Family Collaboration Family Collaboration & &

Home ProgrammingHome Programming

Alyssa BlumAlyssa Blum

Elena Garcia-AlbeaElena Garcia-Albea

Hannah KaplanHannah Kaplan

Catherine TaylorCatherine Taylor

1.1. Why Parent Collaboration?Why Parent Collaboration?

2.2. Research FindingsResearch Findings

3.3. Program Models & ApproachesProgram Models & Approaches

4.4. What’s Missing?What’s Missing?

5.5. Home ProgrammingHome Programming

6.6. Tips for Teachers & ParentsTips for Teachers & Parents

7.7. Working with ParentsWorking with Parents

8.8. Providing Positive & Corrective FeedbackProviding Positive & Corrective Feedback

9.9. How To Handle Potentially Difficult SituationsHow To Handle Potentially Difficult Situations

10.10. More ResearchMore Research

11.11. Parent / Consumer Feedback & SurveysParent / Consumer Feedback & Surveys

12.12. Parent InterviewsParent Interviews

Topics Topics

Research FindingsResearch Findings

Why?Why?What?What?How?How?

ConsiderationsConsiderations

WhyWhy Parent Collaboration?Parent Collaboration?

GeneralizationGeneralization Home Sweet HomeHome Sweet Home StressorsStressors Component of comprehensive Component of comprehensive

programsprograms Social ValiditySocial Validity

Why?Why? GeneralizationGeneralization

Generalization across settings for children with Generalization across settings for children with

autism does not typically occur unless autism does not typically occur unless

programmed for programmed for ((Handleman and Harris, 1979; Handleman Handleman and Harris, 1979; Handleman

and Harris 1980; Koegel, Egel, Williams, 1980)and Harris 1980; Koegel, Egel, Williams, 1980)

Generalization between home and school for Generalization between home and school for

children with autism typically requires children with autism typically requires

programming programming (Harris and Handleman, 1983)(Harris and Handleman, 1983)

Parents less likely to continue parent training with Parents less likely to continue parent training with

no generalization (vicious cycle) no generalization (vicious cycle) (McClannahan and (McClannahan and

Krantz, 1982)Krantz, 1982)

Why?Why?

Home Sweet HomeHome Sweet Home Increase on-task Increase on-task

time-40 hours time-40 hours (Lovaas, 1987)(Lovaas, 1987)

Consistency Consistency (Iovannone,Dunlap, Huber, (Iovannone,Dunlap, Huber, Kincaid,2003)Kincaid,2003)

Need “better than Need “better than average” average” contingency contingency management management skills” skills” (McClannahan and (McClannahan and Krantz, 1982)Krantz, 1982)

Why?Why? StressorsStressors

Hastings and Johnson, 2001Hastings and Johnson, 2001 Studied predictors of stress levels for parents Studied predictors of stress levels for parents of children with autismof children with autism Parents of children with autism scored higher on Parent and Parents of children with autism scored higher on Parent and

Family Problems, Depression, and Pessimism than other Family Problems, Depression, and Pessimism than other parents of typically developing or mild to moderate cognitive parents of typically developing or mild to moderate cognitive impairment. impairment.

More symptomology, less social support, fewer adaptive coping More symptomology, less social support, fewer adaptive coping mechanisms , and less belief in teaching methods correlate mechanisms , and less belief in teaching methods correlate with higher scores in Parent and Family Problems, Depression, with higher scores in Parent and Family Problems, Depression, and Pessimism and Pessimism

We can help provide support groups, suggest importance of We can help provide support groups, suggest importance of existing resources, help them accept that “negative events existing resources, help them accept that “negative events occur and that they need to be dealt with”, “putting a more occur and that they need to be dealt with”, “putting a more positive spin on problems so as not to unnecessarily discourage positive spin on problems so as not to unnecessarily discourage family members”family members”

