Coaching Paraprofessionals to Promote Engagement and Social Interactions During Small Group Activities

Paraprofessionals need adequate training and supports to assist young children with autism spectrum disorders to engage in appropriate social interactions during small group activities with their peers. In this study, we used in situ coaching and brief post-session feedback to improve the use of environmental arrangement, prompting, and praise by three paraprofessionals working in inclusive classrooms. Results suggested the brief coaching intervention was effective for improving target behaviors. In addition, generalized use of behaviors and child outcomes were positive. In situ feedback is a promising practice for improving use of evidence-based practices by non-certified personnel in early childhood settings.     

Effects of textual prompts and feedback on social niceties of adolescents with autism spectrum disorder in a simulated workplace

Previous research demonstrates the efficacy of behavioral skills training with a textual prompt to establish greetings and conversational skills. This study examined the efficacy of a brief intervention of textual prompts with performance feedback for increasing social niceties of adolescents and young adults with autism spectrum disorder in a simulated workplace. Target social niceties included “Do you have a minute?” when a participant initiated an interaction and “Thank you for your time” when a participant ended the interaction. Results revealed this intervention was effective for 7 of 9 participants. This study expands upon previous studies by showing the efficacy of a resource-efficient training on acquisition and generalization of social niceties by people with autism spectrum disorder.     

Evaluation of a French parent-training program in young children with autism spectrum disorder

Parent training programs (PTs) in young children with autism spectrum disorders (ASDs) are known to reduce parenting stress and improve child's behavior and parent-child interactions. Few PTs are available to French speaking families. In order to provide them with this type of intervention, we developed a French parent-training program of 12 bimonthly sessions and three individual home visits based on applied behavior analysis. The purpose of this study is to evaluate the social validity and efficacy of this new PT on eighteen parents who have a child with ASD and developmental delay. For 16 parents, the PT was considered effective, the objectives targeted important and the strategies learned acceptable for use with children. They have significantly improved their knowledge in ASD and behavioral intervention strategies and their children's socialization skills, and reduce their parental stress. This new French PT program seems to be a promising intervention.     

Telehealth parent training for a young child at risk for autism spectrum disorder

The global pandemic has highlighted the importance of telehealth to access behavioral interventions. Face-to-face parent training improves the development and behaviors of young children at risk for autism spectrum disorder (ASD). We evaluated a telehealth parent training intervention for a child at risk for ASD. Two parents identified possible early ASD symptoms in their 30-month-old son (lack of imitation, pointing, and vocal manding). Both parents simultaneously received telehealth behavioral skills training on the Parent Intervention for Children at Risk for Autism program for 1 hour per week over 29 weeks. Multiple baseline designs across parent and child behaviors showed that both parents improved their parent teaching fidelity above 80% and the child improved on all trained behaviors. This study expands the utility of telehealth behavioral parent training to young children at risk for ASD to mitigate early symptoms of ASD.     

Interactive computer training to teach discrete‐trial instruction to undergraduates and special educators in Brazil: A replication and extension

Discrete‐trial instruction (DTI) is a behavioral method of teaching young children with autism spectrum disorders (ASD) that has received a significant amount of research support. Because of a lack of qualified trainers in many areas of the world, researchers have recently begun to investigate alternative methods of training professionals to implement behavioral teaching procedures. One promising training method is interactive computer training, in which slides with recorded narration, video modeling, and embedded evaluation of content knowledge are used to teach a skill. In the present study, the effectiveness of interactive computer training developed by Pollard, Higbee, Akers, and Brodhead (2014), translated into Brazilian Portuguese, was evaluated with 4 university students (Study 1) and 4 special education teachers (Study 2). We evaluated the effectiveness of training on DTI skills during role‐plays with research assistants (Study 1) and during DTI sessions with young children with ASD (Studies 1 and 2) using a multiple baseline design. All participants acquired DTI skills after interactive computer training, although 5 of 8 participants required some form of feedback to reach proficiency. Responding generalized to untaught teaching programs for all participants. We evaluated maintenance with the teachers in Study 2, and DTI skills were maintained with 3 of 4 participants.     

