When working with children and families impacted by autism, respect for individual and cultural differences is imperative. Client-centered practices should be strength-based, focus on building socially important skills, and address behaviors that challenge. There is evidence that interventions grounded in applied behavior analysis (ABA) constitute best practice. Unfortunately, many areas of the world are struggling to access such services. Frequently, limited public resources are spent on low-intensity interventions that are not evidence-based. In these situations, any professional behavior analysts who do exist tend to be overworked, under-supported, and struggling to provide high-quality services. Not surprisingly, misinformation about ABA tends to thrive in such circumstances. Telehealth services can mediate some of these challenges, especially if they focus on developing culturally competent and sustainable support services. Using telehealth, caregivers can be trained to follow protocols and provide behavioral support services to their own children. This chapter outlines the background and practice of behavior-analytic telehealth services in the context of family-centered behavioral applications. Systematic steps are outlined that facilitate caregiver-mediated change efforts in support of a child’s behavior as well as the family’s quality of life.