|Training Caregivers, Part II: Enhancing Treatment Integrity
|Sunday, May 24, 2020
|3:00 PM–4:50 PM
|Area: DDA/AUT; Domain: Translational
|Chair: Lindsay Maffei-Almodovar (Quality Services for the Autism Community (QSAC))
|Discussant: Lindsay Maffei-Almodovar (Quality Services for the Autism Community (QSAC))
|CE Instructor: Lindsay Maffei-Almodovar, Ph.D.
Delivering effective ABA services requires caregivers to deliver interventions with sufficient integrity to result in socially meaningful changes in client behavior. Yet, many services often struggle to maintain the integrity of applied behavior analytic interventions in applied settings. Thus, practitioners must have behavioral technologies available to them to assess, and increase treatment integrity and evaluate interventions to do so. This symposium presents three papers addressing this important issue. These papers include a systematic review of training natural change agents implementing functional analytic procedures, a telehealth intervention error analysis and identify to remedy the implementation errors and an intervention study to improve treatment integrity during functional communication training
Advanced graduate students, Masters and Doctoral practitioners, research students, instructors and professors teaching ABA classes, and psychologists including school psychologists.
|Learning Objectives: Participants will describe (1) current developments in behavioral skills training; (2) current developments in pyramidal training; and (3) the effects of BST and pyramidal training on client behavior .
|Natural Change Agent Implemented Functional Analysis: A Systematic Review and Quality Appraisal
|EMILY GREGORI (University of Illinois at Chicago), Christine Drew (University of Oregon), Stephanie Gerow (Baylor University), Leslie Neely (The University of Texas at San Antonio)
|Abstract: Functional analysis (FA) is the most accurate method for identifying the operant function of challenging behavior. Although trained therapists typically implement FAs, previous research has shown that variables, including the assessment agent, may impact the results of a FA. Given that the assessment agent can impact FA results, there is a need to determine the impact of natural change agent training on fidelity of FA implementation. The purpose of this review was to (a) summarize the available literature on natural change agent implemented FA, (b) determine methods for training natural change agents to implement FAs, and (c) determine the effects of training on change agent implementation fidelity of FA. Thirty-seven studies were identified and evaluated against the What Works Clearinghouse Quality and Evidence standards. Most of the included studies were found to have strong methodological rigor and moderate or strong evidence of effectiveness. Common training components across studies including instructions, modeling, role play, feedback, and coaching. Results suggest these components can be effectively utilized to train parents, teachers, residential staff, and students to implement FA in a variety of applied settings. Recommendations for practitioners and directions for future research will be discussed.
|An Error Analysis of a Telehealth Intervention for Teaching Behaviour Technicians Common Behavioural Protocols
|JOEY ROBERTSON (Brock University), Kendra Thomson (Brock University ), Mary Hume (ONTABA), Carly Magnacca (Brock University), Amanda Marcinkiewicz (Brock University)
|Abstract: The relation between treatment integrity and client outcome has been empirically supported. Further evaluation of whether types of integrity errors (omission/commission) affect client outcomes is needed. We evaluated the efficacy of behavioural skills training delivered through telecommunication for teaching three behaviour technicians how to implement an errorless learning protocol to an actor role playing a child with autism spectrum disorder. Additionally, we assessed generalization to teaching an untrained skill, a child, and assessed corresponding effects on the child’s skill acquisition. We conducted a follow-up analysis of the behaviour technicians’ rate of errors of commission (ECoM; i.e., behaviours not prescribed by the protocol) and errors of omission (EOM; i.e., excluding components of a protocol). Participant 1 demonstrated more ECoM with the actor and the child than EoM. Both types of errors decreased post-training and in follow-up. We are currently analyzing the remaining behaviour technicians’ performance to assess whether the same pattern exists. Implications of the effect of BST training on the rate of EOM and ECoM and the relation to child responding will be discussed in relation to training.
|Effects of Treatment Integrity Errors during Functional Communication Training
|MARIE DAVID (Purdue University), Mandy J. Rispoli (Purdue University)
|Abstract: Functional communication training (FCT) is an evidence-based practice for reducing challenging behavior and increasing communication skills of individuals with developmental disabilities. However, due to the procedural complexity of the intervention, practitioners may find difficulty in implementing the intervention with high integrity. Practitioners express the need for evidenced-based practices to be modified in such that it addresses the complexities of the natural environment and barriers to implementation. Fortunately, recent research on treatment integrity has indicated a potential tolerance for implementing behavioral interventions with lower integrity. Further research is needed to determine the threshold in which reinforcement can be delivered to challenging behavior but still lead to a meaningful outcome. For this study, we are evaluating the effects of systematic changes in treatment integrity by altering errors of commission during reinforcement delivery procedures as part of FCT. We utilized an alternating treatments design to compare varying levels of reinforcement delivered to challenging behavior. Preliminary results of the study, implications for practice, and recommendations for future research will be discussed.
CANCELED: Training Interaction Skills to Caregivers: A Systematic Literature Review
|LORI L FINN (Center for Applied Behavior Analysis, The Sage Colleges)
Interactions between caregivers and individuals with disabilities may have far-reaching effects, including impacting caregiver-client relationships, caregiver stress levels, and client outcomes. Research has shown, however, that caregiver interactions are not consistently optimal. As such, caregiver training on interaction skills may improve quality of services and quality of life. A systematic literature review of empirical peer-reviewed published studies from 2000 to 2018 was conducted to examine the impact of training interaction skills to caregivers of individuals with disabilities. Thirty-four papers met inclusion criteria. Training methods varied, most including some combination of didactic instruction, role play, demonstration, video modeling, coaching, and performance feedback. Caregivers participating in training included parents, teachers, and direct-support staff. Client participants included children and adults with various disabilities, including intellectual/developmental disabilities, autism spectrum disorder, and emotional behavioral disorders. Behavior-specific praise was a training focus in more than half of the papers, while the focus of the remaining papers was broader, including positive parenting, responsive interaction, and positive interactions. Findings suggest that training can improve interactions between caregivers and clients with disabilities and positively affect client outcomes. Papers will be discussed in terms of demographic and methodological features, including results, generalization, maintenance, limitations, implications and future directions.