Evaluation of a social problem-solving skills program for third- and fourth-grade students

The effects of a social problem-solving (SPS) training program for entire classrooms of third- and fourth-grade children were examined in two studies. In the first study, experimental children showed significantly greater improvement in knowledge and performance of SPS skills than control children. However, both positive and negative effects of the intervention (varying by classroom) were found on measures of behavioral adjustment, self-efficacy, and peer acceptance at a 6-month follow-up. The second study compared two different intervention strategies: (a) SPS training with teacher-student dialoguing, peer pairing, and self-monitoring, and (b) SPS training with dialoguing only. It was found that children in both the experimental and control groups improved significantly in performance of SPS skills but no differences between the groups were found for changes in behavioral adjustment, self-efficacy, and peer acceptance. The limitations of cognitively mediated interventions for young children were discussed.     

Examining the Efficacy of Parent–Child Interaction Therapy with Children on the Autism Spectrum

Externalizing behaviors are a common component of the clinical presentation of autism spectrum disorders. Although traditionally used with typically-developing children, parent–child interaction therapy (PCIT) is one behaviorally-based parent training program that has demonstrated success in increasing child compliance, reducing problem behavior, and improving parent–child communication. The study examined the efficacy of PCIT as a treatment for children with autism spectrum disorders by employing a single subject, non-concurrent multiple baseline design across three subjects. Primary findings revealed increases in child compliance, reductions in child disruptive behavior, and improved parenting skills across participants. In addition, each caregiver reported high levels of satisfaction with the intervention. Results suggested that PCIT may be a treatment option for children on the autism spectrum with co-occurring behavioral difficulties. Although the non-concurrent nature of the multiple baseline design is a limitation, this study replicates and extends previous research investigating the efficacy of PCIT with children with autism and their parents.     

Using Behavioral Skills Training to Teach Interview Skills to Young Adults with Autism

With unemployment rates for adults with autism as high as 85%, it is important for young adults to learn necessary prevocational skills (e.g., interviewing) to help them succeed in their search for employment. There is little research showing that individuals with autism can be taught to respond appropriately during an interview to secure future employment opportunities. We replicated the results of Stocco et al. (J Appl Behav Anal 50:495–510, 2017. https://doi.org/10.1002/jaba.385) who evaluated the effects of behavioral skills training on the interview skills of college students. We used a multiple baseline design across three responses (i.e., asking questions, answering questions and appropriate body language) to extend these results to three young adults with autism. During baseline, responding was low across all three responses for all three participants. Behavioral skills training consisted of role-playing simulated interviews, providing feedback and performance rehearsals. For two of the participants, behavioral skills training alone was effective at increasing all three responses. For the third participant, we added textual cues and reinforcement during behavioral skills training to reach criterion performance. Results demonstrated that adults with autism can benefit from modified behavioral skills training to improve interview skills and employment opportunities. Social validity of responses was assessed by asking community members to rate video-taped segments of the interviews.

     

Caregivers can implement play-based instruction without disrupting child preference

Young children diagnosed with autism spectrum disorder often require systematic teaching to learn new skills, and caregivers can teach their children by embedding learning opportunities in a play-based context. However, researchers have not evaluated procedures to train caregivers how to implement a combination of strategies designed to establish rapport and early language skills while maintaining play as a preferred context. Caregiver–child dyads composed of 2 mothers and their sons were recruited to participate. A multiple-probe design across strategies was used to demonstrate the efficacy of behavioral skills training on the mothers' integration of parallel play, child-directed interaction, teaching requests (mands), and teaching labels (tacts). Both children acquired the target requests and labels as a function of their mothers' teaching. By assessing the children's preferences, we confirmed the teaching strategies did not decrease toy engagement or the value of playing with their mother. We obtained stimulus generalization of the mothers' implementation of the strategies from a clinic to their home and maintenance of mother and child performance across a month.     

Behaviorally Based Interventions for Teaching Social Interaction Skills to Children with ASD in Inclusive Settings: A Meta-analysis

Behaviorally based interventions have been demonstrated to be effective to teach social interaction skills for children with autism spectrum disorders in general education. However, the overall and moderating effects of these interventions have not been previously investigated in inclusive settings. The goal of this study was to investigate the overall effectiveness and contextual factors that moderate intervention effectiveness in inclusive settings. Findings showed overall high effect size based on studies previously considered of methodological quality in single-case research. Interventions are demonstrated to be highly effective for children aged 2–10 years. While differences were found according to target social skills and behavioral components used, no differential effects were found regarding intervention implementer and peer training. The findings highlight the practical significance of behavioral interventions and guide educators toward more suitable evidence-based practices in inclusive settings.     

