 to 5. Data were similar with the addition of FBSApp. After coaching was added, levels decreased initially, then followed an increasing trend across intervention. Data remained variable, but with consistent levels in the high end of the range during the final intervention sessions. Patterns were similar when coaching was faded (<emph>range</emph> = 1–7). For Family 3, baseline data started at a moderate level and decreased to consistently lower levels (<emph>range</emph> = 1–3). With the addition of FBSApp, data were variable (<emph>range</emph> = 1–8) with an increasing trend. When coaching was added, data remained variable with a greater range than previous conditions (<emph>range</emph> = 0–10). For Family 4, data were highly variable in baseline. With FBSApp, the data were less variable at low to moderate levels (<emph>range</emph> = 0–6) with one outlier in the final session. When coaching was added, data were more consistent at moderate levels (<emph>range</emph> = 1–8) with two high outliers. When coaching was faded, data were variable with four of six sessions at high levels (<emph>range</emph> = 4–15).</p> <hd id="AN0186910022-48">Interobserver Agreement</hd> <p>IOA by family, condition, and variable is displayed in Table 2. For caregiver variables, average IOA across families and conditions for (a) prevent strategies was 75%, (b) complete teach trials was 95%, and (c) response occurrence was 83% and nonoccurrence was 81%. For child variables, average IOA across families and conditions for (a) CB was 69%, (b) prompted replacement behavior occurrence was 89% and nonoccurrence was 92%, and (c) spontaneous replacement behavior was 40%. IOA ranged from 0 to 100% for all variables. As expected, IOA was lower for variables that were free operant and required more inference-based decisions (i.e., prevent, CB, and spontaneous replacement behaviors; Yoder et al., [<reflink idref="bib39" id="ref45">39</reflink>]).</p> <p>Table 2 IOA Across caregiver and child variables</p> <p> <ephtml> <table frame="hsides" rules="groups"><thead><tr><th align="left"><p>Caregiver Behavior</p></th><th align="left" /><th align="left"><p>Family 1 (%)</p></th><th align="left"><p>Family 2 (%)</p></th><th align="left"><p>Family 3 (%)</p></th><th align="left"><p>Family 4 (%)</p></th></tr></thead><tbody><tr><td align="left"><p>Prevent</p></td><td align="left"><p>Baseline</p></td><td align="left"><p>81</p></td><td align="left"><p>56</p></td><td align="left"><p>78</p></td><td align="left"><p>95</p></td></tr><tr><td align="left" /><td align="left"><p>Intervention</p></td><td align="left"><p>67</p></td><td align="left"><p>45</p></td><td align="left"><p>71</p></td><td align="left"><p>77</p></td></tr><tr><td align="left" /><td align="left"><p>% of sessions</p></td><td align="left"><p>100</p></td><td align="left"><p>100</p></td><td align="left"><p>100</p></td><td align="left"><p>100</p></td></tr><tr><td align="left"><p>Teach Complete</p></td><td align="left"><p>Baseline</p></td><td align="left"><p>100</p></td><td align="left"><p>100</p></td><td align="left"><p>98</p></td><td align="left"><p>97</p></td></tr><tr><td align="left" /><td align="left"><p>Intervention</p></td><td align="left"><p>94</p></td><td align="left"><p>95</p></td><td align="left"><p>95</p></td><td align="left"><p>94</p></td></tr><tr><td align="left" /><td align="left"><p>% of sessions</p></td><td align="left"><p>100</p></td><td align="left"><p>39</p></td><td align="left"><p>100</p></td><td align="left"><p>100</p></td></tr><tr><td align="left"><p>New Response Occurrence</p></td><td align="left"><p>Baseline</p></td><td align="left"><p>84</p></td><td align="left"><p>100</p></td><td align="left"><p>43</p></td><td align="left"><p>86</p></td></tr><tr><td align="left" /><td align="left"><p>Intervention</p></td><td align="left"><p>75</p></td><td align="left"><p>100</p></td><td align="left"><p>77</p></td><td align="left"><p>84</p></td></tr><tr><td align="left" /><td align="left"><p>% of sessions</p></td><td align="left"><p>33</p></td><td align="left"><p>39</p></td><td align="left"><p>35</p></td><td align="left"><p>39</p></td></tr><tr><td align="left"><p>New Response Nonoccurrence</p></td><td align="left"><p>Baseline</p></td><td align="left"><p>100</p></td><td align="left"><p>100</p></td><td align="left"><p>80</p></td><td align="left"><p>76</p></td></tr><tr><td align="left" /><td align="left"><p>Intervention</p></td><td align="left"><p>100</p></td><td align="left"><p>75</p></td><td align="left"><p>37</p></td><td align="left"><p>77</p></td></tr><tr><td align="left" /><td align="left"><p>% of sessions</p></td><td align="left"><p>33</p></td><td align="left"><p>39</p></td><td align="left"><p>35</p></td><td align="left"><p>39</p></td></tr></tbody></table> </ephtml> </p> <p> <ephtml> <table