Clearly Define Parent Training - Approaches for ABA & Behavioral Health Parent Training
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When it comes to parent training in applied behavior analysis services, it can be less than clear what exactly that means. How do you go about providing parent training? Although many ABA educational programs teach an overview of parent training, in practice it can be difficult to know what to actually do in a parent training session and how to make the best use of the often little time you have to work with the parent.
In applied behavior analysis parent training, you may provide services that consist of anything from case coordination and assisting with community referrals and consultations, psychoeducation regarding a variety of topics, helping the parent learn how to help their child develop in the areas of language or social skills, help parents learn techniques that effectively reducing maladaptive behaviors, or review various ABA concepts so the parent can become more familiar with the intervention you are using and how to generalize strategies used in ABA session to the home and community settings (Bearss, et. al., 2015). These are just some examples of what might be provided in a typical applied behavior analysis parent training session.
Understanding the nature of the service that you, as the clinician, are planning to provide is beneficial as it will help you to communicate with caregivers, other professionals, funding sources, and staff about what it is that you are providing in your applied behavior analysis parent training sessions (Bearss, et. al., 2015). Also, having a clear idea of what services you are providing will help you improve your confidence and ultimately the quality of your services as you will have a clear direction of where you are going and what you are trying to do.
Interestingly, when we consider other fields of human services, particularly services directed toward the functioning of youth, we find that parent training has been used for decades and that it is an evidence-based treatment that has been found to be effective for children with disruptive behaviors.
There are many different protocols that may be used with children with disruptive behaviors and some may even be appropriate with some of the kids that you may encounter through your ABA parent training services for children with autism spectrum disorder.
Some examples of these parent training protocols supported by research and often used in other behavioral health settings include:
Webster Stratton’s Incredible Years
Kazdin’s Parent Training
Barkley’s Defiant Children
Eyberg’s Parent-Child Interaction Therapy - an evidence-based intervention to treat disruptive behaviors in children (Lieneman, et. al., 2017).
Although extensive research has been completed on youth with conduct problems and how parent training is effective for this population, less is known about the effectiveness of parent training on youth with autism spectrum disorder and maladaptive behaviors. However, when considering research-supported treatments and knowing your particular client, you may be able to utilize your clinical judgment to select the best parent training curriculum or create an individualized plan for the client you are working with to best suit their needs.
Since “the prognosis for children with conduct problems is poor, with outcomes in adulthood including criminal behavior, alcoholism, drug abuse, domestic violence, child abuse and a range of psychiatric disorders” (Dretzke, et.al., 2009). We can assume that some children with autism spectrum disorder who display conduct problems may also experience these poor outcomes without proper intervention. Therefore, it is imperative to consider the service that you are providing and how you are making use of a parent training session to help the child you work with to obtain the best possible outcomes.
One in four children with autism spectrum disorder also have clinically significant levels of aggressive behavior, in particular (Hill, et.al., 2014). Aggressive behavior in children with ASD is the primary behavior that leads to residential placement for these youth. Aggressive behavior is also associated with greater impairments and more intensive medical interventions as compared to those without high levels of aggressive behaviors. With this knowledge, we may consider the evidence for the effectiveness of parent training with a focus on these aggressive behaviors and related conduct problems.
As mentioned above, parent training in the field of applied behavior analysis and specifically as it relates to working with individuals with autism spectrum disorder (ASD), does not seem to have a clear, commonly accepted definition. This may be partially due to the complexity and spectrum of issues that arise in this population therefore leading to a highly individualized parent training service or it may be due to the lack of attention to this subject in the research and clinical community.
When providing applied behavior analysis parent training when working with youth with autism spectrum disorder, it is important to determine whether you are doing one of two things:
PARENT SUPPORT - Are you providing support and guidance and helping parents to learn more about autism, applied behavior analysis, and how it all relates to their child? OR
PARENT-MEDIATED INTERVENTION - Are you providing a service which is intended to have the parent actively interact with their child to increase skills and decrease maladaptive behaviors?
Maybe you are planning to do some combination of the above two approaches. Regardless of the specific style of your parent training service it is helpful for your clinical work as well as for parents and other professionals involved to understand the purpose and goals of your service (Bearss, et. al., 2016).
Further discussion of how to define your ABA parent training service will be provided in future articles on this site.
Bearss, K., Burrell, T. L., Stewart, L., & Scahill, L. (2015). Parent Training in Autism Spectrum Disorder: What's in a Name?. Clinical child and family psychology review, 18(2), 170-82.
Dretzke, J., Davenport, C., Frew, E., Barlow, J., Stewart-Brown, S., Bayliss, S., Taylor, R. S., Sandercock, J., … Hyde, C. (2009). The clinical effectiveness of different parenting programmes for children with conduct problems: a systematic review of randomised controlled trials. Child and adolescent psychiatry and mental health, 3(1), 7. doi:10.1186/1753-2000-3-7
Hill, A. P., Zuckerman, K. E., Hagen, A. D., Kriz, D. J., Duvall, S. W., van Santen, J., Nigg, J., Fair, D., … Fombonne, E. (2014). Aggressive Behavior Problems in Children with Autism Spectrum Disorders: Prevalence and Correlates in a Large Clinical Sample. Research in autism spectrum disorders, 8(9), 1121-1133.
Lieneman, C. C., Brabson, L. A., Highlander, A., Wallace, N. M., & McNeil, C. B. (2017). Parent-Child Interaction Therapy: current perspectives. Psychology research and behavior management, 10, 239-256. doi:10.2147/PRBM.S91200