|Factors Related to Treatment Adherence by Careproviders and Teachers
|Monday, May 26, 2008
|9:00 AM–10:20 AM
|Area: CBM/EDC; Domain: Applied Research
|Chair: Jennifer J. McComas (University of Minnesota)
|Discussant: John C. Borrero (University of Maryland, Baltimore County)
|Abstract: The effectiveness of a behavioral intervention for addressing challenging behavior depends on ability and willingness of the change-agent (e.g., teacher, parent) to consistently implement the intervention. Three investigations, each using a different approach to the question, study factors related to carerprovider adherence to treatment recommendations for addressing challenging behavior. The first presentation, by Tim Moore, discusses the results of a survey of parents of children with autism and their self-reported likelihood of following different types of treatment protocols for decreasing problem behavior. Next, Peg Gaitan will present a mixed methods study in which she examines the factors that influence teacher adherence with classroom-based protocols for behavior management. Third, Mark Derby will present a longitudinal study on the effects of treatment integrity on intervention effectiveness. Finally, John Borrero will serve as discussant
|Adherence to Behavioral and Medical Treatment Recommendations by Parents of Children with Autism Spectrum Disorders.
|TIMOTHY R. MOORE (University of Minnesota), Frank J. Symons (University of Minnesota)
|Abstract: Estimates of parent adherence to a variety of treatments for a variety of disorders have often been found to be sub-optimal. To date, the extent to which adherence might be problematic with respect to parents of children with mental retardation or developmental disabilities (MR/DD) has not been investigated. The current study involved a treatment adherence survey completed by parents of children with autism spectrum disorders (N=220) who were responsible for implementing recommended behavioral treatment, medical treatment, or both to manage the problem behavior of their children living at home. Overall adherence to medical treatment recommendations was significantly greater than adherence to behavioral treatment recommendations (p < .002). Of the predictor variables studied, diagnosis and marital status were significantly related to adherence to behavioral treatments. Of the behavioral treatments recommended, parents reported significantly greater adherence to antecedent and reinforcement strategies than punishment procedures. These results are discussed with respect to future research to address enhancement of adherence, and methods of measuring adherence.
|Teacher Burnout Factors as Predictors of Adherence to Behavioral Intervention.
|PEGGY E. GAITAN (University of Minnesota), LeAnne Denise Johnson (University of Minnesota), Jennifer J. McComas (University of Minnesota), Joseph H. Wehby (Vanderbilt University)
|Abstract: It is hypothesized that factors related to teacher burnout influence treatment adherence. This study examines the relation of teacher burnout to the frequency and quality of behavioral intervention implementation. A sample of 47 general and special education teachers were trained to implement the Good Behavior Game, an intervention designed to assist teachers in the management of problem behaviors in the classroom, and asked to implement each day for 28 weeks. Direct observation data were collected of teacher implementation of the Good Behavior Game. A multiple regression analysis was used to examine the predictive relation between three subsets of the Maschlach Burnout Inventory and two indicators of adherence; 1) mean frequency of implementation of core elements in the Good Behavior Game and 2) Likert ratings of quality of implementation. Results are discussed in terms of variables that comprise and influence treatment adherence.
|A Descriptive Evaluation of Long-Term Treatment Integrity.
|K. MARK DERBY (Gonzaga University), Maire K. Arkoosh (Gonzaga University), David P. Wacker (The University of Iowa), Wendy K. Berg (The University of Iowa), Thomas Ford McLaughlin (Gonzaga University), Anjali Barretto (Gonzaga University)
|Abstract: The validity of selecting treatment contingencies based upon the results obtained via functional analysis is well documented. However, a number of second generation questions have emerged. One of which is what are the parameters required to achieve desired treatment outcomes. More specifically, the degree of treatment integrity needed for the successful reduction of problem behavior. The current study had two purposes; first to describe the relationship between treatment integrity levels and treatment effectiveness and second to highlight the importance of reporting the treatment integrity in outcome based research. Our results indicate that a high level of treatment integrity is required for treatment success. We also found that very low levels of integrity may be required for behavioral reduction procedures (i.e., extinction) if high levels of reinforcement are provided.