|Training and Supporting Caregivers of Children with Autism|
|Sunday, May 28, 2023|
|3:00 PM–4:50 PM |
|Convention Center Mile High Ballroom 1C/D|
|Area: DDA; Domain: Applied Research|
|Chair: Andrew Sodawasser (University of Nebraska Medical Center)|
|Discussant: Cynthia P. Livingston (University of Nebraska Medical Center)|
|CE Instructor: Cynthia P. Livingston, M.A.|
Autistic children commonly present with difficulties in communication and social interactions and are at risk for developing dangerous problem behavior (Doehring et al., 2014). These difficulties and risks can increase as children age (Gray, 2006; Ingersoll & Hambrick, 2011). As a result, caregivers of these children experience increased stress and challenges in providing care. Caregiver reports and surveys indicate a need for training to address their child's specific challenges and support to cope with associated stress (Lai & Oei, 2014). This symposium comprises four studies to improve the lives of caregivers and their autistic children. Studies focused on training caregivers to teach skills or address problem behavior with their children and evaluated caregiver-related outcomes. Study results suggest that clinical providers consider the care and wellness of the children they serve and their caregivers.
|Instruction Level: Intermediate|
|Keyword(s): Caregiver training, Problem Behavior, Skill Acquisition|
|Target Audience: |
Board Certified Behavior Analysts; Board Certified Assistant Behavior Analysts; Therapists; Practitioners Audience members should have a general understanding of caregiver training, behavior skills training, and common symptomology of Autism Spectrum Disorder.
|Learning Objectives: At the conclusion of the presentation, participants will be able to: 1) Identify strategies in which telehealth and video conferencing platforms may be used for the assessment and treatment of not only children with autism, but their parents and caregivers as well, 2) Identify the mental, physical, and psychological challenges parents and caregivers may experience when caring for individuals with severe challenging behaviors, and 3) Identify at least one strategy to better support parents, caregivers, and their children with autism.|
Virtual Acceptance and Commitment Therapy Groups for Parents of Children With Autism: Acceptability and Feasibility
|ABIGAIL MORETTI (Rowan University), Christina Simmons (Rowan University)|
Parents of children with autism spectrum disorder (ASD) experience higher rates of anxiety, depression, stress, poor overall well-being, and difficulty with adaptive coping, particularly when their child also engages in challenging behavior. As such, acceptance and commitment therapy (ACT), which encourages psychological flexibility and mindfulness, is particularly suited for this population. The current study examined the feasibility and acceptability of implementing virtual ACT groups with parents of children with ASD and co-occurring challenging behavior. Participants attended an in-person intake interview, six virtual ACT group sessions, and two in-person individualized parent training sessions to learn behavior management techniques and practice implementing behavioral intervention when faced with treatment challenges. Participants included 10 parents across three different groups; however, only six completed all post-study measures. Participants who completed all study measures demonstrated a statistically significant improvement in psychological flexibility and reduction in stress, and perceived the intervention to be highly acceptable. Findings suggest that participating in six virtual group sessions may not be feasible for all parents of children with ASD and challenging behavior. However, the intervention produced positive treatment outcomes for participants completing all study measures, suggesting that this intervention should be adapted to improve feasibility and promote accessibility for this population.
Caregivers of Children With Autism Spectrum Disorder and the Impact of Their Posttraumatic Stress Disorder Symptomology
|JENNIFER M. HODNETT (University of South Florida), Nadrat Nuhu (Marcus Autism Center), Joanna Lomas Mevers (Marcus Autism Center), Mariah Huggins (Marcus Autism Center)|
Posttraumatic stress disorder (PTSD) can be a debilitating mental health illness, consisting of persistent cognitions, feelings of detachment, and severe dysfunction surrounding an individual’s daily life (National Institute of Mental Health, 2020). Most often PTSD is associated with being a victim of a violent crime, exposure to combat situations, and/or experiencing natural disasters (Breslau, 2009; National Institute of Mental Health, 2020). However, exposure to traumatic events is the key variable which results in a formal diagnosis of PTSD. We investigated how the severe challenging behavior children diagnosed with autism spectrum disorder and related neurodevelopmental disorders impact their caregivers, specifically if it results in PTSD symptomology. The presence of PTSD symptomology could influence a caregiver’s ability to adhere to treatment recommendations thus affecting a child’s intervention for challenging behavior. By better understanding the potential association between the challenging behaviors caregivers encounter and the presence or absence of PTSD, the most appropriate and effective resources can be accessed.
|Further Evaluating Skills-Based Approaches: Training Caregivers to Teach Behavioral Readiness for Child-Dyads via Telehealth|
|JAVID RAHAMAN (University of Nebraska Medical Center), Kevin C. Luczynski (Universal Behavioral Consulting Services)|
|Abstract: Caregivers face the daunting task of preparing their children for everyday expectations and challenges. This task can increase in difficulty when more than one child is in the household and risk factors for problem behavior are present (e.g., autism). Skill-based approaches have been used to teach behavior readiness for various challenging situations children may commonly encounter. These approaches use a combination of probabilistic reinforcement, synthesized reinforcement, and contingency-based delays to teach communication and self-control skills. Despite its efficacy, skill-based approaches have only been used to teach a single child at a time, and an evaluation of simultaneously teaching multiple children is warranted. We trained caregivers over telehealth to teach two children communication and self-control skills across various challenging situations to promote behavioral readiness. After, we evaluated the generality of training for caregivers and teaching, for each child, across other distinction situations. We observed decreases in emerging problem behavior and increases in communication and self-control skills for four autistic children. Caregivers averaged procedural integrity scores above 90% following training. Moreover, caregivers reported high acceptability scores on the training procedures and modality, and children’s outcomes. All children reported favorable social validity outcomes. Future directions, considerations, and limitations will be discussed.|
Comparing Vocal and Textual Feedback in Behavioral Skills Training With Parents via Telehealth
|MADELYN DOUGLAS (The New England Center for Children), Cammarie Johnson (The New England Center for Children; Western New England University; Simmons University)|
Extensive research demonstrates that behavioral skills training (BST) is effective in training a wide range of skills, including training parents to implement behavior analytic teaching methods. In a literature review, the feedback component of BST was often not technologically described, which hinders potential replications of BST studies. A technological definition of feedback would include when and where it is delivered, what is delivered, how and by whom it is delivered, and how many feedback statements are given, with specific examples of the feedback given. The purpose of this study was to compare the effectiveness and efficiency of preferred vocal and textual feedback in behavioral skills training delivered via a video conference application. A secondary goal was to serve as a technological application and description of feedback. An alternating treatment, nonconcurrent multiple baseline design across 2 parents of children with autism was used to teach two craft activities. Reliability measures were collected on the dependent and independent variables and were above 90%. Results did not suggest that one feedback condition was more effective or efficient than the other. A post-study, social validity survey indicated that parents valued the training and were confident in their ability to perform the activities they learned.