Association for Behavior Analysis International

A fundamental and persistent challenge for behavior analysts since the inception of our field has been the development of behavioral interventions that produce enduring beneficial outcomes. Two of the most important variables affecting whether treatment effects maintain or whether relapse occurs are: (a) the extent to which parents, teachers, staff members, and other caregivers learn to implement the treatment with high procedural integrity; and (b) whether they continue to apply the treatment with fidelity when the professional behavior analyst is not present. In this symposium, three of our field’s leading experts will describe the best practices they have developed and tested for promoting the acquisition and maintenance of procedural integrity in the implementation of effective behavioral interventions by caregivers. Lynn Bowman of the Kennedy Krieger Institute will describe the development and implementation of a comprehensive staff training and management system. Rebecca MacDonald of the New England Center for Autism will demonstrate how video modeling can be used to produce large and rapid improvements in treatment implementation by both parents and staff. Finally, Cathleen Piazza will illustrate how effective in-clinic and telehealth parent-training strategies can be employed to promote accurate and sustained implementation of feeding interventions by parents in the home setting.

Certified behavior analysts, licensed psychologists, graduate students.

Some of the earliest identification markers that precede a diagnosis of autism are deficits in social behavior. Lack of eye contact, joint attention, and social referencing are the hallmarks of the disorder. Best outcomes have been achieved with early intensive behavior analysis which by definition involves implementation of behavioral protocols by skilled clinicians and parents. In our current work, we have found video modeling to be more effective than written instructions to teach both clinicians and parents to provide effective instruction in the area of joint attention. We have achieved high procedural integrity on a variety of protocols and children acquire the targeted skills quickly. The components of the video modeling instructional videos will be reviewed and a discussion of the importance of each element will be discussed.

Children with autism spectrum disorder often display feeding problems (Schreck, Williams, & Smith, 2004). These feeding problems may result in diets that are nutritionally deficient and may place the child at risk for health, learning, and behavior problems. Treatments for pediatric feeding disorders based on applied behavior analysis are the only ones that have empirical support in the literature. Although these treatments are effective, caregiver training and follow through is a critical factor in maintaining their long-term efficacy. This presentation will show data on training caregivers to implement treatments for pediatric feeding disorders in clinic, home, and virtual settings.

The incidence rate for severe behavioral disorders is higher for individuals with autism and related disorders than for other populations (Smith, Russo, & Lee, 1999). The Neurobehavioral Inpatient Unit at Kennedy Krieger specializes in the assessment and treatment of approximately 40 such individuals and their families per year, and employs (a variety of) staff including approximately 120 entry-level direct care technicians. Successful treatment outcomes in the clients we serve are dependent not only on well-devised behavioral plans based on functional analysis results, but also on the integrity with which the treatment is implemented by staff. A high level of expertise and training is often needed for plan implementation; however, paraprofessionals often have little experience performing such plans prior to employment/admission. System-wide approaches, as well as more targeted efforts used on the NBU, will be discussed. Participants will glean effective strategies to implement in human service settings including the use of data and other best practice strategies to drive staff training projects.