Why?Why? StressorsStressors

Koegel, Bimbela, Schreibman, 2007Koegel, Bimbela, Schreibman, 2007 Parent training in 2 conditions: Which one delivers better Parent training in 2 conditions: Which one delivers better

family interaction outcomes (lower stress)family interaction outcomes (lower stress) Individual Target Behavior: discrete trials, clear tasks and Individual Target Behavior: discrete trials, clear tasks and

instruction, functional reinforcers for response, shaping and instruction, functional reinforcers for response, shaping and promptingprompting

Pivotal Response Training: child chooses materials, intersperse Pivotal Response Training: child chooses materials, intersperse maintenance, attempts to respond correctly maintenance, attempts to respond correctly

were also reinforced, use only naturally occurring reinoforcers were also reinforced, use only naturally occurring reinoforcers intrinsic in part of task being taught. intrinsic in part of task being taught.

Video of dinnertime was scored through Positive Interaction Video of dinnertime was scored through Positive Interaction Rating ScaleRating Scale

PRT condition showed increases in happiness and interest, PRT condition showed increases in happiness and interest, lower stress during interactions, more positive style of parent-lower stress during interactions, more positive style of parent-child communicationchild communication

Why?Why? Comprehensive Comprehensive

ProgramsPrograms PCDI, LOVAAS, Alpine Learning PCDI, LOVAAS, Alpine Learning Group, Douglas Developmental all Group, Douglas Developmental all have parent collaboration as a have parent collaboration as a major component of their programmajor component of their program

Why?Why? Social ValiditySocial Validity

Wolf, 1978Wolf, 1978 1. 1. The social significance of the goals.The social significance of the goals. Are Are

the specific behavioral goals really what society the specific behavioral goals really what society

wants?wants?

2. 2. The social appropriateness of the The social appropriateness of the

procedures.procedures. Do the ends justify the means? Do the ends justify the means?

That is, do the participants, caregivers and That is, do the participants, caregivers and

other consumers consider the treatment other consumers consider the treatment

procedures acceptable?procedures acceptable?

3. 3. The social importance of the effectsThe social importance of the effects. Are . Are

consumers satisfied with the results? All the consumers satisfied with the results? All the

results, including any unpredicted ones?results, including any unpredicted ones?

Why?Why? Social ValiditySocial Validity

Wolf, 1978Wolf, 1978

““If the participants don't like the If the participants don't like the treatment then they may avoid it, treatment then they may avoid it, or run away, or complain loudly. or run away, or complain loudly. And thus, society will be less likely And thus, society will be less likely to use our technology, no matter to use our technology, no matter how potentially effective and how potentially effective and efficient it might be.”efficient it might be.”

What What types of skills can parent’s types of skills can parent’s

benefit from training?benefit from training? (should be skills that parents want)(should be skills that parents want) DTTDTT Incidental Teaching (NLP, Time Delay)Incidental Teaching (NLP, Time Delay) Sibling InteractionSibling Interaction Photographic Activity Schedules/ Leisure/PlayPhotographic Activity Schedules/ Leisure/Play Nonfunctional behaviors-aggressive, self-injurious, Nonfunctional behaviors-aggressive, self-injurious,

stereotypy, noncompliance, “voluntary belching”, stereotypy, noncompliance, “voluntary belching”, “playing radio at appropriate volume”“playing radio at appropriate volume”

Daily living-feeding, sleeping, chores, phobiasDaily living-feeding, sleeping, chores, phobias AcademicsAcademics Community??Community??

HowHow is training facilitated?is training facilitated?

Lecture/didactic, Lecture/didactic,

model, practice, model, practice,

feedback feedback (McClannahan (McClannahan

and Krantz, 1982)and Krantz, 1982)

Multiple exemplarsMultiple exemplars (Crocket, Fleming, Doepke, (Crocket, Fleming, Doepke,

Stevens, 2005; Koegel, Glahn, Stevens, 2005; Koegel, Glahn,

Nieminen, 1978)Nieminen, 1978)

Pyramidal training Pyramidal training (Kuhn, Lerman, Vorndran, 2003)(Kuhn, Lerman, Vorndran, 2003)

How?How?

