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Association for Behavior Analysis International

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44th Annual Convention; San Diego, CA; 2018

Event Details

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Symposium #36
CE Offered: BACB
Transferring Successful Skill-Based Treatments to Caregivers
Saturday, May 26, 2018
10:00 AM–11:50 AM
Manchester Grand Hyatt, Grand Hall A
Area: DDA/AUT; Domain: Applied Research
CE Instructor: Shannon Ward, M.S.
Chair: Shannon Ward (New England Center for Children; Western New England University)
Discussant: Florence D. DiGennaro Reed (University of Kansas)
Abstract: One of the primary goals of applied research is to identify efficacious treatments for problem behavior that relevant caregivers can implement in relevant settings. In this symposium, we will review efficacious strategies for treating problem behavior and specific methods that will assist in training caregivers on the implementation of those strategies. First, an assessment and treatment model for treating feeding problems in the home setting will be reviewed in which caregivers were involved from the initial assessment through a 12-month follow-up. Next, we will review a skill-based treatment for food selectivity in an adolescent diagnosed with autism who engages in problem behavior, without evoking problem behavior throughout the teaching process. Then, an efficacious training program will be reviewed in which parents were taught to implement a comprehensive treatment for socially mediated problem behavior with their child. Finally, the utility of a training rubric will be reviewed as a tool for successfully transferring skill-based treatments to parents and caregivers in the treatment of socially mediated problem behavior.
Instruction Level: Intermediate
Keyword(s): caregiver training, food selectivity, parent training, problem behavior
Target Audience: Graduate students, practitioners, researchers
Learning Objectives: At the conclusion of the symposium, participants will be able to: 1. Describe an assessment and treatment model for treating food refusal in home-based settings. 2. Describe a skill-based treatment for food selectivity for a child with autism without evoking problem behavior throughout treatment. 3. Describe strategies that will lead to the successful transfer of efficacious treatments to parents and relevant caregivers for treatment of socially mediated problem behavior.
Caregiver Involvement, Implementation, and Longer Term Adherence in the Treatment of Pediatric Feeding Disorders
Sarah Leadley (University of Auckland), JAVIER VIRUES ORTEGA (The University of Auckland)
Abstract: Multiple reviews focusing on the treatment of severe feeding disorders have recommended an increased focus on caregiver implementation, and nutritional and social outcomes. However, research continues to concentrate on the analysis of specific treatment procedures implemented by trained therapists during treatment admission. In this study, a home-based behavioural assessment and treatment model was evaluated for nine children with tube dependency. Caregivers informed assessment conditions, participated during experimenter-led sessions, and then received sequential phases of training to implement treatment protocols. We monitored caregiver implementation until the childs treatment goal was achieved (tube feeding cessation), then during follow-up visits conducted up to 12 months following the study. By the final follow-up, six of nine children had ceased tube feeding. We discuss the impact of caregiver participation on child performance, training requirements, and procedural integrity. In addition, we highlight barriers to longer-term adherence and recommendations for future research.
Meals Without Tears: The Treatment of Food Selectivity in Children With Autism
JULIANA MARCUS (New England Center for Children), Gregory P. Hanley (Western New England University), Kyle Sears (Western New England University), Holly Gover (Western New England University), Kelsey Ruppel (Western New England University), Christine Ann Warner (New England Center for Children )
Abstract: Between 67 and 89% of individuals with developmental disabilities have feeding problems (Silbaugh et al., 2016). This study describes a skill-based treatment to address food selectivity in children with autism who engage in problem behavior. An assessment was conducted with the participant's caregivers to identify foods to use in a preference analysis and to identify possible reinforcement contingencies influencing food refusal. Results were used to design a functional analysis of refusal. The reinforcement contingency shown to influence refusal in the analysis was then arranged to strengthen more appropriate food refusal behaviors. A contingency-based delay fading procedure was used to thin the schedule of reinforcement for appropriate refusal while suppressing inappropriate refusal and problem behavior and increasing mealtime requirements prior to reinforcement. By the end of this study, the participant consumed small meals consisting of multiple bites of a variety of foods that he did not eat previously, but that caregivers had reported wanting him to eat. Treatment was extended to caregivers in relevant environments. Interobserver agreement averaged 92% (range, 85% to 100%) for all variables measured. The results of this study suggest that these procedures may be useful for treating food selectivity without evoking problem behavior in children with autism.
A Technological Description of Teaching Parents to Implement Skill-Based Treatment of Socially-Mediated Problem Behavior
ROBIN K. LANDA (Western New England University), Gregory P. Hanley (Western New England University), Adithyan Rajaraman (Western New England University)
Abstract: Problem behavior that occurs exclusively with parents during a functional analysis (e.g., Hanley, Jin, Vanselow, & Hanratty, 2014; Ringdahl & Sellers, 2000) necessitates that parents serve as the sole interventionists. Researchers have demonstrated that parent-implemented treatments can be successful; however, prior research in this area is limited by (a) the incompleteness of the treatment evaluated (Marcus, Swanson, & Vollmer, 2001; Wacker et al., 2005) (b) the lack of technological descriptions of parent training (e.g., Hanley et al., 2014), or (c) the absence of treatment fidelity data (e.g., Hanley et al., 2014). We evaluated the efficacy of a training program consisting of instructions, textual models, feedback, and shaping in teaching parents to serve as interventionists for children who exhibit severe problem behavior sensitive only to parent-mediated reinforcement. The training program resulted in correct implementation of the skill-based intervention and elimination of errors (e.g., coaxing, arguing). The parent-implemented intervention led to a reduction in the child’s problem behavior and acquisition of functional communication responses, tolerance responses, and compliance. Interobserver agreement was assessed for more than 20% of sessions with a minimum agreement of 80%.
Utility of a Training Rubric for Transferring Successful Skill-Based Treatment of Problem Behavior to Caregivers
KELSEY RUPPEL (Western New England University), Adithyan Rajaraman (Western New England University), Gregory P. Hanley (Western New England University), Robin K. Landa (Western New England University), Holly Gover (Western New England University)
Abstract: Hanley, Jin, Vanselow, and Hanratty (2014) described a comprehensive, efficacious functional assessment and treatment process for the severe problem behavior of three children with autism. Although the authors presented child behavior data following caregiver training and implementation of treatment in the participants’ homes, they did not provide a detailed description of the caregiver-training process. We replicated the Hanley et al. assessment and treatment process with two young children who lacked diagnoses but were reported to engage in intolerable levels of problem behavior. After clinic-based behavior analysts obtained similar effects to those reported in Hanley et al., we trained caregivers using behavioral skills training and a performance rubric. We present a technological description of the parent training process, as well as parent treatment integrity data and child behavior data. Results show that parents learned to implement the treatment with integrity, children demonstrated improved social skills, and child problem behavior was substantially reduced or eliminated while parents implemented treatment.



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