|The Use of Naturalistic Developmental Behavioral Interventionsin Community Settings|
|Sunday, May 29, 2022|
|11:00 AM–12:50 PM |
|Meeting Level 2; Room 257B|
|Area: AUT/DDA; Domain: Applied Research|
|Chair: Diondra Straiton (Michigan State University)|
|Discussant: Aubyn C. Stahmer (UC Davis Health)|
|CE Instructor: Allison Jobin, Ph.D.|
Naturalistic Developmental Behavioral Interventions (NDBIs) utilize natural contingencies and behavioral strategies (Schreibman et al., 2015) and are effective at increasing skills in autistic children. A recent meta-analysis of early interventions for autistic children found that NDBIs outperform other behavioral interventions (Sandbank et al., 2020). Yet most ABA providers report limited training in NDBIs. This symposium describes applied research from 13 institutions on the use of NDBIs in community settings. The first presentation reports improvements in adaptive behavior, social skills, and autism symptoms for autistic children receiving NDBIs within an inclusive preschool setting. The second and third presentations present data on practitioner perspectives on NDBIs, with presentation 2 demonstrating how ABA provider perceptions of NDBIs change over time and with consultation, and presentation 3 illustrating preschool teachers’ experience with and perceptions of NDBIs. Finally, the fourth presentation demonstrates the parent coaching practices of NDBI-trained early intervention (EI) providers, noting barriers and facilitators to parent coaching in the EI system. Dr. Amy Matthews (discussant) will draw on her expertise in the implementation of NDBIs in community settings and will provide recommendations for provider training and scale-up implementation efforts, particularly in publicly funded service systems.
|Instruction Level: Basic|
|Keyword(s): behavioral interventions, community settings|
|Target Audience: |
Behavior analysts and other practitioners interested in learning more about the implementation of Naturalistic Developmental Behavioral Interventions (NDBIs) in community settings
|Learning Objectives: At the conclusion of the presentation, participants will be able to: 1) describe the theoretical basis of Naturalistic Developmental Behavioral Interventions (NDBIs) and the behavior analytic principles of NDBIs, 2) describe the effects of NDBIs on child outcomes in community settings across 3 domains: adaptive behavior, social skills, and autism symptoms; 3) identify ABA provider perceptions of NDBIs and how these perceptions change over time and with expert consultation; and 4) describe at least 3 barriers and 3 facilitators to providing parent coaching practices within NDBIs delivered in the early intervention system.|
Delivery of Naturalistic Developmental Behavioral Interventions in a Community-Based Preschool Inclusion Program for Children With Autism Spectrum Disorder
|ALLISON JOBIN (California State University San Marcos), Nora M Camacho (Rady Children's Hospital), Aubyn C. Stahmer (UC Davis Health), Gina May (University of Nebraska-Lincoln), Kristin Gist (Rady Children’s Hospital San Diego), Lauren I. Brookman-Frazee (UC San Diego)|
The importance of inclusive environments for children with autism spectrum disorder (ASD) is well established, and positive outcomes have been reported for some preschool inclusion programs (e.g., Strain & Bovey, 2011). However, these studies report extensive training from researchers, and limited data are available on the effectiveness of community-based and self-sustaining preschool inclusion programs. Moreover, few studies have reported outcomes from the community-based delivery of naturalistic developmental behavioral interventions (NDBI) in group-based community care. This quasi-experimental study reports outcomes for 26 children, 3-5 years of age at entry and diagnosed with ASD, who were enrolled in a community-based inclusion preschool program delivering NDBI for at least 6 months. Paired sample t-test indicated statistically significant improvements from entry to exit on standardized measures of adaptive behavior (Figure 1), social skills (Figure 2), and autism symptoms (Figure 3). The majority of children were testing in the adequate or higher range across measures after an average of 18 months of intervention (SD=6.5 months). Implications for the effectiveness of inclusive settings for preschool-aged children, considerations in the delivery of NDBI in group inclusive settings, and future directions will be discussed.
