|Maximizing Alignment Between Trauma-Informed Care and Applied Behavior Analysis|
|Monday, May 29, 2023|
|11:00 AM–12:50 PM |
|Convention Center 403/404|
|Area: EDC/CBM; Domain: Applied Research|
|Chair: Marney Squires Pollack (Vanderbilt University)|
|Discussant: Jennifer L. Austin (Georgia State University)|
|CE Instructor: Marney Squires Pollack, M.S.|
Trauma-informed care (TIC) is an approach to health and human service delivery initially conceptualized to address the unique needs of individuals exposed to trauma. In recent years, a growing number of behavior analysts have acknowledged the importance of aligning intervention procedures with principles of TIC, recognizing that the client populations with whom many behavior analysts work are likely to be at increased risk of experiencing traumatic events (e.g., abuse, neglect). In this symposium, we present data from four evaluations of trauma-informed approaches to behavior analytic intervention. We first share outcomes from a systematic literature review that informed the development of a framework outlining function-based intervention procedures that are consistent and inconsistent with TIC. Presenters then describe procedures and outcomes of a variety of behavior-change programs that incorporate procedures aligned with TIC to promote skill development and increased autonomy, while also avoiding any procedures that could potentially result in re-traumatization. These programs varied widely with respect to client characteristics, intervention contexts, behavior change goals, and programmed procedures. Taken together, outcomes demonstrate the promise of trauma-informed approaches to behavior analytic service delivery.
|Instruction Level: Intermediate|
|Keyword(s): maximizing safety, promoting autonomy, trauma, trauma-informed care|
|Target Audience: |
The target audience for this session includes practicing behavior analysts who oversee behavior change programs that address challenging behavior. Audience members should be competent in selecting, designing, and implementing behavior change interventions. The session is particularly relevant for practitioners who support individuals who have experienced trauma, though this is not required.
|Learning Objectives: At the conclusion of the presentation, participants will be able to: (1) identify areas of alignment and misalignment between the pillars of trauma-informed care and function-based intervention procedures; (2) describe the MAPSS model for delivering services to foster and adoptive families; (3) identify ways in which the Preschool Life Skills curriculum can be adapted for older children who have experienced trauma; (4) describe how a modified version of Skill-Based Treatment addressing food selectivity is aligned with commitments of trauma-informed care.|
Evaluating Alignment Between Pillars of Trauma-Informed Care and Function-Based Interventions for Students With Emotional/Behavioral Disorders
|MARNEY SQUIRES POLLACK (Vanderbilt University), Blair Lloyd (Vanderbilt University), Lilian Doyle (Vanderbilt University), Gabrielle Crowell (Vanderbilt University ), Matthew Santini (Vanderbilt University)|
Traumatic experiences are associated with the development of externalizing challenging behaviors — a common characteristic of students with emotional/behavioral disorders (EBD; Rasche et al., 2016). Ironically, the same externalizing behaviors can put students at risk for re-traumatization, and further exacerbation of these challenges (Rajaraman et al., 2022). The National Child Traumatic Stress Network (2017) recommends that schools implement function-based interventions (FBIs) consistent with trauma-informed care. While the promise of FBIs for students with EBD has been documented (McKenna et al., 2016), the extent to which they align with principles of trauma-informed care remains unknown. We conducted a systematic review of FBI studies including students with EBD to evaluate the extent to which these interventions incorporate critical elements of a trauma-informed approach. Using systematic search and screening procedures, we identified 56 articles that evaluated FBIs for elementary students with EBD. We used an iterative process to identify FBI procedures consistent and inconsistent with trauma-informed care and then explored the extent to which interventions incorporated these procedures. Results highlight areas of both alignment and misalignment between FBI procedures and trauma-informed care. Implications for research and practice with respect to incorporating trauma-informed procedures in FBIs for students with EBD will be discussed.
|Multi-Agency Permanency Support Service (MAPSS): Building Effective Trauma-Informed Services for Care-Experienced Children|
|LAURA ANNE NEAL (The Behaviour Clinic), Katie Murphy (The Behaviour Clinic)|
|Abstract: “Care-experienced” children include those who are fostered, adopted, or living with relatives or in residential care. These children have often experienced multiple adverse childhood experiences (ACEs) and present with complex trauma histories that impact their social and emotional development. A regional partnership board in South Wales, supported by Welsh Government funding, have taken an innovative approach to supporting care-experienced children using a behavioural model of trauma-informed therapeutic care. The underlying goal of this collaboration is to support children’s residency in safe and stable environments, precluding the need for multiple placement moves. In this presentation, we will discuss the practical application of the model and present case examples to demonstrate treatment effects across a range of behaviours, from toileting accidents to aggression. We also will discuss current trends in the presenting needs of the care experienced population and the importance of working collaboratively with service providers.|
Using the Preschool Life Skills Curriculum to Teach Critical Skills to Children With Trauma Histories
|RACHEL ELIZABETH REES (The Behaviour Clinic), Christopher Seel (University of South Wales ), Barney George Huxtable (The Behaviour Clinic), Jennifer L. Austin (Georgia State University)|
The Preschool Life Skills curriculum (PLS; Hanley et al., 2007) teaches critical learning and social skills to preschool-aged children, with a growing body of research demonstrating its effectiveness across typically developing and autistic children in school and home settings. Although developed for young children, older children with multiple adverse childhood experiences (ACEs) frequently have the same early-learner skills deficits targeted by the program. The current study partially replicated Hanley et al.’s (2007) PLS training model with two typically developing male participants, who were receiving trauma-informed, behaviourally based services in South Wales. The two boys, aged 9 and 11, had both experienced multiple ACEs and were living in shared family care or foster care. Skill development was assessed using a multiple-baseline across skills design for both participants, and showed that both children learned the skills quickly and maintained them at follow up. We will discuss the applicability of the PLS curriculum for children with trauma histories, as well as the trauma-informed adaptations to ensure that safety, shared governance, and choice were built into the training process. We also will address future directions in using skill-based approaches when working with children that have experienced childhood trauma and how to promote generality to other settings.
|Is the Treatment of Food Selectivity Effective and Trauma Informed? Presentation of a Treatment Model Package|
|ROSARIA BENINCASA (Neapolisanit Rehabilitation Center), Floriana Canniello (Neapolisanit Clinical and Research Center), LUIGI IOVINO (Neapolisanit Center), Mariangela Cerasuolo (AIAS Onlus sez.Nola), Maria Gallucci (AIAS Onlus sez.Nola), Annapia Mautone (Neapolisanit s.r.l.)|
|Abstract: Several studies have shown that escape extinction is useful in increasing the consumption of nonpreferred foods in children with autism (ASD) with food selectivity. However, although effective in expanding food repertoire, this strategy may result in increased problem behaviors and a higher risk of generating trauma. Here, we used a modified version of the Skill-Based Treatment (SBT; Hanley et al., 2014) to treat food selectivity and mealtime problem behaviors. Five autistic children (mean age = 6.68) with severe food selectivity were recruited for the study. An adapted version of the SBT protocol was used based on shaping response topographies without extinction procedures. This treatment prioritized creating a safe physical and emotional environment to reduce the risk of trauma. The Parenting Stress Index (Abidin, 2016) was used to evaluate the magnitude of stress in the parent-child system. Social validity was assessed using a 7-point scale. After the treatment, participants’ food repertoire increased, whereas the number of mealtime problem behaviors decreased. Furthermore, the acceptance rate of subsequent foods increased faster, and treatment effects were successfully transferred to other settings and persons. Finally, caregivers recognized the social validity of the protocol, by reporting high levels of satisfaction and usability and lower stress levels after the treatment.|