Association for Behavior Analysis International

Interventions for children with autism are often implemented by parents, trained staff, or students. The integrity with which components of the intervention are followed can be closely linked to overall outcome effectiveness. This symposium focuses on describing novel procedures used in four different treatment programs for children with autism to evaluate treatment integrity. Suess will discuss the integrity of parents who were trained through telehealth consultation to conduct in-home Functional Communication Training with their child. Higbee will describe two studies in which on-line training was used to teach students and teachers to conduct discrete trial training (DTT) with young children with autism. Brunson will present on a study examining the maintenance and generalization of DTT procedures that are taught to parents via telehealth consultation. Higbee will detail a study focused on evaluating and increasing the integrity with which therapists conduct DTT with children with autism through the use of video recordings.

Evaluating parent integrity with treatment procedures is relevant to telehealth since parents do not have physical contact with a behavior consultant. We conducted a retrospective, descriptive evaluation of the integrity with which parents of three children with autism conducted functional communication training (FCT) in their homes. All training was provided to the parents via telehealth by a behavior consultant in a hospital setting. FCT trials coached by the behavior consultant were conducted during weekly 1-hr visits. Parents made video recordings of treatment trials in which they conducted the procedures independent of coaching. We evaluated the levels of integrity during coached and independent trials within a multielement design and recorded parents omission and commission errors during different components of the treatment over time. The results showed no consistent differentiation between the coached and the independent trials. Some errors (e.g., omission errors associated with reinforcing manding) occurred more frequently overall, but none of the errors appeared to have a strong relationship with treatment outcomes. All children showed reductions in problem behavior during the final treatment trials. These results suggest that behavior analysts can use telehealth to implement FCT with acceptable integrity and to achieve substantial reductions in childrens problem behavior.

Learning behavior-analytic skills, specifically discrete-trial training (DTT), may be of particular importance for parents of young children with autism living in rural areas who may have difficulty accessing providers. The current study used a multiple baseline design to examine the extent to which DTT skills trained in-vivo maintain across time and generalize to new teaching programs. Participants were rural parents of children with autism spectrum disorders under the age of 12. Parents conducted a baseline session with their child at an area clinic and were provided a written manual on DTT to read prior to their next appointment. During the second appointment, parents worked with a clinician to complete a behavioral skills training package aimed at developing the skills necessary to conduct DTT sessions and demonstrated mastery of the skills. Clinicians met with the parents via webcam bi-weekly and weekly following training and provided praise for components implemented correctly and corrective feedback for components implemented incorrectly. During the teleconsultation phase, parents maintained skills at mastery level and generalized the skills to new programs. This suggests that teleconsultation can be an alternative method for service delivery when traditional methods are not available.

Discrete trial teaching (DTT) is often used to teach academic and other skills. Previous research has shown that therapists fidelity to DTT protocol must be high (>90%) to promote optimal learning. Our aim was to identify, and then correct, therapists within-trial treatment integrity errors in DTT for 8 children with a diagnosis of autism spectrum disorder and intellectual disability. All components of discrete trials were coded and time-stamped from video recordings of therapist-learner dyads in their typical setting (home or school). Between 110 and 1531 discrete trials per dyad were included. Markov transition matrices identified treatment integrity errors for all dyads. Errors that were consistent across all dyads included learner self-corrections, response prompt errors, and incorrect application of error correction procedures. With 4 dyads, program consultants were advised of the errors so that therapist re-training could be targeted. At follow-up, increases in treatment integrity were observed for 3 of the 4 dyads. We conclude that Markov transition matrices may be a useful tool in evaluating treatment integrity in DTT and can have clinical utility.

As behavior analytic teaching techniques have become more widespread in applied practice with young children with autism, the need for improved training procedures to facilitate the rapid dissemination of these techniques has become apparent. Interactive online training is one approach that has emerged to fill this need. Interactive online training incorporates behavior analytic teaching procedures, such as programmed instruction and video modeling, to help the learner acquire the targeted skills. Researchers have recently begun to systematically evaluate the effectiveness of this approach to train practitioners to implement behavior analytic techniques with young children with autism. This presentation will describe two studies that were completed in Brazil investigating the effectiveness of interactive online training to teach university students and special education teachers to implement discrete trial teaching (DTT) with young children with autism. Participants performance of DTT with children with autism was measured both before and after the training modules, within a multiple baseline across participants design, to evaluate the effectiveness of the training package. All participants acquired the targeted skills and their behavior generalized to new teaching programs and maintained over time.