The Effect of Time and Consultation on Applied Behavior Analysis Provider Perceptions of Project ImPACT
|DIONDRA STRAITON (Michigan State University), Brooke Ingersoll (Michigan State University)|
Background: Little is known about how ABA provider perceptions of Naturalistic Developmental Behavioral Interventions (NDBIs) change over time. Consultation may also affect provider perceptions of these interventions. We investigated the effect of time and consultation on perceptions of Project ImPACT, an empirically supported NDBI. Methods: We fit 9 two-level multilevel models. We report preliminary analyses from 9 providers across 4 agencies in the Medicaid system (single case design). Providers delivered Project ImPACT during baseline (randomized to 3-6 weeks) and during the 12 weeks of consultation. Providers completed the Perceived Characteristics of Intervention Scale (PCIS) weekly. Results: Perceptions of Project ImPACT were moderately high (see Figure 1). See Table 1 for model parameters. There was an effect of time on trialability and task issues; regardless of whether providers were receiving consultation, each week, providers rated Project ImPACT as easier to try out and more helpful at improving the quality of their work. The effect of time on trialability varied depending on condition. The average rating of trialability was lower during baseline than during consultation and trialability ratings increased each week during baseline, but not during consultation. Though marginal, there was an effect of time on observability; each week, providers rated client improvements from ImPACT to be more observable. There was no effect of consultation. Conclusions: Increased use of NDBIs over time results in more favorable perceptions. Consultation does not appear to change providers’ perceptions. Implications for provider training will be discussed.
|Preschool Teacher’s Perceptions of Naturalistic Developmental Behavioral Interventions|
|SOPHIA R D'AGOSTINO (Utah State University)|
|Abstract: Naturalistic developmental behavioral interventions (NDBIs) are empirically validated interventions that are well matched for the preschool classroom context as they are designed for use in natural settings and integrate both behavioral and developmental intervention approaches. This study explored the perspectives of preschool teachers regarding common NDBI components. One hundred fifty-two preschool teachers across one Midwest state who taught at least one child with an identified disability in their classroom completed an electronic questionnaire. The questionnaire consisted of open and closed ended questions on preschool teachers’ NDBI training experience, knowledge, reported use, and perceptions of social validity. Overall, most preschool teachers received preservice and inservice training experiences in child development and early childhood teacher practices but did not receive preservice or inservice training in strategies based on applied behavior analysis. Preschool teachers agreed that NDBI components are acceptable for use within their classroom context and align with current classroom practices. Open-ended comments revealed benefits and barriers to NDBI implementation as well as specific training needs. Implications for practice and future research needs will be discussed.|
|Parent Coaching in Early Intervention for Autistic Children: What Providers Say versus What Providers Do|
|JORDAN ALBRIGHT (Virginia Tech; University of Pennsylvania, Center for Mental Health, Perelman School of Medicine), Liza Tomczuk (University of Pennsylvania, Center for Mental Health, Perelman School of Medicine), Aubyn C. Stahmer (University of California – Davis, Department of Psychiatry and Behavioral Sciences; University of California – Davis, MIND Institute, Sacramento), Rinad Beidas (University of Pennsylvania, Center for Mental Health, Perelman School of Medicine), David Mandell (University of Pennsylvania, Center for Mental Health, Perelman School of Medicine), Rebecca Stewart (University of Pennsylvania, Center for Mental Health, Perelman School of Medicine), Melanie Pellecchia (University of Pennsylvania, Center for Mental Health, Perelman School of Medicine)|
Parent coaching in early intervention (EI) can lead to improvements in parent and child outcomes for young autistic children. Little is known about how parent coaching is implemented in publicly funded EI systems. Using a mixed-methods approach, this study aims to 1) identify barriers/facilitators to the implementation of parent coaching in EI and 2) evaluate EI provider fidelity of parent coaching.
Semi-structured interviews were conducted with 36 EI providers and agency leaders to learn about barriers/facilitators to using parent coaching. Transcripts were analyzed iteratively using an integrated approach. Twenty-five EI sessions were coded for parent coaching fidelity using direct observation.
Several barriers and facilitators to parent coaching during EI sessions were identified (Figure 1). While EI providers reported using a variety of evidence-based parent coaching techniques, findings from provider observations indicate use of parent coaching strategies is low overall, with significant variability across providers (Figure 2). A strong correlation was observed between fidelity of collaboration and in-vivo feedback (r = .68, p = .000), providers who used collaborative coaching strategies were more likely to provide in-vivo feedback (Table 1).
Targeted implementation supports are needed to improve the implementation of parent coaching for autistic children in publicly funded EI.|