Parent implemented intervention for children with autism spectrum disorders
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Parent Implemented Intervention for Children with Autism Spectrum Disorders. Dawn R. Hendricks, Ph.D.

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Parent Implemented Intervention for Children with Autism Spectrum Disorders

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Parent implemented intervention for children with autism spectrum disorders

Parent Implemented Intervention for Children with Autism Spectrum Disorders

Dawn R. Hendricks, Ph.D.

National Professional Development Center on Autism Spectrum Disorders (2008). In Foundations of autism spectrum disorders: An online course. Chapel Hill: FPG Child Development Institute, The University of North Carolina at Chapel Hill.


Parent implemented intervention session topics

Parent Implemented Intervention:Session Topics

  • Rationale for parent involvement in their child’s program

  • Measures of efficacy for parent implemented intervention

  • Skills targeted through parent implemented intervention

  • Effective components of parent training programs


Objective 1 describe the rationale to involve parents in their child s program

Objective #1

Describe the rationale to involve parents in their child’s program


Parent involvement why is it needed with children with asd

Parent Involvement: Why is it needed with children with ASD?

  • Early intervention

  • Intensive intervention

  • Intervention agents throughout his/her lifespan

  • Challenging behavior

  • Generalization


Parent involvement why use it with individuals with asd

Parent Involvement: Why use it with individuals with ASD?

  • Parents of children with ASD report higher levels of stress and depression

  • Two of the most frequently described sources of stress for family members are:

    • Potentially disruptive behavior in public places

    • The corresponding restrictions this behavior places on family activities

  • Involved parents report increased feelings of competence and decreased feelings of depression and stress


Parent implemented intervention for children with autism spectrum disorders

Objective # 2

Describe the measures used to determine the efficacy of parent implemented intervention


Measures of efficacy

Measures of Efficacy

Child Progress

  • Immediate

  • Long Term


Measures of efficacy1

Measures of Efficacy

Koegel, Koegel, Harrower, & Carter (1999)

  • Family/environment “goodness of fit”

  • Parents’ implementation (frequency & fidelity)

  • Parents’ generalization to novel skills/situations

  • Parents’ concerns/issues/values

    Symon (2001)

  • Cost-benefit analysis


Parent implemented intervention for children with autism spectrum disorders

Objective # 3

Describe the skills targeted through parent implemented intervention


Child progress

**Child Progress

Sufficient Evidence Base:

-Reduction of problem behaviors

-Improvement in adaptive behavior

-Improvement in communication

-Improvement in social skills

-Improvement in cognitive performance

-Improvement in on task behavior


Strategies employed to reduce problem behavior

Strategies Employed to Reduce Problem Behavior

  • Functional Behavior Assessment

  • Functional Communication Training

  • Prompting

  • Reinforcement

  • Natural Environment Strategies

  • Environmental Arrangement

  • Visual Strategies

  • Social Stories

  • Pivotal Response Training


Strategies employed to improve communication social

Strategies Employed to Improve Communication / Social

  • Natural Environment Strategies

  • Imitation and Modeling

  • Joint Action Routines/Joint Attention

  • Pivotal Response Training

  • Prompting

  • Reinforcement

  • Environmental Arrangement

  • Functional Behavior Assessment

  • Functional Communication Training

  • Discrete Trial / Structured Teaching

  • Picture Exchange Communication System


Parent implemented intervention for children with autism spectrum disorders

Objective #4

Describe the components of parent training programs that have been demonstrated to be effective


Six essential steps

Presented by the Virginia Autism Resource Center

Six Essential Steps:

1) Determine needs of the family

2) Determine goals

3) Develop the intervention plan

4) Train parents

5) Implement the intervention

6) Monitor progress


Step 1 determine needs of the family

Presented by the Virginia Autism Resource Center

Step 1 Determine Needs of the Family

  • Areas of concerns and needs regarding the child

  • Strengths of the child and family

  • Child behaviors that impact family functioning

  • Parent-child interactions including type, frequency, nature, and reciprocity of interactions

  • Family activities, routines, and physical layout of the home

  • Supports and resources within the immediate and extended family and community


Step 2 determine goals

Step 2Determine Goals

  • Address areas of concern and priority for the child, parents, and/or family members

  • Create a positive impact on family functioning and not cause additional stress to the parents or family

  • Can be implemented by parents with consistency

  • Are appropriate for parents to implement in home and/or community settings


Goals

Goals


Goals examples

Goals: Examples

Jake will use a spoon to feed himself pudding, yogurt, and other viscous foods for a minimum of 10 bites during snack.

Megan will make a choice between two items visually presented by pointing to the desired item on at least 3 out of four occasions.

Jamar will independently complete the 5 steps of his bed time routine on Friday and Saturday evenings.

  • Callie will state 3 things she did at school when asked by her parent.


Goals examples1

Goals: Examples

  • Jake’s sister will participate in motor exercises three times each week by modeling the exercises and interacting with Jake.

  • Megan’s brother will present two choices for a play activity and will play for five minutes.

  • Paris will independently clean up her play area when visiting her grandmother.

  • When asking Callie a question or giving an instruction, Callie’s family members will first gain her attention by standing in front of her, tapping her on the shoulder, and pointing to his/her mouth.


Step 3 develop the intervention plan

Step 3Develop the Intervention Plan

  • Incorporates intervention within the context where target behaviors occur

  • incorporates intervention into naturally occurring daily routines to the maximum extent possible

  • Includes practices that have an evidence base and have been shown to be effective when implemented by parents

  • Includes instructional practices that are compatible with parent knowledge, characteristics, routines, and preferences


Step 3 develop the intervention plan1

Step 3Develop the Intervention Plan

  • Instructional strategy broken down into step-by-step directions

  • Frequency and duration of instruction

  • When and where to provide instruction

  • Who will implement

  • Materials required

  • How long to implement

  • Consequences / reinforcement


Step 4 provide training

Step 4Provide Training

Location

  • Home

  • Community

  • Clinic

  • School

Format

  • Individual Sessions

  • Group Workshop


Teaching activities

Teaching Activities

  • Modeling

  • Didactic Instruction

  • Live Feedback / Coaching


Teaching activities1

Teaching Activities

  • Role Playing / Behavioral Rehearsal

  • Individual videotape analysis

  • Videotape vignettes

  • Individualized discussion of concerns / individualized problem solving


Parent implemented intervention for children with autism spectrum disorders

Objective # 5

Describe the areas of need for future research


Development of a standardized protocol

Development of a Standardized Protocol

Standardization should include:

  • Components that have empirical support

  • Training that can be implemented in a variety of settings, including a school or clinic

  • Components that can be delivered uniformly in a multi-site study

  • Components that can be replicated

  • Components that can be applied more broadly


Summary

Summary

The literature demonstrates that parent training does work to produce a positive effect on the skills of the child and the performance and mental health of the parent.


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