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| A Further Evaluation of Caregiver Training Models to Teach Implementation of Behavioral Assessment and Treatment |
| Sunday, May 24, 2015 |
| 9:00 AM–10:50 AM |
| 214D (CC) |
| Area: DDA/AUT; Domain: Applied Research |
| Chair: Amanda Zangrillo (Munroe-Meyer Institute, University of Nebraska Medical Center) |
| Discussant: David P. Wacker (The University of Iowa) |
| CE Instructor: Amanda Zangrillo, Psy.D. |
| Abstract: In this symposium, we will present four investigations related to parent training, pertaining specifically to the role of caregivers in the implementation of assessment and treatment. The paper by Greer and colleagues examines the effects of discriminative control developed during therapist-implemented response restriction, functional communication training sessions and the transfer of treatment effects to the caregiver during caregiver-conducted treatment. The paper by Luczynski et al. conducted a randomized clinical trial to evaluate a 20-hour, web-based, E-Learning program for training parents in Early Intensive Behavioral Intervention protocols. Zarcone and colleagues evaluated parent-training approaches aimed at implementation of functional analysis and behavioral interventions to reduce severe problem behavior and implementation of a modified version of Parent-Child Interaction Therapy. Last, Smith et al. conducted a randomized-clinical trial comparing a parent training program and a parent education program. The overall theme and implications of these studies will be discussed and summarized by Dr. David Wacker. |
| Keyword(s): autism, behavioral assessment, behavioral treatment, parent training |
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| Using Response Restriction During Functional Communication Training to Promote Rapid Transfer of Treatment Effects |
| BRIAN D. GREER (University of Nebraska Medical Center), Wayne W. Fisher (Munroe-Meyer Institute, University of Nebraska Medical Center), Katie Lichtblau (University of Nebraska Medical Center’s Munroe Meyer Institute), John Lamphere (Munroe-Meyer Institute, University of Nebraska Medical Center) |
| Abstract: Fisher, Greer, and Querim (under review) found that functional communication responses (FCRs) come under rapid discriminative control when schedule-correlated stimuli used in the initial training context are introduced in other contexts. The current investigation extends this work by evaluating the transfer of treatment effects to a caregiver when response restriction (RR) was used during functional communication training (FCT) for one girl’s destructive behavior (i.e., aggression and self-injurious behavior). Functional analysis results from therapist- and caregiver-conducted sessions suggested that destructive behavior was maintained by both attention and escape. The caregiver conducted baseline sessions during the treatment evaluation while therapists implemented FCT. Once rates of destructive behavior decreased and levels of correct FCRs increased during RR FCT, the schedule of reinforcement was successfully thinned to produce a more manageable treatment for implementation by the caregiver. The caregiver was then trained to implement RR FCT. Rapid transfer of the effectiveness of RR FCT was observed during caregiver-conducted RR FCT sessions, despite the caregiver’s long history of reinforcement of the girl’s destructive behavior. Results are discussed in terms of the ability of arbitrary stimuli to exert strong discriminative control over responding and the utility of this discriminative control on the transfer of treatment effects. |
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| Preliminary Results of a Randomized Clinical Trial of a Web-based Program for Training Parents with a Child with an Autism Spectrum Disorder |
| Wayne W. Fisher (Munroe-Meyer Institute, University of Nebraska Med), Kevin C. Luczynski (University of Nebraska Medical Center's Munroe-Meyer Institute), MYCHAL MACHADO (University of Nebraska Medical Center), Aaron D. Lesser (Munroe-Meyer Institute, University of Nebraska Medical Center), Stephanie A. Hood (Briar Cliff University), Andrew Blowers (University of Nebraska Medical Center’s Munroe-Meyer Institute), Maegan Pisman (University of Nebraska Medical Center’s Munroe-Meyer Institute), Megan E Vosters (University of Nebraska Medical Center’s Munroe-Meyer Institute) |