McClannahan Krantz, McClannahan Krantz, 19821982

Establish a positive parent/home Establish a positive parent/home programmer relationshipprogrammer relationship

trainer serves as prompt and trainer serves as prompt and reinforcer for parent participation reinforcer for parent participation (high levels of reinforcement)(high levels of reinforcement) trainer is provided with materials on answers trainer is provided with materials on answers

to frequently asked questions and materials to frequently asked questions and materials related to frequently encountered problems related to frequently encountered problems with parent trainingwith parent training

adequate follow-up support for parentsadequate follow-up support for parents

How?How? McClannahan Krantz,1982McClannahan Krantz,1982

Selection of Child Target BehaviorsSelection of Child Target Behaviors

Parent involvement for children’s Parent involvement for children’s needs and intervention goals: needs and intervention goals: ““informed and non-coerced consent”informed and non-coerced consent” Parents often fail to report significant child Parents often fail to report significant child

problems because they have adapted: problems because they have adapted: important to provide home programmers important to provide home programmers with techniques for obtaining parent with techniques for obtaining parent participation in interviewparticipation in interview

Home programmers encourage parents to Home programmers encourage parents to choose goals that will lead to success choose goals that will lead to success initially. Next is dangerous or highly initially. Next is dangerous or highly disruptive behaviorsdisruptive behaviors

How?How? McClannahan Krantz, 1982McClannahan Krantz, 1982

Treatment Begins in SchoolTreatment Begins in School

Ensures that the kinks are worked out so that Ensures that the kinks are worked out so that parents are not confused and frustrated when parents are not confused and frustrated when they implement at homethey implement at home

Parents come and observe new proceduresParents come and observe new procedures Parents rehearse proceduresParents rehearse procedures Parent feedbackParent feedback Advantages of being at school: eliminates Advantages of being at school: eliminates

interferences and increases parent attention, interferences and increases parent attention, availability of professionals, training trainersavailability of professionals, training trainers

How?How? McClannahan Krantz, 1982McClannahan Krantz, 1982

Parent Implementation At HomeParent Implementation At Home

Generalization of parent skills from school to home is Generalization of parent skills from school to home is facilitated when home programmer directly supervises facilitated when home programmer directly supervises initial use of intervention procedures at homeinitial use of intervention procedures at home

Parent training in home increases reinforcing value of Parent training in home increases reinforcing value of parentsparents

Trainers must establish guidelines for interactionsTrainers must establish guidelines for interactions Package should be set up with all materials necessary for Package should be set up with all materials necessary for

successfully implementing programsuccessfully implementing program As parents skills improve, more programs can be addedAs parents skills improve, more programs can be added

How?How? McClannahan Krantz, 1982McClannahan Krantz, 1982

Data CollectionData Collection Baseline: When parents Baseline: When parents

take baseline data it take baseline data it may eliminate the need may eliminate the need for formal interventionfor formal intervention

Parents need to submit Parents need to submit data weekly in a timely data weekly in a timely fashionfashion

Many parents were not Many parents were not returning data so a returning data so a prompting model was prompting model was createdcreated

How?How? McClannahan Krantz, 1982McClannahan Krantz, 1982

Data Prompting ProcedureData Prompting Procedure Data sheets were expected to be in by Monday morningData sheets were expected to be in by Monday morning Administration checked for data sheets Monday morningAdministration checked for data sheets Monday morning If received there were no further prompts and positive praise was If received there were no further prompts and positive praise was

often givenoften given If data sheets were not received, home programmer sent note home If data sheets were not received, home programmer sent note home

asking them to send it in tomorrowasking them to send it in tomorrow If data sheets were received on Tuesday, no further promptsIf data sheets were received on Tuesday, no further prompts If data sheets were not received, administrator called parents and If data sheets were not received, administrator called parents and

have a “brief pleasant conversation”: any illnesses or special have a “brief pleasant conversation”: any illnesses or special problems?problems?

