Parent-Implemented Positive Behavior Support Strategies for Young Children on the Autism Spectrum: A Pilot Investigation

Abstract

Purpose: Parents of children on the autism spectrum enrolled in early intervention often receive coaching to address both social communication and disruptive behavior, which are the two most frequently reported concerns by parents. Intervention techniques for both are often recommended to be implemented across daily routines and require the parents to learn new ways of interacting with their child. A sequential approach to instructing parents in these key intervention targets may reduce burden and increase adherence. Method: This multiple-baseline design pilot study included three mother–child dyads who received instruction in a disruptive behavior intervention immediately following a social communication intervention. Maternal maintenance of social communication strategies and child disruptive behaviors were measured during probes throughout the study. Results: Results indicate that although mothers readily learned to implement the techniques, fidelity of implementing social communication strategies declined after introduction of the positive behavior support strategies. Conclusions: A sequenced approach to parent-mediated intervention is feasible and acceptable. Clinical implications and future directions are discussed. Supplemental Material: https://doi.org/10.23641/asha.19528978

Addressing disruptive behaviors within naturalistic developmental behavioral interventions: Clinical decision-making, intervention outcomes, and implications for practice

“…Previous research exploring the integration of positive behavior supports within NDBIs has done so through the delivery of NDBI strategies and positive behavior supports as discrete interventions to study the effects of ordering these specific modules (Hampton et al, 2022). However, in addition to the use of formal modules, the present study suggests that clinicians are flexibly incorporating a variety of strategies to address disruptive behavior and to support child regulation and that these approaches do not negatively affect child social communication outcomes.…”

“…Clinicians reported feeling that the flexibility of their approach was important as not all children require positive behavior support or to the same degree. Although research has begun to examine sequencing NDBIs so that they are followed by positive behavior interventions (Hampton et al, 2022), the results of the current study suggest the importance of considering how to support the adaptation of NDBIs to more flexibly apply positive behavior supports. This could include the incorporation of clinical and shared decision-making tools that focus on factors that clinicians reported weighing (e.g.…”

“…For example, Gulsrud et al (2010) demonstrated significant reductions in child negative affect and increases in maternal emotional scaffolding throughout the course of a caregiver-mediated NDBI. In addition to examining disruptive behavior as an outcome within NDBIs, Hampton and colleagues (2022) recently used a single case study design to explore the outcomes associated with a caregiver-mediated NDBI that was followed by more explicit support navigating disruptive behavior (Hampton et al, 2022). This research demonstrated that following NDBI strategies with a caregivermediated disruptive behavior curriculum resulted in lower caregiver fidelity when implementing social communication strategies (Hampton et al, 2022).…”