frame="hsides" rules="groups"><thead><tr><th align="left"><p>Child Behavior</p></th><th align="left" /><th align="left"><p>Family 1 (%)</p></th><th align="left"><p>Family 2 (%)</p></th><th align="left"><p>Family 3 (%)</p></th><th align="left"><p>Family 4 (%)</p></th></tr></thead><tbody><tr><td align="left"><p>Challenging Behavior</p></td><td align="left"><p>Baseline</p></td><td align="left"><p>67</p></td><td align="left"><p>70</p></td><td align="left"><p>82</p></td><td align="left"><p>80</p></td></tr><tr><td align="left" /><td align="left"><p>Intervention</p></td><td align="left"><p>68</p></td><td align="left"><p>51</p></td><td align="left"><p>81</p></td><td align="left"><p>68</p></td></tr><tr><td align="left" /><td align="left"><p>% of sessions</p></td><td align="left"><p>100</p></td><td align="left"><p>100</p></td><td align="left"><p>100</p></td><td align="left"><p>100</p></td></tr><tr><td align="left"><p>Prompted RB Occurrence</p></td><td align="left"><p>Baseline</p></td><td align="left"><p>67</p></td><td align="left"><p>67</p></td><td align="left"><p>100</p></td><td align="left"><p>81</p></td></tr><tr><td align="left" /><td align="left"><p>Intervention</p></td><td align="left"><p>99</p></td><td align="left"><p>94</p></td><td align="left"><p>83</p></td><td align="left"><p>77</p></td></tr><tr><td align="left" /><td align="left"><p>% of sessions</p></td><td align="left"><p>33</p></td><td align="left"><p>39</p></td><td align="left"><p>35</p></td><td align="left"><p>39</p></td></tr><tr><td align="left"><p>Prompted RB Nonoccurrence</p></td><td align="left"><p>Baseline</p></td><td align="left"><p>97</p></td><td align="left"><p>100</p></td><td align="left"><p>71</p></td><td align="left"><p>85</p></td></tr><tr><td align="left" /><td align="left"><p>Intervention</p></td><td align="left"><p>94</p></td><td align="left"><p>100</p></td><td align="left"><p>75</p></td><td align="left"><p>92</p></td></tr><tr><td align="left" /><td align="left"><p>% of sessions</p></td><td align="left"><p>33</p></td><td align="left"><p>39</p></td><td align="left"><p>35</p></td><td align="left"><p>39</p></td></tr><tr><td align="left"><p>Spontaneous RB</p></td><td align="left"><p>Baseline</p></td><td align="left"><p>55</p></td><td align="left"><p>67</p></td><td align="left"><p>34</p></td><td align="left"><p>62</p></td></tr><tr><td align="left" /><td align="left"><p>Intervention</p></td><td align="left"><p>38</p></td><td align="left"><p>30</p></td><td align="left"><p>51</p></td><td align="left"><p>32</p></td></tr><tr><td align="left" /><td align="left"><p>% of sessions</p></td><td align="left"><p>33</p></td><td align="left"><p>39</p></td><td align="left"><p>35</p></td><td align="left"><p>39</p></td></tr></tbody></table> </ephtml> </p> <p> <emph>RB</emph> replacement behaviors</p> <hd id="AN0186910022-49">Procedural Fidelity</hd> <p>Procedural fidelity was collected via self-report during 100% of sessions during initial procedures. The mean procedural fidelity was 97% (<emph>range</emph> = 80–100) across families during baseline. During adapted intervention, the responses to the modified checklist were inconsistent and not checked for accuracy during the course of the study. Thus, these data were not analyzed.</p> <hd id="AN0186910022-50">Social Validity</hd> <p>Responses to the post-study survey were idiosyncratic. Specific results for each family who responded (<emph>n</emph> = 3) are available via OpenScience Framework. Families reported the ease of use and the overall performance of the app favorably, and were very satisfied with the ability to collaborate with professionals within the app. Families' responses regarding the likelihood that they would continue using the app, or that they would recommend the app to other families or professionals, were mixed (i.e., one participant was likely to continue using the app, one participant was not, and one participant was unsure). Families also reported varying levels of confidence in addressing their child's behaviors using the app, ranging from confident to not at all confident. These results might indicate that FBSApp is a feasible format for families to receive information, but the application of the information may not be accessible to all families. All families reported being satisfied with the coaching, indicating stronger preferences for the individualized coaching procedures paired with the app compared to independent use of the app. Overall, the families reported that they were satisfied with their experience participating in the study.