If data sheets were received on Wednesday, no further promptsIf data sheets were received on Wednesday, no further prompts If data sheets were not received, phone call from home programmer: If data sheets were not received, phone call from home programmer:

problems related to data collection or intervention procedure? problems related to data collection or intervention procedure? Immediate home visit needed?Immediate home visit needed?

Continue to check for data sheetsContinue to check for data sheets

McClannahan Krantz, 1982McClannahan Krantz, 1982

How?How? McClannahan Krantz, 1982McClannahan Krantz, 1982

External ReviewExternal Review Professionals from beyond the Professionals from beyond the treatment agencytreatment agency Assess individualized home programs Assess individualized home programs

delivered by parents: effectiveness delivered by parents: effectiveness and appropriatenessand appropriateness

More than 2/3 of the home program More than 2/3 of the home program were considered successfulwere considered successful

None were considered inappropriateNone were considered inappropriate

How?How? Multiple ExemplarsMultiple Exemplars

Crocket, Fleming, Doepke, Stevens, 2005; Crocket, Fleming, Doepke, Stevens, 2005; Koegel, Glahn, Nieminen, 1978Koegel, Glahn, Nieminen, 1978

Some parents are able to generalize Some parents are able to generalize training skill from one intervention to training skill from one intervention to another with little traininganother with little training

Others are unable to do soOthers are unable to do so Providing multiple exemplars increases Providing multiple exemplars increases

generalizationgeneralization Determining what parents need and do Determining what parents need and do

not need multiple exemplars can help not need multiple exemplars can help with cost efficiencywith cost efficiency

Multiple ExemplarsMultiple ExemplarsKoegel, Glahn, Nieminen, 1978Koegel, Glahn, Nieminen, 1978

How?How? Pyramidal Training Pyramidal Training

Kuhn, Lerman, Vorndran, Kuhn, Lerman, Vorndran, 20032003 Primary caregiver trains other family membersPrimary caregiver trains other family members

More cost efficient way of training multiple More cost efficient way of training multiple family membersfamily members

Primary caregiver training 1: written and Primary caregiver training 1: written and verbal instruction, role play, immediate and verbal instruction, role play, immediate and delayed feedbackdelayed feedback

Primary caregiver training 2: taught to give Primary caregiver training 2: taught to give written and verbal instruction, role play, written and verbal instruction, role play, immediate and delayed feedbackimmediate and delayed feedback

Other caregiver training: primary caregiver Other caregiver training: primary caregiver instructed other caregivers to implement instructed other caregivers to implement treatment using specified procedurestreatment using specified procedures

1 out of 3 students was successful1 out of 3 students was successful

How?How? Pyramidal Training Pyramidal Training

Kuhn, Lerman, Vorndran, 2003Kuhn, Lerman, Vorndran, 2003

Most caregivers Most caregivers

achieved very achieved very

high accuracy of high accuracy of

responses when responses when

implementing implementing

procedureprocedure

How?How? Pyramidal Training Pyramidal Training

Kuhn, Lerman, Vorndran, Kuhn, Lerman, Vorndran, 20032003

Only one out of Only one out of

the three students the three students

exhibited exhibited

significant significant

decrease in decrease in

behavior with all behavior with all

three caregiversthree caregivers

ConsiderationsConsiderations

Family Context Family Context (Moes, Frea, 2002)(Moes, Frea, 2002)

Parental Parental Perspective Perspective (Geiger, Smith, (Geiger, Smith, Creaghead, 2002)Creaghead, 2002)

Non-adherence Non-adherence (Allen, Warzak, 2000)(Allen, Warzak, 2000)

Program Program Models/ApproachModels/Approach

eses

Alpine Learning GroupAlpine Learning Group(ALG)(ALG)