THE EFFECTS OF BEHAVIOR SKILLS TRAINING ON CORRECT TEACHER IMPLEMENTATION OF NATURAL LANGUAGE PARADIGM TEACHING SKILLS AND CHILD BEHAVIOR

Natural Language Paradigm (NLP) is a naturalistic teaching strategy for children with autism that increases immediate and delayed imitative utterances, spontaneous utterances and new words, and production of utterances. NLP includes increasing child choice, varying stimulus items, loose shaping contingencies for communicative attempts, and providing reinforcers with a direct relationship to the response. Only one previous study investigated the effects of behavioral skills training (BST) on staff acquisition and generalization of implementation of NLP and child behavior. A BST package of instructions, modeling rehearsal and feedback, was used to train teachers to implement NLP teaching procedures with three pre‐school children with autism spectrum disorder. Training increased correct teacher performance systematically across all three teachers during NLP teaching sessions and with children for whom teachers did not directly receive training. Correct teacher performance increased appropriate child vocalizations and decreased maladaptive behavior for four of six children. BST is effective in quickly training teachers in the generalized implementation of complex NLP teaching procedures across children. Copyright © 2012 John Wiley & Sons, Ltd.     

Caregiver‐mediated joint attention intervention

Joint attention is a pivotal social communication skill often absent or impaired in young children with autism spectrum disorder. Joint attention is the shared and alternating attention of two individuals on an object or event, and has implications for later communication and social communication skills. This study used a concurrent multiple‐baseline design across 3 caregiver–child dyads to train caregivers to teach response to joint attention behaviors to their 3–6 years old children with moderate to severe autism spectrum disorder. Caregivers were trained on strategies including prompting, time delay, and elements of naturalistic teaching and implemented the intervention in brief 10‐min sessions 2–3 times per week. Results indicate parent mastery of intervention and substantial increase in child response to joint attention behaviors both prompted and independent. Implications for practice and areas for future research are discussed.     

Educational advocacy for children with autism

There exists a great divide between parents' demands for intensive behavioral interventions for their children with autism and the public education system's reluctance to support early intensive behavioral intervention programs. More and more, professionals with expertise in applied behavior analysis are being asked to advocate for effective, early behavioral intervention for autism in education litigation brought about by frustrated parents. The progress made in recent years in the behavioral treatment of children with autism and the schools' lack of adherence to the requirements of IDEA have made it possible for educational policy change through effective advocacy by behavioral interventionists. This paper discusses preparing for educational advocacy on behalf of young children with autism. We explore the personal and emotional reasons why parents choose to engage in the financially risky endeavor of educational litigation. We then outline an approach to developing expert testimony based upon evaluation of the target child and his/her educational history. Issues related to assessment, training, and ethical practice are addressed. Copyright © 2002 John Wiley & Sons, Ltd.     

Using Web-Based Instruction,Brief Workshops,and Remote Consultation to Teach Community-Based Providers a Parent-Mediated Intervention

Parent-mediated interventions for young children with autism spectrum disorder (ASD) are highly under-utilized in community settings. A challenge to the dissemination of these programs is that provider training protocols must teach both the intervention techniques, and the parent coaching strategies. The current study assesses the feasibility an innovative multimodal training protocol to teach community-based intervention providers Project ImPACT (Improving Parents as Communication Teachers). A total of 30 providers (90% female; 76% Caucasian, 13.3% Multiracial/Other, 3.3% Hispanic/Latino, and 3.3% Asian/Pacific Islander) participated in Phase 1, and 15 of these participants (80% female; 60% Caucasian, 33.3% multiracial, and 6.6% Hispanic/Latino) participated in Phase 2. In Phase 1, providers completed questionnaires and videotaped interactions before and after a web-based tutorial and interactive workshop focused on intervention techniques. In Phase 2, providers completed questionnaires and videotaped interactions before and after a second interactive workshop focused on parent coaching. Results from Phase 1 indicate that the addition of the workshop resulted in higher ratings of training satisfaction (p?<?.01), training adequacy (p?<?.01), and self-efficacy (p?<?.01) of the intervention techniques. Results from Phase 2 indicate the addition of the second workshop resulted in greater training adequacy of the parent coaching strategies, p?<?.01. These results suggest that use of this training protocol is a feasible way to increase access to high quality training in evidence-based intervention for providers working with children with ASD in the community; however, larger scale community-based trials of the training protocol are an important next step.     

