|Parent Training: Exploring Approaches to Sleep, Communication, Skill Development and the State of the Literature
|Sunday, May 30, 2021
|3:00 PM–4:50 PM
|Area: AUT; Domain: Applied Research
|Chair: Julie Koudys (Brock University)
|Discussant: Joe M. Lucyshyn (University of British Columbia)
|CE Instructor: Joe M. Lucyshyn, Ph.D.
Parent training has been shown to be beneficial for parents of children with ASD and those at risk for ASD in terms of child skill development and behaviour reduction. However, few studies specifically report parent implementation fidelity, or parents’ ability to generalize and maintain newly developed skills. In this symposium results from three studies that used telehealth or combined face to face and telehealth models to teach parents to support their child’s general skill development, to support the use of augmentative alternative communication systems, and to address sleep challenges will be presented. Talks will focus on strategies to facilitate parent and child skill generalization and maintenance, and practical considerations for telehealth service delivery. Finally, this symposium will explore what we do and do not know in terms of the quality and rigor of single-case experimental design literature related to parent training for child behaviour reduction.
|Instruction Level: Intermediate
|Keyword(s): autism, parent training, systematic review, telehealth
Intermediate audience. Attendees should have an understanding of foundational behavioral terminology and single-case experimental design.
|Learning Objectives: At the conclusion of the presentation, participants will be able to: (1) describe how BST may be used in a telehealth format to train parents; (2) describe the steps required to implement general case training; (3) identify the importance of programming for generalization and/or maintenance in parent training; (4) describe the state of the literature related to parent training to reduce challenging behavior in children with ASD.
|Go to Sleep Already! Evaluation of a Blended Face-to-Face and Telehealth Parent-Implemented Sleep Intervention
|JULIE KOUDYS (Brock University), Catherine McConnell (Kalyana Support Systems), Angeline Savard (The Gregory School for Exceptional Learning), Krysten Spottiswood (Pyramid Educational Consultants of Canada), Alyssa Treszl (Brock University), Kaitlyn Harrison (Kalyana Support Systems), Michelle Guzman-Ratko (Kalyana Support Systems), Paige O'Neill (Brock University)
|Abstract: High prevalence rates of sleep problems have been reported in children with autism spectrum disorder (ASD). Research suggests that sleep problems negatively affect children with ASD and their families, including correlations between diminished sleep and challenging behavior (Cohen et al., 2014). Reviews of treatments for pediatric sleep problems encourage behavioral strategies, including functional analysis and a comprehensive approach to sleep intervention (e.g., Mindell, Kuhn, Lewin, Meltzer, & Sadeh, 2006). Although reviews are promising, more research is required to determine the effectiveness of parent-led behavioral sleep interventions, implemented by community-based clinicians. Further, models of intervention that incorporate telehealth technology should be investigated. The current study used a non-concurrent multiple-baseline across participants design to evaluate the results of a parent-implemented, behavior-analytic sleep intervention that incorporated telehealth approaches. Individualized behavior-analytic sleep interventions (e.g., faded bedtime, eliminating sleep dependencies) were implemented with three children with ASD in conjunction with community-clinical services. Nightly sleep log and video data indicated that sleep onset delay and sleep interfering behaviors decreased, and duration of time asleep alone increased. Interobserver agreement was above 80%. Practical considerations for implementing community-based, parent-led behavioral sleep interventions will be discussed, including considerations when providing telehealth sleep services.
Evaluating the Effects of Picture Exchange Communication® Mediator Training Via Telehealth Using Behavioral Skills Training
|ALYSSA TRESZL (Brock University), Julie Koudys (Brock University), Amanpreet Randhawa (Brock University), Michelle Guzman-Ratko (Kalyana Support Systems)
There is extensive research indicating that the Picture Exchange Communication System® (PECS®) is an effective functional communication system for children with autism spectrum disorder (e.g., Wong et al., 2015). However, little is known about how best to train parents to support their child’s PECS use. Similarly, little is known about how to train parents to use PECS via telehealth. The present study involved online mediator training amid the global COVID-19 pandemic. The purpose of the study was to bridge the gap between PECS and telehealth research, and to explore strategies to help parents support their child’s PECS use at home. One father-mother dyad was recruited for the study. Researchers used behavioral skills training to teach parents and applied strategies of general case training to actively program for generalization. A multiple baseline design across skills was used to measure the primary parent’s treatment fidelity and a multiple probe design was embedded to monitor both parents’ fidelity in the natural environment with their child. Results demonstrated that the primary parent acquired target PECS skills within the training setting. However, not all target PECS skills were reliably demonstrated by parents’ in the generalization setting during follow-up. Implications for practice will be discussed.
|General Case Parent-Mediated Telehealth Intervention for Young Children at Risk for Autism Spectrum Disorder
|CLAIRE SHINGLETON-SMITH (Brock University), Maurice Feldman (Dept. of Applied Disability Studies, Brock University), Alicia Azzano (Brock University), Julie Koudys (Brock University), Paige O'Neill (Brock University), Amanpreet Randhawa (Brock University)
|Abstract: Research indicates that young children at-risk for autism spectrum disorder (ASD) show developmental improvements with the implementation of a parent training intervention, although evidence of parent generalization to novel skills is inconsistent (Azzano et al., 2020a, b). This ongoing study aims to determine the effects on generalization of a parent-mediated early intervention using general case training (GCT) combined with behaviour skills training (BST) via telehealth for young children at-risk for ASD. Three parent-child dyads are currently participating. Child target skills were identified through the Parent Observation of Early Markers Scale (Feldman et al., 2012) and confirmed through direct observation. Nine exemplars from three child skill categories that target deficits representative of early signs of ASD were taught to parents using a multiple baseline across participants design. Data are being collected for the percentage of correct parent teaching skills implemented, as well as the percentage of child correct responses to the target skills. Preliminary IOA is 85% (range 73–93). Early results demonstrate an increase in parent teaching skills across all trained participants for both target and novel child skills. These results provide preliminary support for GCT combined with BST via telehealth as an effective early intervention model.
Single-Case Research on Parent Training to Reduce Challenging Behaviors in Children With Autism Spectrum Disorder: A Systematic Review
|PAIGE O'NEILL (Brock University), Julie Koudys (Brock University), Amanpreet Randhawa (Brock University), Meghan Dunnet (Kalyana Support Systems), Claire Shingleton-Smith (Brock University), Alyssa Treszl (Brock University)
Many children with autism spectrum disorder (ASD) demonstrate challenging behaviors and interventions based on applied behavior analysis (ABA) have been shown to be effective for reducing these challenging behaviors, often through multicomponent interventions. Previous research has shown that parents can be trained to effectively implement multicomponent ABA interventions with their children to address challenging behavior, but systematic reviews examining research in this area are lacking. The present study included a complete review of single case design studies of parent training in multicomponent ABA interventions to reduce challenging behavior in children with ASD and summarizes the state of the literature, specifically scientific rigor, risk of bias, and reporting of parent and child demographics, nature and format of interventions, functional assessment of challenging behaviors, and follow-up and social validity data. Results show that many studies have rigor levels that allow for initial evidence of treatment effects, and that risk of bias is variable across domains. Further, demographic information is commonly underreported, particularly with respect to parent participants, and generalization, maintenance, and social validity data are lacking. However, studies frequently report that interventions are provided in natural settings, and that functional assessments are typically conducted, often with parent involvement. Future directions are suggested.