|
| Evaluating the Impact of Practitioner Training and Service Delivery Models Through Retrospective Consecutive Case Series |
| Sunday, May 30, 2021 |
| 9:00 AM–10:50 AM |
| Online |
| Area: TBA/EDC; Domain: Service Delivery |
| Chair: Bailey Copeland (Vanderbilt University) |
| Discussant: Sally Bereznak Shepley (The University of Kentucky) |
| CE Instructor: Sally Bereznak Shepley, M.Ed. |
| Abstract: This symposium will present a suite of talks intended to serve as a forum for introspective data analysis, reflection, and future directions for two distinct service provision models. Both models offer behavior analytic services to individuals who have a history of engaging in challenging behavior and who lack important adaptive skills necessary for success in school and society. The first model discussed in this symposium, an outpatient severe behavior clinic (SBC), developed a brief, family-centered service provision model to meet the unique needs of the surrounding communities. The SBC aimed to (a) identify the function of each client’s challenging behavior, (b) create an effective, function-based treatment plan, (c) train caregivers to successfully implement the plan at home. The second model discussed in this symposium, the Vanderbilt Behavior Analysis Clinic, operates under a threefold mission: (a) service delivery, (b) practitioner training, and (c) research. Across talks, presenters evaluate the extent to which the two programs meet their reported goals and discuss to need for routine program evaluation. Ongoing evaluation of program level practices ensures that practitioners monitoring services and making modifications as needed to promote meaningful outcomes for children, families, and future practitioners. |
| Instruction Level: Advanced |
| Keyword(s): caregiver buy-in, practitioner training, service delivery, treatment framework |
| Target Audience: Audience members should have experience with functional analysis methodology and designing function based treatments. The talks in this symposium require audience members to be familiar with evaluating behavior-analytic systems at a program-wide level. |
| Learning Objectives: At the conclusion of the presentation, participants will be able to: (1) Identify tailoring factors that should be considered when individualizing assessment and treatment of severe challenging behavior. (2) Describe the benefits of a practitioner training model focused on individualization and iterative processes. (3) Identify the benefits of using caregiver report in conjunction with direct observation measures to evaluate treatment outcomes. |
| |
| Evaluation of a Brief Family-Centered Service Provision Model for Treating Children’s Severe Behavior |
| COLLIN SHEPLEY (University of Kentucky) |
| Abstract: We conducted an initial program evaluation of a service provision model for providing behavior analytic services to families living in the central Kentucky area. A retrospective consecutive case series design was used to evaluate the effectiveness, feasibility, and cost of the model. We analyzed records for all families served through the model from summer 2017 to fall 2018. A total of 55 families received services, and children ranged from preschool to high school age, with 87% having autism and 63% having intellectual disability. Within-participant single-case experimental designs were used to evaluate the clinic’s assessment procedures. Conclusive assessment results were obtained for approximately 69% of children. For families that received treatment, 92% reported improved child behavior. Intent-to-treat analyses that included families that withdrew from services prior to receiving treatment, indicated that 61% of families experienced improved child behavior. Assessment and treatment outcomes for families that attended all appointments are commensurate to that of other similar clinics reported in the literature; however, the percentage of families that withdrew from services is substantially higher. For families adhering to the clinic’s services, children’s challenging behavior may be effectively assessed and treated through brief out-patient contacts utilizing services based on applied behavior analysis. |
| |
| Evaluation of a University-Based Practicum Tailored to Train Scholars to Address Challenging Behavior |
| JESSICA LEE PARANCZAK (Vanderbilt University), Joseph Michael Lambert (Vanderbilt University), Bailey Copeland (Vanderbilt University), Margaret Jane Macdonald (Vanderbilt University) |
| Abstract: Since its inception, the mission of the field of applied behavior analysis (ABA) has been to generate a behavior-change technology capable of improving lives under socially significant circumstances. Verified course sequences are designed to provide future practitioners with a subset of skills that are applicable to a variety of domains. However, in practice, clinicians commit their lives to specific populations or applications of ABA. There is limited empirical evidence on domain specific training experiences. Vanderbilt University has crafted their training model based on conventional wisdom and professional judgement. The purpose of this study was to describe an empirical framework used to evaluate the quality and validity of an ABA-internship experience across a 6-year period of time. This experience was designed to meet the unique needs of pre-service practitioners in a special education department. Further, data were analyzed to determine the success of the internship experience in promoting the anticipated outcomes. |
| |
| Outcomes of a Focused University Practicum: Creating a Function-Informed Mechanism-Based Framework for Challenging Behavior |
| Margaret Macdonald (Vanderbilt University), JOSEPH LAMBERT (Vanderbilt University), Bailey Copeland (Vanderbilt University), Jessica Lee Paranczak (Vanderbilt University) |
| Abstract: Practitioner papers suggest individualization and iterative design are good ideas for both assessment and treatment of problem behavior for individuals with disabilities. However, there are no validated frameworks for engaging in this iterative process. Due to the nature of research in the field of behavior analysis, empirically validating a decision tree would be an extensive and time-consuming process. To mitigate these time restraints, we propose analyzing a framework through a retrospective controlled consecutive case series. Client data from a university-based practicum were analyzed across a 6-year period to describe and summarize functional-analysis and treatment data for clients served through a university-based internship. We then analyzed treatment outcome data to evaluate the degree to which functions identified through functional analyses facilitated clinically significant improvements in challenging behavior. The purpose of this study was to describe a function-informed, mechanisms-based framework for selecting intervention components in the treatment of persistent, challenging behavior. Preliminary results are discussed. |
| |
Exploring the Impact of Focused Service Delivery on Families of Children With Challenging Behavior |
| AMANDA SANDSTROM (Vanderbilt University), Joseph Michael Lambert (Vanderbilt University), Robert Hodapp (Vanderbilt University) |
| Abstract: Interventions for the treatment of challenging behavior are often delivered intensively, over relatively short periods of time. In a focused service delivery model employed by a local, graduate-level training program, discharge occurs shortly after the reduction of problem behavior and the increase of appropriate alternative responding. While plentiful data exist documenting the immediate effects of intervention implementation on reduced rates of challenging behavior and increased rates of appropriate responding, less data document long-term effects of service delivery. In this study, 25 caregivers of children who participated in this model were contacted one-to-five years following discharge. Caregivers discussed their original expectations of services, experience participating in these services, and the current state of their child’s problem behavior. Social validity measures, as well as qualitative reports of caregiver perceptions of problem behavior and appropriate responding, are analyzed. The results compare perceived and empirical effects and suggest the persistence of service impact across several years. |
|
| |