Differential rates of skill acquisition and outcomes of early intensive behavioral intervention for autism

Intensive behavioral intervention for very young children with autism has received increased attention in recent years. Researchers have documented unprecedented success in educating some young children with autism, although not every child makes dramatic developmental gains. It might be useful to identify early in treatment those children who will benefit most from the current methodology and who might require slight variations in instructional format or curricular focus. The present study suggests that initial learning rates are moderately correlated with treatment outcomes after two years. Among 20 children receiving early, intensive behavioral intervention, initial acquisition of skills was correlated with later learning rates, severity of autism symptomatology and adaptive behavior profiles two years into treatment. Implications are discussed, especially in light of the universal need for intensive intervention in this population. Copyright © 1999 John Wiley & Sons, Ltd.     

Teacher Implementation of Trial-Based Functional Analysis and Differential Reinforcement of Alternative Behavior for Students with Challenging Behavior

The purpose of this study was to examine the effects of a training package on three middle school special education teachers’ accurate implementation of trial-based functional analysis (TBFA) and differential reinforcement of alternative behavior (DRA) with their students with autism spectrum disorders or emotional and behavioral disorders in the classroom setting. We also examined the effects of the DRA on six students’ challenging and replacement behaviors. Using a multiple probe across teacher participants design, we demonstrated that all three teachers implemented TBFA during TBFA training with performance feedback conditions and DRA during DRA training with performance feedback conditions with high procedural fidelity. Further, two of three teachers generalized high procedural fidelity with a new student. Finally, results indicated a reduction in all six students’ challenging behavior and an increase in their replacement behavior after the teachers received training and performance feedback on DRA implementation. Limitations and implications for research and practice are discussed.     

TEACHING ABDUCTION‐PREVENTION SKILLS TO CHILDREN WITH AUTISM

Three children with autism were taught abduction‐prevention skills using behavioral skills training with in situ feedback. All children acquired the skills, which were maintained at a 1‐month follow‐up assessment. In addition, 1 of the children demonstrated the skills during a stimulus generalization probe in a community setting.     

Effects of behavioral skills training on parental treatment of children's food selectivity

We used behavioral skills training to teach parents of 3 children with autism spectrum disorder and food selectivity to conduct a home-based treatment package that consisted of taste exposure, escape extinction, and fading. Parent performance following training improved during both taste sessions and probe meals and was reflected in increases in children's acceptance of bites and decreases in their disruptive behavior. Parents also reported that increases in diet variety were maintained at follow-up.     

Use of behavioral techniques by paraprofessional staff: A review and proposal

Paraprofessionals are increasingly being employed to provide direct care to children and adults who have behavioral deficits and excesses, such as those labeled developmentally disabled, mentally ill, or delinquent. Behavioral techniques, if effectively taught to paraprofessionals, offer ways of both teaching new skills to clients and reducing their undesirable behaviors. This article describes the methods that have been used to teach paraprofessionals to use behavioral techniques, how these skills can be maintained on the job, and the effects upon client behavior that result from this teaching of paraprofessionals. In addition, a system for teaching staff to implement and continue to use behavioral techniques is proposed.     

Evaluating the Performance Diagnostic Checklist‐Human Services to assess incorrect error‐correction procedures by preschool paraprofessionals

The Performance Diagnostic Checklist‐Human Services (PDC‐HS) has been used to assess variables contributing to undesirable staff performance. In this study, three preschool teachers completed the PDC‐HS to identify the factors contributing to four paraprofessionals' inaccurate implementation of error‐correction procedures during discrete trial training sessions. The PDC‐HS indicated insufficient training as a contributing factor. We then implemented a nonindicated intervention (posting reminders), followed by an indicated intervention (behavioral skills training). The nonindicated intervention failed to produce desired performance improvements; however, the PDC‐HS indicated intervention resulted in improvements for all paraprofessionals.