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.
The efficacy and consequential validity of an ecological approach to
behavioral intervention with families of children with developmental
disabilities was examined. The approach aimed to transform coercive into
constructive parent-child interaction in family routines. Ten families
participated, including 10 mothers and fathers and 10 children 3–8 years
old with developmental disabilities. Thirty-six family routines were selected (2
to 4 per family). Dependent measures included child problem behavior, routine
steps completed, and coercive and constructive parent-child interaction. For
each family, a single case, multiple baseline design was employed with three
phases: baseline, intervention, and follow-up. Visual analysis evaluated the
functional relation between intervention and improvements in child behavior and
routine participation. Nonparametric tests across families evaluated the
statistical significance of these improvements. Sequential analyses within
families and univariate analyses across families examined changes from baseline
to intervention in the percentage and odds ratio of coercive and constructive
parent-child interaction. Multiple baseline results documented functional or
basic effects for 8 of 10 families. Nonparametric tests showed these changes to
be significant. Follow-up showed durability at 11 to 24 months postintervention.
Sequential analyses documented the transformation of coercive into constructive
processes for 9 of 10 families. Univariate analyses across families showed
significant improvements in 2- and 4-step coercive and constructive processes
but not in odds ratio. Results offer evidence of the efficacy of the approach
and consequential validity of the ecological unit of analysis, parent-child
interaction in family routines. Future studies should improve efficiency, and
outcomes for families experiencing family systems challenges.
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