Efficacy of a Public School Intensive Parent Training Program for Difficult Behavior of Children with the Autisms

Background:

Parent training for children with the autisms is considered an integral treatment component.  Behavioral parent training is a behaviorally-based model evolved from the discipline of applied behavior analysis (ABA). It addresses socially relevant issues of parenting, such as management of difficult behavior and increasing prosocial abilities. Although children with autism spectrum disorders (ASD) are integrated within our public school systems, providing parent education within the system is challenging because of parent follow through, time, and cost.  Thus, there is a lack of research on public school provision for parent training.  This study explores the success of a manualized parent education program for families with ASD implemented within a public school system.  

Objectives:

A Behavioral Parent Education program was developed to provide parents evidenced-based behavioral management strategies to use when their child demonstrates stressful, and upsetting behaviors. The goal of the study is to evaluate preliminary pre-course and post-course data on fidelity of implementation of strategies learned in a small group format and generalized to the home setting. A secondary goal of the program is to evaluate pre-course and post-course parental affect.

Methods:

This poster presents the results of five parent-child dyads whose children qualified for public school special education under the autistic classification. A modified ABA pre-course/post-course design is used where the first “A” phase is no-training baseline. The “B” phase is data collection following training, and the second “A”, is data collection months following training.  Additionally, affective change in parent-child dyads from precourse to postcourse is compared. Training followed a manualized program. Set in a small group format, training consisted of 12-hours, over 4-weeks. Home visits and, 50-minute on-campus clinics follow group training. Behavioral raters code video sessions on project-generated data sheets to examine training effects. All video was captured in the home.  Overall interobserver agreement (IOA) is calculated at 85% (range = 76% to 90%).

Results:

Preliminary results suggest parents can apply basic strategies with fidelity. To date, 71 families completed the program. Results depict families that completed all aspects of the program, and provided permission for use of data.  These data are reported on percentage of correct use of components for redirection, prompting, and differential reinforcement strategies. Moreover, a change in parent affect was observed. Affect data are reported on ratings of happiness, interest, stress and confidence. Social validity data indicate parents perceived the program as important and helpful. Data collection is ongoing.

Conclusions:

The study found support for the efficacy of an intensive parent education program for difficult behavior within a public school setting. In general, strategies taught and used by parents are correctly implemented. Parents improved in self-efficacy, defined as decreased stress and increased confidence. Moreover, parent’s desire to ‘work through’ difficult behavior increases. Parent education presented in a public school system is promising for families of children with ASD with long term sustainability. Ongoing results of this work are utilized to support parent training for families of children with ASD where treatment is provided in a public-funded agency.