Evaluation of a Brief Family-Centered Service Provision Model for Treating Children’s Severe Behavior: A Retrospective Consecutive Case Series Analysis

Abstract

This article serves as an initial program evaluation of a service provision model for providing applied behavior analysis services to families with severe behavior needs. A retrospective consecutive case series design was used to evaluate the effectiveness, feasibility, and cost of the model. We analyzed records for all families served through the model from summer 2017 to fall 2018. A total of 55 families received services, with 87% of children having autism and 63% having an intellectual disability. Withinparticipant single-case experimental designs were used to evaluate the clinic's assessment procedures, and caregiver interviews were used to evaluate the feasibility and effectiveness of developed and implemented treatments. Conclusive assessment results were obtained for approximately 69% of children. For families that received treatment, 92% reported improved child behavior. Intent-to-treat analyses that included families that withdrew from services prior to receiving treatment indicated that 61% of families experienced improved child behavior. Assessment and treatment outcomes for families that attended all appointments are commensurate with those of other similar clinics reported in the literature; however, the percentage of families that withdrew from services is substantially higher. For families adhering to the clinic's services, children's challenging behavior may be effectively assessed and treated through brief outpatient contacts utilizing services based on applied behavior analysis.Keywords Applied behavior analysis . Autism . Functional analysis . Program evaluation . Severe behavior Program evaluations should be conducted to obtain an unbiased determination regarding the extent to which a program's stakeholders find that a program is achieving its intended purpose (Miller, 2017). For community-based providers of applied behavior analysis (ABA) services, stakeholders include the children and families receiving services. The utility of program evaluation is that the collected information may be used to improve a program's future activities (CDC, 2011). Across community-based ABA providers, such activities pertain to the assessment, development, and implementation of behavioral interventions and treatments. The relevance of program evaluation for community-based ABA providers has increased in recent years, as health insurance providers across the United States offer coverage for treatments based on ABA for children with autism, thus making services more accessible for many families. Although methods for analyzing data collected by community-based ABA providers for program evaluation purposes have been proposed (Burns, 2015), there is little evidence to suggest such evaluations are being conducted and shared via publication or presentation (Miller, 2017; cf. Dixon et al., 2017;Leaf et al., 2011).Program evaluation often differs from research, given that services or interventions provided by a program will continue after the evaluation is complete. In contrast, in research the services or interventio...

Description and evaluation of a function‐informed and mechanisms‐based framework for treating challenging behavior

“…Practitioners who preserve the opportunity to produce well‐controlled demonstrations of the impact (or lack thereof) of their practices are eventually empowered to not only provide strong empirical evidence of what has been possible (through single‐case design), but of what has been prevalent (through retrospective CCCS; cf. Shepley et al, 2021).…”

The Practices of Family-Centered Care for Hospitalized Children: Comparison of Iranian Mothers and Nurses' Perceptions

“…Parental understandings of healthcare service may also be associated with belief in the practice of FCC, cultural beliefs, provision of support for community members, support for family members, family roles, and complexity of the child' s health conditions [5]. Family members may not feel ready to take full care of their child and refuse to participate in care interventions [6].…”