Association for Behavior Analysis International

The Association for Behavior Analysis International® (ABAI) is a nonprofit membership organization with the mission to contribute to the well-being of society by developing, enhancing, and supporting the growth and vitality of the science of behavior analysis through research, education, and practice.


49th Annual Convention; Denver, CO; 2023

Event Details

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Symposium #305
Training Residential Home Staff, Caregivers, and Child Welfare Case Managers to Implement Behavioral Techniques
Monday, May 29, 2023
8:00 AM–9:50 AM
Convention Center Mile High Ballroom 2A
Area: DDA/CSS; Domain: Applied Research
Chair: Jennifer Trang Nguyen (University of Houston-Clear Lake)
Discussant: Kimberly Crosland (University of South Florida)

Behavioral techniques implemented by direct-care staff and caregivers are an essential component of effective intervention. Thus, it remains important that the quality of implementation by such individuals be evaluated. The studies in this symposium will discuss the outcomes of trainings to teach professionals and caregivers to implement behavioral techniques. Three of the four studies also examined the practicality of virtually delivered training. In the first study, Kanaman and colleagues assessed the efficacy of an intervention package informed by the Performance Diagnostic Checklist-Human Services (PDC-HS) to increase staff implementation of healthy behavior practices in a residential home for adults with intellectual and developmental disabilities (IDD). Next, Tsami and colleagues evaluated the outcomes of a caregiver-implemented intervention package aimed to increase cooperation to routine dental procedures by adults with IDD. In the third study, Walker and colleagues examined the feasibility of caregiver-led behavior intervention to increase Continuous Positive Airway Pressure (CPAP) machine use by adults with Down syndrome and sleep apnea. Finally, Fuller and colleagues evaluated the efficacy of training child welfare case managers to develop individualized behavior intervention programs addressing youth runaway behaviors derived from the results of the Functional Assessment Interview for Runaways (FAIR).

Instruction Level: Intermediate
Keyword(s): caregiver training, medical/dental noncompliance, professional training, telehealth
Assessing and Enhancing the Maintenance of Staff Skills Using the Performance-Diagnostic Checklist–Human Services
NICOLE KANAMAN (GoodLife Innovations), Claudia L. Dozier (The University of Kansas), KY Clifton KANAMAN (University of Kansas), Catherine McHugh (University of Kansas), Bryan Simmons (University of Kansas)
Abstract: The Performance Diagnostic Checklist-Human Services (PDC-HS; Carr et al., 2013) is an indirect assessment used to assess employee performance, identify barriers to satisfactory performance, and develop interventions that address the variables influencing performance deficits. In Study 1, we conducted the PDC-HS with participants in three group homes at a residential program for adults with intellectual and developmental disabilities to identify barriers to staff implementation of a company-wide intervention procedure (healthy behavioral practices [HBP]; Kamana et al., in preparation). Results of the initial PDC-HS revealed barriers in all four domains with higher reports of barriers in participant skill deficits and tasks impeding implementation of the practices. Based on these results, we derived a packaged intervention which included the development of a home schedule and implementation of a staff intervention package (i.e., booster training, introduction of job aids, and feedback) and evaluated efficacy of the package for increasing staff implementation of HBP. Baseline and post-training observations were conducted remotely and participants were not made aware of the observations to reduce potential reactivity. Results of Study 2 demonstrated the efficacy of the intervention package for increasing staff implementation of HBP in the group home setting.

Remote Caregiver Coaching to Promote Cooperation During Dental Exams for Adults With Developmental Disabilities

LOUKIA TSAMI (University of Houston-Clear Lake), Dorothea C. Lerman (University of Houston-Clear Lake), Jennifer Trang Nguyen (University of Houston-Clear Lake), Emma Jean Walker (University of South Florida)

Some adults with intellectual and developmental disabilities (IDD) are uncooperative during routine dental exams, leading to problems with oral health. This presentation describes an interdisciplinary model consisting of behavior analysts and dentists aiming to evaluate and promote compliance to dental exams. The behavior analyst coached caregivers via telehealth to conduct mock exams with the participants in their homes and coached dentists to conduct exams with participants at a large hospital clinic. Caregivers of participants who exhibited noncompliance during the dentist-delivered exams then received behavioral services. The behavior analyst coached the caregivers via telehealth to implement increasingly complex interventions to increase the participants’ cooperation during mock dental exams. Nine of the fifteen participants were compliant in the absence of any interventions. Noncontingent reinforcement was effective for two participants. The remaining participants required graduated exposure. Additionally, compliance at home with the caregiver during the mock exam predicted compliance at the clinic during an exam with the dentist for all 15 participants.


Telehealth Training of Caregivers to Increase Positive Airway Pressure (PAP) Machine Use in Adults With Down Syndrome and Sleep Apnea

EMMA JEAN WALKER (University of South Florida), Dorothea C. Lerman (University of Houston-Clear Lake), Jennifer Trang Nguyen (University of Houston-Clear Lake)

A common sleep disorder among individuals with Down syndrome is obstructive sleep apnea (OSA). The most common treatment of OSA is Positive Airway Pressure (PAP) therapy. However, adherence to PAP therapy prescriptions is low. The high prevalence of OSA and low adherence with PAP therapy emphasized the need for an intervention to increase PAP machine use in individuals with DS. The following study evaluated a caregiver-implemented behavioral intervention aiming to increase PAP machine use in adults with DS using a multiple baseline across participants design. Participants in this study included four adults diagnosed with DS and OSA. The researchers utilized behavioral skills training via videoconferencing software to train the caregivers to implement the intervention. The intervention included the use of graduated exposure to the PAP therapy (i.e., slow progression of steps leading up to 4 hours of PAP machine use), differential negative reinforcement (i.e., longer breaks following compliance, shorter breaks following noncompliance with the graduated exposure step), contingent positive reinforcement (i.e., rewards following compliance with the graduated exposure step) and noncontingent reinforcement (i.e., access to a leisure item during intervention sessions). This caregiver-implemented behavioral intervention was effective at increasing PAP machine use for all participants. The results of this study serve as preliminary results for the effectiveness of this behavioral intervention when implemented by caregivers.

Evaluating Virtual Training and Consultation to Teach Case Managers to Use the FAIR and Create Interventions to Address Runaway Behavior
ASHA FULLER (University of South Florida), Kimberly Crosland (University of South Florida), Ryan Estes (SAFY of America), Arturo Garcia (University of South Florida)
Abstract: According to the U.S. Department of Health and Human Services (2021), over 600,000 youth were served in the child welfare system the previous year. Youth in child welfare can have a variety of placements including foster family homes with relatives or non-relatives, group homes, or institutions. Running away is a problem across different placement and can be defined as an event where a youth disappears from their caregiver’s custody (Administration for Children’s Services, 1992). Currently, for youth that chronically run away from their child welfare placements, interventions are placement changes and/or therapy. The Functional Assessment Interview for Runaways (FAIR) is a semi-structured interview to be used to develop individualized behavior support plans for youth who frequently run away from alternative living settings (Crosland et al., 2020). The current study used an online training to teach case managers to use the FAIR and monthly online consultation meetings to create individualized interventions to address runaway behavior of youth in child welfare. FAIR results and subsequent individualized interventions will be discussed.



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