| Abstract: Estimates indicate that autism affects about 1 in 68 American children. Research has shown that Early Intensive Behavioral Interventions (EIBI) is effective when implemented by appropriately trained and supervised technicians. In additional to services provided by technicians, parents often contribute to their child’s EIBI programming by extending teaching opportunities throughout the day. However, few empirically supported programs are available for training parents that include performance-based measures. We are conducting a randomized clinical trial to evaluate a 20-hour, web-based, E-Learning program for training parents in EIBI protocols. The two primary dependent variables are the Behavioral Implementation Skills for Play Activities (BISPA) and the Behavioral Implementation Skills for Work Activities (BISWA). To date, 10 participants have completed pretest and posttest assessments on these measures, three in the treatment group and seven in the control group. Mean component skills implemented correctly on the pretest and posttest for the treatment and control groups for the BISPA were 4.0%, 6.1%, 89%, and 0%, respectively. For the BISWA, the results were 23.6%, 16.9%, 100%, and 27.3%, respectively. The results provide strong preliminary support for the efficacy of our web-based program, which can be delivered to parents anywhere in the world that has broadband Internet access. |
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| Training Across the Continuum of Parent-child Interaction: Functional Analysis, Behavioral Treatment, and Positive Parenting Skills |
| Patricia F. Kurtz (Kennedy Krieger Institute), Roy Justin Boyd (Kennedy Krieger Institute (NBU-OP)), JENNIFER R. ZARCONE (Kennedy Krieger Institute), Julia T. O'Connor (Kennedy Krieger Institute), John M. Huete (Kennedy Krieger Institute), Louis P. Hagopian (Kennedy Krieger Institute) |
| Abstract: Research has demonstrated that parents of children with intellectual disability can effectively implement functional analysis (FA) and behavioral interventions to reduce severe problem behavior, and implement strategies to improve parent-child interactions. We summarize results from three studies of complementary parent training approaches. In Study 1, caregivers of children with severe problem behavior were trained to conduct FAs when staff-conducted FAs were questionable. Results indicated that parent-conducted FAs effectively determined behavioral function. In Study 2, parent-implemented treatments based on FA results were demonstrated to effectively reduce problem behavior by 96%. In Study 3, we examined the effects of a modified version of Parent-Child Interaction Therapy (PCIT), an evidence-based treatment program designed to improve parent-child interactions. Baseline data were collected with each caregiver, and then operationally defined positive and negative interactions skills were taught using a multiple baseline design across skills and participants. Results indicated that all caregivers were able to learn each skill, and for some children there was a collateral reduction in problem behavior. Implications for future research will be discussed. |
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| Parent Training in Children with Autism Spectrum Disorder and Disruptive Behavior: A Randomized Trial |
| TRISTRAM SMITH (University of Rochester Medical Center), Karen Bearss (Emory University), Luc Lecavalier (Ohio State University), Cynthia R. Johnson (University of Pittsburgh), Naomi Swiezy (IU School of Medicine), Denis Sukhodolsky (Yale University), Lawrence Scahill (Emory University) |
| Abstract: Many single-subject studies show that parents can learn to use applied behavior analytic strategies to reduce disruptive behavior displayed by their children with autism spectrum disorder (ASD). To integrate these strategies into an exportable, cost-effective intervention, we developed a parent training (PT) program that includes 11 core sessions (each 60 to 90 minutes in duration, delivered 1:1 with the primary caregiver), two booster sessions, two home visits, and two optional sessions. We then conducted a randomized clinical trial comparing PT and a parent education program (PEP; 12, 1:1 informational sessions on ASD characteristics, services, and supports plus one home visit). Participants were 180 children, age 3-6 years, with ASD and disruptive behavior, at six universities: Emory, Rochester, Ohio State, Pittsburgh, Indiana, and Yale. After 24 weeks, independent evaluators, blind to group assignment, rated 69% of PT children and 40% of PEP children as “much” or “very much improved.” In addition, PT children improved more than PEP children on the parent-rated Aberrant Behavior Checklist-Irritability subscale (effect size = 0.71) and Home Situations Questionnaire (effect size = 0.52). An analogue behavioral assessment of parent-child interaction was also administered (data analysis underway). Overall, PT appeared efficacious in reducing disruptive behavior in our sample.
Keywords: autism, parent training, problem behavior, behavioral assessment |
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