Grandparent-Implemented Interventions to Reduce Challenging Behavior of an Adult With Autism: A Pilot Telehealth Case Study

Adults with autism spectrum disorder (ASD) often engage in challenging behavior that requires individualized intervention to remediate. However, access to high-quality services is limited for adults, leaving this population without necessary behavioral healthcare. This study addressed the needs of a 22-year-old man with ASD and intellectual disability (ID) who lived with his grandmother and engaged in tangibly maintained challenging behavior. The interventionist coached his grandmother via telehealth in the implementation of two behavior analytic interventions: signaled multiple schedule arrangement and a modified contingency contract. The effects of the interventions were evaluated using an alternating treatments design with baseline. While both interventions were effective at decreasing challenging behavior when compared to baseline, the signaled multiple schedule arrangement resulted in zero instances of challenging behavior. Both the participant and the grandparent completed post-intervention social validity assessments and reported overall positive satisfaction with the interventions. Practice recommendations are presented.