</p> <p>Anecdotally, families who continued until the end of the study (i.e., 1, 2, 4) reported satisfaction with both the coaches and the FBSApp. For example, Family 1 reported, "Bath time is now one of my favorite parts of the week!!" Family 4 said, "The information and support you all have given me has been a blessing." Family 3, who did not stay in the study as long as the other families, reported lower social validity scores. They also reported, "I found the communication directly with [the coach] much more helpful than the app... But I will say I found the app to be helping in reminding me how to handle behaviors and the best ways to respond. It was motivating." The families anecdotally reported that the support from the coach paired with the information and resources provided within the app was helpful to understand and use the recommended strategies to support their child's behavior.</p> <hd id="AN0186910022-51">Discussion</hd> <p>Our study had several specific aims including examining the efficacy of the FBSApp with professional coaching for increasing parent use of function-based strategies and child use of challenging behaviors and replacement skills. Although we did not identify consistent behavior change across all caregivers in relation to their use of the FBSApp, the results of our study have multiple important contributions. First, we found that responsive, supportive, family-centered research CAN—and should—be conducted despite significant history events (e.g., global pandemic). This was important for continuing to explore efficient and effective strategies for virtually supporting families, which will have a lasting impact on services given the efficiency of virtual supports (Steed et al., [<reflink idref="bib33" id="ref46">33</reflink>]). We learned that virtual support systems (e.g., Zoom™ coaching, text message/email communication, app usage) can be a valid and effective method for coaching families across contexts as they support their child's social emotional development. The research on virtual coaching has increased over the previous years but more work is needed in this area (Poole et al., [<reflink idref="bib25" id="ref47">25</reflink>]). Our study contributes new knowledge by demonstrating that the use of a mobile app along with virtual meeting platforms (FaceTime, Zoom™) can be effective (Meadan et al., [<reflink idref="bib22" id="ref48">22</reflink>]). Virtual supports can be more cost-efficient and effective for families and can increase access to services for families who might otherwise have difficulty access services (e.g., families in rural areas, families experiencing homelessness, families who have health restrictions). Virtual services allow for families to receive access to supports while maintaining family-centered approaches including providing coaching in the natural environment across routines, using the family's materials, and building on the families' strengths. Research and technology in this area is burgeoning and additional, innovative studies are needed to ensure the field has robust and varied strategies, technologies, and methods of service delivery available to meet the idiosyncratic and changing needs of families. Our data suggest the FBSApp with virtual coaching is a promising method for supporting some families; more research is needed.</p> <p>Second, the use of the FBSApp with individualized coaching resulted in increases in strategy use by parents in two of four families and decreases in child CB. Further, we also observed anecdotal (i.e., family-reported) improvements in child CB and quality of targeted routines across children and their families. Given that observations occurred in dynamic and naturally occurring contexts, with a complex intervention being utilized by indigenous implementers, we assert that these data are reflective of highly applied research occurring in a "real life" context. However, our data do not show sustained improvements, which suggests the dosage or type of supports might need to be adapted to ensure families experience lasting change, or that the strategies we taught families were not aligned with their values or feasible within their current routines. These are important avenues for future research.</p> <p>Finally, we used single case research design methodology which is inherently dynamic and allowed for flexibility in supporting families while maintaining experimental control (Barton et al., [<reflink idref="bib3" id="ref49">3</reflink>]). Our applied research study was responsive to each family's needs and caregiver rates of responding while also being methodologically sound. Given the onset of the global pandemic, we wanted to be particularly sensitive to families changing needs and increased stress. Our design allowed for flexibility in when and how we provided the intervention, while maintaining experimental control. Researchers should continue to examine how to flexibly support families while providing meaningful empirical data.