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Evaluating the Efficacy and Preference of Procedures to Train Caregivers in Compliance and Embedded-Teaching Strategies |
Saturday, May 26, 2018 |
11:00 AM–12:50 PM |
Manchester Grand Hyatt, Grand Hall C |
Area: AUT; Domain: Applied Research |
Chair: Ciobha Anne McKeown (University of Nebraska Medical Center's Munroe-Meyer Institute ) |
Discussant: Nicole Heal (Margaret Murphy Center for Children) |
CE Instructor: Ciobha Anne McKeown, M.S. |
Abstract: The symposium features four studies on training undergraduates or caregivers to implement behavior analytic treatments. Hallie Ertel will present on the efficacy of and caregiver preference for differing ratios of low-p to high-p instructions to increase compliance, and the results suggest that caregivers tend to prefer the most efficacious ratio. Elizabeth Foley will present on a self-instruction package on implementation of guided compliance, and the results suggest that this type of training is an efficacious alternative when resources are limited. Mary Halbur will present an evaluation on caregiver preference and acceptability of three prompting strategies prior to and following acquisition of caregiver implementation. These results provide insight on how to improve the accuracy of preference and acceptability measures. Finally, Maegan Pisman will present on an evaluation to teach caregivers to implement multiple evidence-based strategies within a play context. Given the acquisition, generalization, and child-preference outcomes, this intervention seems well suited for caregivers to use when teaching young children with an autism spectrum disorder. We are excited and honored that Dr. Nicole Heal is serving as the discussant given her expertise and passion for these areas of research. |
Instruction Level: Intermediate |
Keyword(s): caregiver training, compliance, staff training, treatment acceptability |
Target Audience: Target audience will include practitioners interested in efficacious training procedures for staff and caregivers |
Learning Objectives: At the conclusion of the presentation, the participants should be able to describe recent advancements in treating noncompliance, methodology to assess caregiver preference and acceptability of a treatment, and variables that make treatment packages efficacious. |
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The Effect of Various High-P to Low-P Instruction Ratios on Compliance |
HALLIE MARIE ERTEL (Florida Institute of Technology), David A. Wilder (Florida Institute of Technology), Ansley Catherine Hodges (Florida Institute of Technology), Lianne Hurtado (Florida Institute of Technology) |
Abstract: The high-probability (high-p) instructional sequence, which involves the delivery of a series of high-probability instructions immediately before delivery of a low-probability instruction, is a commonly used procedure to increase compliance among children and individuals with intellectual disabilities. Although the modal ratio of high-p instructions to low-p instructions is 3:1, other ratios may be more effective. In the current study, we compared three ratios of high-p to low-p instructions (i.e., 1:1, 3:1, and 5:1) during use of the high-p instructional sequence to increase compliance among three children with autism. Results suggest that the 5:1 ratio was most effective. Although less effective, the 3:1 ratio and 1:1 also produced increases in compliance. In addition, we had each participant's caregiver nominate the most preferred ratio and we then evaluated caregiver implementation of the most effective ratio. In general, the most preferred ratio was also the most effective ratio, even when implemented by caregivers. Implications of these findings and directions for future research are discussed. |
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An Evaluation of Self Instruction on the Implementation and Generalization of Guided Compliance |
ELIZABETH FOLEY (University of Kansas), Claudia L. Dozier (The University of Kansas), Jessica Foster Juanico (Trumpet Behavioral Health), Bertilde U Kamana (University of Kansas), Rachel Jess (University of Kansas), Nicole Coleman (University of Kansas) |
Abstract: We examined the effects of a self-instruction package, which included written instructions and a data sheet on participants’ accurate implementation of a guided compliance procedure with four undergraduate student participants. Additionally, we assessed generalization of the accurate implementation of the procedure across (a) treatment setting, (a) treatment recipient (learner), and (c) instruction type. During all sessions, a simulated client followed one of several scripts, which varied in the sequence of client responses across trials. Three of the four participants demonstrated mastery of the guided compliance procedure with the self-instruction package. For these three participants, the skill successfully generalized across the three parameters and maintained after we removed access to the self-instruction package. The fourth participant required the use of behavioral skills training (i.e., video modeling and feedback) to achieve mastery of the skill. For this participant, the skill successfully generalized and maintained after we removed access to the intervention. Overall, results suggested that the self-instruction package may be an effective alternative to more resource intensive training methods. |
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An Evaluation of Caregiver Preference for Prompting Procedures |
MARY HALBUR (University of Wisconsin Milwaukee), Tiffany Kodak (University of Wisconsin Milwaukee), Erin Corrigan (University of Wisconsin Milwaukee), Raven Wood (University of Wisconsin Milwaukee), Brittany Ann Juban (May Institute) |
Abstract: Previous researchers have suggested that caregiver participation in intervention can enhance intervention and promote generalization of skills across settings. Thus, parents should be trained to implement behavioral interventions. The purpose of the current investigation was to evaluate caregiver preference for and acceptability of three commonly used prompting procedures. Experimenters trained caregivers of children with disabilities to use three evidence-based prompting strategies (i.e., least-to-most, most-to-least, and a progressive prompt delay). Once the caregiver reached the mastery criteria with each prompting procedure, his/her preference for each of the strategies was evaluated using a concurrent-chains arrangement. Additionally, treatment acceptability of all procedures was measured multiple times throughout the study. All participants met the mastery criteria for each of the prompting procedures and showed a preference for least-to-most prompting. Results suggested that caregivers' preferences for procedures prior to training were different than post-training/post-child practice. In addition, indirect assessment scores corresponded to choice trials during the end assessments. The data obtained during this study support the utility of objective measures for studying preference for behavioral skill-acquisition procedures. |
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Caregiver Integration of Four Teaching Strategies in a Play Context on Child Acquisition and Preference. |
MAEGAN D. PISMAN (University of Nebraska Medical Center's Munroe-Meyer Institute), Kevin C. Luczynski (University of Nebraska Medical Center's Munroe-Meyer Institute) |
Abstract: Young children diagnosed with an autism spectrum disorder (ASD) often require systematic teaching to learn tacts and mands, and activity-based play serves as one situation in which these skills can be taught. However, no study has shown how to teach caregivers to implement multiple evidence-based strategies while maintaining play as a preferred context. We recruited two dyads composed of two mothers and their sons (three and four years old). We used a multiple-probe design across responses to demonstrate the efficacy of behavioral skills training on the mothers’ simultaneous implementation of parallel play, child-directed interaction, incidental teaching (mand), and direct teaching (tact); we also, subsequently, observed their child acquire the target mand and tact as a function of the mothers’ teaching. By assessing the children’s preference between playing alone with toys versus playing with toys and their mother, we confirmed that introducing the teaching strategies did not decrease the value of playing with their caregiver. We obtained stimulus generalization and maintenance of the caregivers’ skills from the clinic to their home, and the caregivers taught an additional target mand and tact. The outcomes serve as preliminary support for an intervention that all parents raising a child with an ASD should receive. |
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