|Service Delivery Models for Caregiver-Mediated Interventions|
|Monday, May 30, 2016|
|3:00 PM–4:50 PM |
|Columbus Hall EF, Hyatt Regency, Gold East|
|Area: AUT/DDA; Domain: Translational|
|Chair: Christopher A. Tullis (Georgia State University)|
|Discussant: Natalie A. Parks (Positive Behavior Supports Corporation)|
|CE Instructor: Christopher A. Tullis, Ph.D.|
Many caregivers are playing a larger role in the service delivery of interventions to their children with developmental disabilities. These services can be provided across a variety of settings. This symposium includes four papers on behavioral parent training to address the core and associated deficits associated with autism and related development disabilities. Each study provided caregiver-implemented interventions in a particular setting or across a different medium (i.e., clinic-based, home-based, web-based, or live telehealth). Specifically, Connolly, Wilczynski, Finch and McIntosh evaluated the use of an online training to improve parent confidence within a school setting. Lea, Baker, Gillespie, Walton, and Delfs compared parent satisfaction and programmatic outcomes across three different service delivery models in a large scale parent training program. Walton, Yosick, Shillingsburg, Kansal, and Delfs evaluated the feasibility of a 12- week mand training program delivered via telehealth to the parents of preverbal children with ASD in rural Georgia. Durand and Parks modified a feeding intervention delivered in home by parents and evaluated the generalizability of the intervention. Data will be presented on individual outcomes, parent satisfaction, attendance, and other variables relevant to each study. Information on the feasibility and utility of these technologically-based parent interventions will be discussed.
|Keyword(s): Caregiver training, Technology|
Caregiver-Mediated Mand Training Using Telehealth: A Feasibility Study
|WILLIAM WALTON (Marcus Autism Center), Rachel Yosick (Marcus Autism Center), M. Alice Shillingsburg (Marcus Autism Center, Emory University School of Medicine), Caitlin H. Delfs (Marcus Autism Center and Emory University School of Medicine)|
Abstract: Language deficits are one of the most common presenting complaints of parents of children with ASD (De Giacomo & Fombonne, 1998). Mand Training (MT), which focuses on teaching individuals to request items, activities, or actions from others, is based on the conceptualization of language as verbal behavior first described by Skinner (Skinner, 1957). MT is an intervention for severe language delays that incorporates behavioral techniques (e.g., prompting, reinforcement, specific antecedent manipulations) within naturalistic teaching opportunities (Paul, 2008, Le Blanc et al., 2006). MT can be implemented by therapists through direct services or delivered as a caregiver-mediated intervention (Loughrey et al., 2014). Several barriers to accessing evidence-based treatment for language deficits in ASD are unfortunately, common, and include cost and distance. Other behavioral services have been previously delivered via telehealth technology; however, it is not yet clear if MT is feasible for delivery via telehealth. The purpose of this open pilot study was to evaluate the feasibility of caregiver MT in a well-characterized sample of 15 preverbal children with ASD (ages 2.0 years to 4.9 years) via telehealth in rural Georgia that participated in a 12 week MT program. Data has been collected to determine if therapists can reliably train caregivers with a high level of fidelity, if caregivers can implement MT with fidelity, if there is improvement in the childs social communication skills, and if caregivers find the use of telehealth technology acceptable.
|Web-Based Parent Training and Identification of Evidence Based Treatments|
|SARAH CONNOLLY (Marcus Autism Center and Emory University School of Medicine), Susan Wilczynski (Ball State University), Holmes Finch (Ball State University), David E. McIntoch (Ball State University)|
|Abstract: The process of entering into the special education maze may be an overwhelming task for parents of children with autism who seek to best meet the needs of their children. Poor communication and collaboration between the family and school personnel may result in parental feelings of confusion during IEP meetings, as well as dissatisfaction with services (Stoner et al., 2005). A lack of knowledge regarding their child’s condition or the evidence-based treatments that can improve their child’s educational experiences may serve as a significant barrier to parental involvement. Families who have not learned enough credible information about their child’s diagnosis or treatments may have increased difficulty in advocating for their child’s needs. Web-based instruction is a method of increasing parental knowledge of evidence-based treatments for ASD is an emerging area of research, with a limited number of existing studies exploring the effects of web-based instruction on knowledge acquisition for parents of children with ASD (Jang et al., 2011). Should web-based learning become an option for parents of children with ASD, this may result in more cost effective and time efficient delivery of training in the area of behavioral interventions. The purpose of this study was to explore web-based training as a method of increasing parent knowledge of behavioral interventions for children with autism. The current study also aimed to determine if parents who received the training were better equipped to request these evidence based treatments in their child’s IEP. Findings, implications, and future directions will be discussed.|
Comparison of Service Delivery Models for a Behavioral Parent Training Program: Clinic-Based, Home-Based, and Telehealth
|CLAIRE LEA (The Marcus Autism Center), Ashley Baker (Marcus Autism Center), William Walton (Marcus Autism Center), Caitlin H. Delfs (Marcus Autism Center and Emory University School of Medicine)|
Parent training programs based in applied behavior analysis have been utilized as an alternative to intensive behavioral interventions for children with autism to alleviate the costs for parents and lessen the disparity between the number of children with autism who need services and the number of available trained professionals. Positive outcomes of parent training programs have been found when conducted in the home, in the clinic, and more recently via telehealth services; however, more research is needed to evaluate the feasibility and comparative effectiveness. The current study evaluates a 12-week parent training program that provides strategies on teaching new skills and managing problem behavior to over 100 parents of children with autism across the three service delivery models. Collectively, the data show the parent training program increases participants parenting skills and decreases parental stress. The current analysis aimed to assess whether the parents ability to acquire new skills and evaluation of the service differed depending on the location of parent-training.
Procedural Modifications of an In-Home Feeding Treatment to Facilitate Generalization and Maintenance With Parent Implementation
|SHANNON DURAND (Positive Behavior Supports Corporation), Natalie A. Parks (Positive Behavior Supports Corporation)|
Feeding issues and difficulty during mealtime effects up to 40% of all children, ranging from picky eating to almost complete refusal or selectivity (Sharp et al., 2010). Anywhere between three and ten percent of children develop chronic feeding issues that will not resolve without specific intervention. While research on feeding treatments and their effectiveness is rather vast, the literature on parent implementation of protocols, long-term outcomes, and implementing feeding treatments solely in the home setting are much more limited. This study examined the effects of a treatment developed solely within the home setting and that focused heavily on parent training and implementation. The caregiver was trained to implement treatment and long-term gains were measured. Initially the child made remarkable gains in both variety and texture; however, these gains were lost over time. Measures of treatment integrity of caregiver were measured and modifications were made as a result of caregivers inability to maintain high integrity over time to ensure long-term success and outcomes.