</p> <hd id="AN0186910022-52">Limitations</hd> <p>The greater global events that occurred impacted the initially intended procedures and weakened experimental control. There were several major history events that affected the study across tiers (i.e., tornado and pandemic) and within tiers (i.e., job loss). In an attempt to respond to all of these events, the coaching methods were disparate across families. While this limits conclusions that can be drawn about the efficacy of a specific coaching method, it demonstrates that the FBSApp can be a tool used in a variety of approaches to meet families' specific needs. Because procedures veered from those originally proposed and were tailored to each family, PF was not collected. This is a significant limitation that will be addressed in future studies of the FBSApp and individualized coaching.</p> <p>The coding scheme was complex and resource intensive, requiring a team of five coders to conduct several passes of the videos to capture all caregiver and child variables. As video recording adapted to Zoom™, many sessions contained uncodeable segments due to internet connectivity issues, limited intelligibility, or recording logistics. Although averages for CB, RB, and prevent strategies were sometimes below modern standards for IOA (e.g., Ledford & Gast, [<reflink idref="bib16" id="ref50">16</reflink>]; What Works Clearinghouse, [<reflink idref="bib37" id="ref51">37</reflink>]), our procedures for protecting against bias (e.g., consensus coding, graphing secondary alongside primary data throughout data collection, secondary coders who were partially masked to study condition) were methodologically rigorous. We also suspect that IOA was lower for particular variables (i.e., prevent strategies, CB, spontaneous replacement behaviors) due to the nature of the recording procedures and the cognitive load of coding highly inferential variables for each family-specific function. In addition, in attempting to make the coding system and definitions broad enough for application across families and settings, we may have limited the sensitivity to detect changes in individually specific caregiver and child behaviors.</p> <hd id="AN0186910022-53">Implications for Research and Practice</hd> <p>Additional research is needed examining the efficacy of the FBSApp along with virtual coaching for supporting families with children with challenging behaviors. Research specifically examining and identifying effective coaching strategies that can be used along with the FBSApp to increase efficiency might have important implications for service delivery (e.g., reducing costs, and increasing access). Research also is needed for identifying strategies for individualizing supports to each family's unique needs (in practice <emph>and</emph> research) by asking families about their preferences, being flexible and making systematic adjustments as needed, and documenting procedures. Also, continuing to expand behavioral science and special education research into applied settings—including homes—is critical. This will allow for the identification of socially and ecologically valid supports. Future research should identify (and explicitly report) methods, dosage, and family preference for coaching to identify a comprehensive understanding of family coaching components, including strategies and dosage that do <emph>not</emph> lead to sustained improvements. Finally, wraparound systems of supports for families are still sorely needed (e.g., all families only had one, at most, community professionals they could identify as potential support). We know communication and meaningful supports to families from professionals are often limited even outside of the global pandemic and can have lasting impact on both children and their families and communities.</p> <hd id="AN0186910022-54">Conclusion</hd> <p>Challenging behaviors have been identified as a primary concern facing families (Doubet & Ostrosky, [<reflink idref="bib7" id="ref52">7</reflink>]). Further, challenging behaviors can have lasting impacts; more than 50% of students identified with disruptive disorders as young children exhibited challenging behaviors when they entered school (Shaw et al., [<reflink idref="bib28" id="ref53">28</reflink>]). The FBSApp has potential to address critical gaps in providing (a) ongoing support to parents to enhance their capacity to prevent and reduce their child's challenging behaviors and promote social emotional skills, and (b) effective FA-based intervention practices for young children with disabilities and challenging behaviors to prevent negative long-term developmental outcomes and promote social emotional competence and school readiness. Although more research is needed, our results are promising and suggest family-centered supports can be provided efficiently and effectively with innovative technologies such as mobile apps and virtual coaching.