This study is evaluating whether a telehealth-based applied behavior analysis (ABA) program can improve the care of adolescents and young adults with autism spectrum disorder (ASD) who are hospitalized because of severe challenging behaviors, such as aggression, self-injury, property destruction, or elopement.
Participants will be randomly assigned to receive either standard hospital care alone or standard hospital care plus a Telehealth Applied Behavior Analysis for Hospitalized Adolescents and Young Adults With Autism Spectrum Disorder (TeleABA) program. The TeleABA program includes assessment by a Board Certified Behavior Analyst (BCBA), individualized behavior support recommendations, coaching for hospital staff, caregiver training, discharge planning, and four weekly telehealth sessions with caregivers after the participant leaves the hospital.
Researchers will compare the two groups to determine whether the TeleABA program improves behavioral outcomes, caregiver confidence and stress, hospital experiences, and the transition from the hospital to home. The findings may help identify more effective ways to support individuals with autism and their families during and after behavioral health hospitalizations.
Age 12 years or older.
Established or documented diagnosis of autism spectrum disorder (ASD) in the electronic medical record or confirmed by the attending provider using DSM-5 criteria.
Admitted to a participating Hackensack Meridian Health hospital due to behavioral concerns (e.g., aggression, self-injury, elopement, or property destruction) that contribute to or prolong hospitalization.
Behavioral support identified by the attending provider as a primary component of the current admission.
Admission for an acute medical condition in which behavioral concerns are not a primary driver of hospitalization.
Medical instability that precludes participation in telehealth sessions.
Absence of a caregiver or legally authorized representative able to provide informed consent.
Parallel
Standard Hospital Care
BehavioralStandard inpatient behavioral health care provided by the hospital, including psychiatric evaluation, medication management, nursing care, therapeutic programming, and discharge planning in accordance with routine clinical practice.
Telehealth Applied Behavior Analysis (TeleABA)
BehavioralThe TeleABA intervention is a telehealth-delivered applied behavior analysis (ABA) program designed to support adolescents and young adults with autism spectrum disorder during hospitalization and the transition to home. A Board Certified Behavior Analyst (BCBA) conducts caregiver interviews, behavioral assessment, functional assessment when indicated, and develops individualized behavior support recommendations. The intervention includes consultation and coaching for hospital staff, caregiver training, discharge planning, and four weekly telehealth caregiver coaching sessions following hospital discharge to support implementation of behavior support strategies and continuity of care.
Change in Aberrant Behavior Checklist-Irritability (ABC-I) Score
The Aberrant Behavior Checklist-Irritability Subscale is a caregiver-reported measure of irritability, agitation, aggression, tantrums, and self-injurious behavior. Scores range from 0 to 45, with higher scores indicating greater irritability and more severe behavioral symptoms. The primary outcome is the change from baseline in ABC-I score, comparing participants receiving Hospital TeleABA with those receiving standard care.
Clinical Global Impression-Improvement (CGI-I)
The Clinical Global Impression-Improvement (CGI-I) is a clinician-rated measure of overall improvement in behavioral symptoms compared with baseline. Scores range from 1 to 7, where 1 = very much improved, 4 = no change, and 7 = very much worse. Lower scores indicate greater clinical improvement. CGI-I scores will be compared between participants receiving Hospital TeleABA and standard care.
Clinical Global Impression-Severity (CGI-S)
The Clinical Global Impression-Severity (CGI-S) is a clinician-rated measure of the severity of behavioral symptoms at the time of assessment. Scores range from 1 to 7, where 1 = normal, not at all ill and 7 = among the most extremely ill patients. Higher scores indicate greater symptom severity. CGI-S scores will be compared between participants receiving Hospital TeleABA and standard care.
Hospital Length of Stay, days
Hospital length of stay, defined as the number of days from hospital admission to hospital discharge, obtained from the electronic health record.
Use of Restrictive Interventions
Number of manual or chemical restraint events during hospitalization, extracted from the electronic health record.
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Caring Technologies, Inc.
Lead sponsor
National Institute of Mental Health (NIMH)
Collaborator
Hackensack Meridian Health
Collaborator
Center for Social Dynamics
Collaborator
Rutgers University
Collaborator
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