Evaluating the Efficacy and Social Validity of a Culturally Adapted Training Program for Parents and Service Providers in India

Abstract

In regions such as India, where one-to-one behavior-analytic intervention is not easily accessible, parents and service providers may advocate for children with disabilities better if they have foundational training in behavioral approaches to problem behavior. The purpose of this study was to evaluate a culturally adapted training delivered in an underresourced region of India. Ten parents and professionals from Chennai completed the training, and the researchers evaluated its effects using a multiple-baseline design. Participants showed improvements in correct responses on a structured form designed to capture skills involved in function-based assessment and intervention, as well as the fidelity of implementation of extinction and functional communication training. Moreover, participants rated the acceptability of training highly on measures of social validity. Guidelines for the education of parents and service providers in underresourced areas outside of the United States are discussed. Keywords Cultural adaptations . Function-based treatment . India . Problem behavior . Training manualFor decades, addressing the problem behavior of individuals with developmental disabilities has involved a functional approach to assessment and treatment (Hanley, Iwata, & McCord, 2003;Horner, 1994;Iwata et al., 1994). Functionbased procedures have been replicated, extended, and discussed across hundreds of studies and have strong empirical support. However, most research on their efficacy and adoption has been developed and conducted in North American settings (e.g., Special Issue on Functional Analysis, 2013). Given the differential outcomes of behavioral interventions across varied ethnic or demographic characteristics (Artiles & Trent, 1994;Sugai, O'Keeffe, & Fallon, 2012), a careful examination of culture is crucial to our implementation of and training on the functional approach to problem behavior worldwide. To maximize the outcomes and generality of these practices across populations (Baer, Wolf, & Risley, 1968), research must be conducted crossculturally and cross-linguistically.The prevalence of autism spectrum disorder (ASD) in South Asia is estimated at 1 in 93 children (Hossain et al., 2017) and that of intellectual disabilities in India has been quoted at 1% (McKenzie, Milton, Smith, & Ouelette-Kuntz, 2016). Further, problem behavior (e.g., aggression, disruption, self-injury) is commonly associated with ASD and other neurodevelopmental disorders (Brown, Brown, & Dibiasio, 2013;Horner, Carr, Strain, Todd, & Reed, 2002). To our knowledge, no studies have tested the effectiveness of function-based behavioral interventions in treating problem behavior in children with developmental disabilities in South Asian populations, particularly in India. Martin, Nosik, and Carr (2016) quantified the relative paucity of research Research Highlights • The education and training of parents and service providers in managing problem behavior are crucial in regions with few certified professionals. • A manualized training was effec...

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