</p> <hd id="AN0186910022-55">Acknowledgments</hd> <p>Additional details regarding the participants, coding and coaching procedures and social validity can be found on OpenScience Framework (https://doi.org/ https://doi.org/10.17605/OSF.IO/69DSC).</p> <hd id="AN0186910022-56">Author contributions</hd> <p>All authors contributed to the study conception and design, material preparation, and data collection. Data analysis was conducted by EEB, CW, MSV, MT, and BML. The first draft of the manuscript was written by EEB and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript, submitted by CW.</p> <hd id="AN0186910022-57">Funding</hd> <p>The work in this publication was funded in part by the Institute of Education Sciences, U.S. Department of Education, through Grant R324A160086 to Vanderbilt University.</p> <hd id="AN0186910022-58">Declarations</hd> <p></p> <hd id="AN0186910022-59">Conflict of interest</hd> <p>The authors have no conflicting interests to declare that are relevant to the content of this article.</p> <hd id="AN0186910022-60">Publisher's Note</hd> <p>Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.</p> <ref id="AN0186910022-61"> <title> References </title> <blist> <bibl id="bib1" idref="ref22" type="bt">1</bibl> <bibtext> AUTHORS. (2022). Family Behavior Support App (version 1.0.1). 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  Data: Field Testing the Family Behavior Support Mobile Application (FBSApp) during a Global Pandemic
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  Data: <searchLink fieldCode="AR" term="%22Erin+E%2E+Barton%22">Erin E. Barton</searchLink> (ORCID <externalLink term="http://orcid.org/0000-0002-5575-5713">0000-0002-5575-5713</externalLink>)<br /><searchLink fieldCode="AR" term="%22Claire+Winchester%22">Claire Winchester</searchLink> (ORCID <externalLink term="http://orcid.org/0000-0001-9125-2593">0000-0001-9125-2593</externalLink>)<br /><searchLink fieldCode="AR" term="%22Marina+S%2E+Velez%22">Marina S. Velez</searchLink> (ORCID <externalLink term="http://orcid.org/0000-0002-6879-8392">0000-0002-6879-8392</externalLink>)<br /><searchLink fieldCode="AR" term="%22Mollie+Todt%22">Mollie Todt</searchLink> (ORCID <externalLink term="http://orcid.org/0000-0002-9407-3969">0000-0002-9407-3969</externalLink>)<br /><searchLink fieldCode="AR" term="%22Brandy+M%2E+Locchetta%22">Brandy M. Locchetta</searchLink> (ORCID <externalLink term="http://orcid.org/0000-0003-3940-1023">0000-0003-3940-1023</externalLink>)<br /><searchLink fieldCode="AR" term="%22Emma+Skiba%22">Emma Skiba</searchLink>
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  Data: <searchLink fieldCode="SO" term="%22Journal+of+Autism+and+Developmental+Disorders%22"><i>Journal of Autism and Developmental Disorders</i></searchLink>. 2025 55(8):2680-2695.
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  Data: Springer. Available from: Springer Nature. One New York Plaza, Suite 4600, New York, NY 10004. Tel: 800-777-4643; Tel: 212-460-1500; Fax: 212-460-1700; e-mail: customerservice@springernature.com; Web site: https://link.springer.com/
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  Data: 10.1007/s10803-024-06373-8
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  Data: 0162-3257<br />1573-3432
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  Data: We developed and tested an evidence-based mobile application designed to support families in using functional assessment-based intervention strategies with their young children with disabilities and challenging behaviors in home settings. Five families participated in the study. We utilized a multiple-probe across participants design to examine the effects of the FBSApp on parents' use of intervention strategies and childrens' use of challenging behaviors and replacement behaviors. We adapted our procedures to include individualized coaching to provide meaningful and effective support after the onset of the COVID-19 pandemic. A functional relation was not identified between access to FBSApp and caregiver use of strategies; however, the addition of coaching did lead to increased strategy use for two of four caregivers. A functional relation was identified between the use of the FBSApp plus coaching and CB. Families reported the app and coaching procedures favorably. We found that responsive, family-centered research CAN be conducted in spite of significant history events, and that mobile apps and virtual meeting platforms can be an accessible and efficient method for supporting families. The use of single case design allowed for flexible, yet methodologically sound procedures. More work is needed examining effective and efficient virtual supports for families.
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