Parent-implemented Behavior Interventions via Telehealth for Older Children and Adolescents
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Date
2020-02-27
Authors
Drew, Christine
Journal Title
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Publisher
University of Oregon
Abstract
Children and adolescents with intellectual and developmental disabilities (IDD) are more likely to engage in challenging behavior than their typically developing peers. Challenging behavior has been linked to many negative outcomes including educational and social implications. The most effective interventions to address challenging behavior in children and adolescents with IDD incorporate function-based assessments. The results of these assessments are then used to develop individualized interventions. Functional communication training (FCT) is an evidence based practice to decrease challenging behavior. Natural change agents have served as effective interventionists for FCT. Parents are ideal interventionists because of the amount of time they spent with their children. Parents are also present for a variety of routines such as mealtimes, chores, and personal care, which may elicit challenging behavior. Behavioral parent training (BPT) can effectively teach parents to intervene on their child’s challenging behavior, which can result in decreased frequency of challenging behavior and increased socially appropriate replacement behavior. There are limited skilled professionals who can provide function based intervention or train parents to do so. The use of telehealth can enable greater access to trained professionals and can decrease barriers to accessing services for parents of children and adolescents with IDD. This study used withdrawal designs to determine whether BPT increased parent fidelity of implementation of function-based intervention which then resulted in decreasing rates of child challenging behavior while increasing rates of appropriate replacement behavior. Four participants aged 8-17 were included in the study with their parents serving as interventionists. The routines of concern were mealtime, toothbrushing, and room cleaning with various topographies of challenging behavior impacting the quality of these family routines. Each parent achieved high treatment fidelity with one session of BPT and bug-in-ear coaching. Three participants had an immediate decrease in challenging behavior upon the introduction of the intervention. Three participants showed reliable reversals to their challenging behavior with the withdrawal of the intervention and corresponding decreases in challenging behavior when the intervention was reintroduced. All parents reported high acceptability, ease of use, and contextual fit pre- and post-intervention. Results and implications for practice and future research were discussed.
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Keywords
adolescents, applied behavior analysis, challenging behavior, parent training, telehealth