The study evaluates a comprehensive, ecological approach to behavioral family intervention with a family of a child with severe disabilities and severe problem behaviors. A multiple-baseline design across family routines assessed the functional relationship between parent implementation of a multicomponent intervention and improvement in child behavior and successful completion of routines. Results indicate durable improvements in child behavior and routine completion. Associated outcomes included generalized improvements in child behavior and enhanced activity patterns. Results verify the efficacy of the approach for ameliorating problem behaviors and empowering parents to build successful family routines. The value of collaborative research with families is briefly discussed.
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We conducted an observational study of parent-child interaction in home activity settings (routines) of families raising young children with developmental disabilities and problem behavior. Our aim was to empirically investigate the construct validity of coercion in typical but unsuccessful family routines. The long-term goal was to develop an expanded ecological unit of analysis that may contribute to sustainable behavioral family intervention. Ten children with autism and/or mental retardation and their families participated. Videotaped observations were conducted in typical but unsuccessful home routines. Parent-child interaction in routines was coded in real time and sequential analyses were conducted to test hypotheses about coercive processes. Following observation, families were interviewed about the social validity of the construct. Results confirmed the presence of statistically significant, attention-driven coercive processes in routines in which parents were occupied with non-child centered tasks. Results partially confirmed the presence of escape-driven coercive processes in routines in which parent demands are common. Additional analysis revealed an alternative pattern with greater magnitude. Family perspectives suggested the social validity of the construct. Results are discussed in terms of preliminary, partial evidence for coercive processes in routines of families of children with developmental disabilities. Implications for behavioral assessment and intervention design are discussed. HHS Public Access Author Manuscript Author ManuscriptAuthor Manuscript Author ManuscriptAlthough there have been significant advances in our understanding of child problem behavior and parent-child interaction (Patterson, 1982;Stormshak, Bierman, McMahon, & Lengua, 2000), very little of this knowledge has been developed in the context of families raising children with developmental disabilities. The etiology of problem behavior in the context of parent-child interaction in the home has been studied in non-disabled populations almost exclusively (McMahon, 1994;Reid, Patterson, & Snyder, 2002). Despite significant social costs of problem behaviors for families of children with disabilities (Singer & Irvin, 1991), the scientific literature includes few studies that address processes of parent-child interaction that develop and maintain problem behaviors among these families (Floyd & Phillipe, 1993). Furthermore, there are no studies in the developmental disabilities literature that have examined the way in which typical family contexts may affect the development of child problem behavior. Such research is viewed as necessary if we are to develop behavioral family interventions that are acceptable, effective and sustainable when used by parents in natural family settings (Bristol et al., 1996). Although there is growing empirical evidence for the effectiveness of positive behavioral interventions for children with disabilities and problem behavior (Koegel, Koegel, & Dunlap, 1996), there is only modest evidenc...
The purpose of this study was to evaluate the effectiveness of a family-centered positive behavior support approach to the amelioration of food refusal behavior in a child with autism. The study was conducted with the child and his family in their home. It employed an empirical case study design with one meal routine: snack time. Following training and support with the child's mother, results show high levels of child food acceptance, successful child participation in observed snack routines, and high parental ratings of social validity and contextual fit. Improvements maintained up to 26 months postintervention. Implementation also was associated with generalization of the child's eating behavior to new foods and to his father's supporting him during snack time. Child behavioral improvements also were associated with parental reports of gains in family quality of life. Results are discussed in terms of implications for practitioners and researchers involved in behavioral feeding interventions.
This study examined the efficacy, social validity, and durability of a positive behavior support (PBS) approach with the family of a girl with autism and severe problem behavior. The study was conducted across a 10-year period beginning when the child was 5 years old. A multiple baseline across family routines design evaluated the functional relationship between parent implementation of a PBS plan and longitudinal improvements in child behavior and successful participation in routines. Daily indicator behavior data allowed us to assess generalized improvements in child behavior. An inventory of monthly community activities allowed us to assess changes in child quality of life. In addition, social validity and contextual fit were assessed. Results document that the intervention was associated with a 75% reduction in problem behavior, and that the effects were maintained across a 6-month to 7-year follow-up period. Associated outcomes included generalized improvements in child behavior and enhanced community activity patterns. Parents also rated the social validity and contextual fit of the approach highly. Results verify the efficacy and social validity of the approach and offer preliminary descriptive evidence of its durability. Contributions to the literature, implications, and future directions are discussed.
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