Family InvolvementFamily Involvement

3 hours per month school 3 hours per month school observationobservation

Attendance at monthly parent Attendance at monthly parent meetingsmeetings

Home visits by family consultantHome visits by family consultant

Family ConsultationFamily Consultation

Goals:Goals: Ensure stimulus generalizationEnsure stimulus generalization Assist families in teaching functional Assist families in teaching functional

skillsskills Address problem behavior Address problem behavior Ensure parents/caregivers can use the Ensure parents/caregivers can use the

techniques necessary to increase skills techniques necessary to increase skills and address problem behaviorand address problem behavior

Alpine OfferingsAlpine Offerings

Upon Enrolling:Upon Enrolling: Offered weekly home visits (during first Offered weekly home visits (during first

year)year) Participation in a didactic parent training Participation in a didactic parent training

coursecourse Second Year:Second Year:

Home visitation every other weekHome visitation every other week Third Year and throughout:Third Year and throughout:

One home visitation per month One home visitation per month

Assessment of Home and Assessment of Home and Community FunctioningCommunity Functioning

At time of Enrollment:At time of Enrollment: Home and community skills assessment conducted. Home and community skills assessment conducted.

Domains include: self-care, leisure skills, domestic skills, Domains include: self-care, leisure skills, domestic skills, receptive and expressive language, community skills, receptive and expressive language, community skills, and problem behavior.and problem behavior.

Working Together:Working Together: Family consultants work with parents in prioritizing Family consultants work with parents in prioritizing

objectives and identifying relevant teaching strategies. objectives and identifying relevant teaching strategies. Example: Parent’s may want their child to be involved in Example: Parent’s may want their child to be involved in

a community recreation program- ALG family consultant a community recreation program- ALG family consultant may be required to visit the recreation site and train may be required to visit the recreation site and train personnel there. personnel there.

Parent VisitsParent Visits

ALG- open door policy:ALG- open door policy: Parent’s can observe as often as they like Parent’s can observe as often as they like

(minimum of 3 hours is required each month)(minimum of 3 hours is required each month) Clipboard with questions about their visitClipboard with questions about their visit

* “Did you achieve the goals of your visit?”* “Did you achieve the goals of your visit?” Interactions are minimal to none with teaching Interactions are minimal to none with teaching

staff and learner’s during visits- set time aside staff and learner’s during visits- set time aside for training sessionsfor training sessions

Communication:Communication:* Daily communication book, e-mail or * Daily communication book, e-mail or telephone contacttelephone contact

Parent MeetingsParent Meetings

Monthly group meetings Monthly group meetings

(Parents, directors, and teachers)(Parents, directors, and teachers) Average of 8 held yearlyAverage of 8 held yearly Topics: ALG policies and procedures, Topics: ALG policies and procedures,

Agency issues, current topics and Agency issues, current topics and issues, and general programming issues, and general programming issues.issues.

Consumer EvaluationConsumer Evaluation

Annual basis:Annual basis: Formally asked to share concerns or Formally asked to share concerns or

compliments to ALG programs (anonymous compliments to ALG programs (anonymous consumer evaluation)consumer evaluation)

*Rate overall effectiveness of intervention *Rate overall effectiveness of intervention services by responding to a written questionnaireservices by responding to a written questionnaire

Example: “How satisfied are you with the amount Example: “How satisfied are you with the amount of cooperation and assistance you have received of cooperation and assistance you have received from ALG administrative staff this school year?”from ALG administrative staff this school year?”

Princeton Child Development Princeton Child Development InstituteInstitute(PCDI)(PCDI)

Parents are welcomed for school visitsParents are welcomed for school visits Home Programmer-regularly visits the Home Programmer-regularly visits the

homehome Consent for new intervention (parents Consent for new intervention (parents

observe, collect data, and implement observe, collect data, and implement with assistance)with assistance)

Program comes home when target Program comes home when target skills are acquired at school. skills are acquired at school.

Upon returning home from Upon returning home from schoolschool

examples:examples: A 9-year old learns to remain independently engaged A 9-year old learns to remain independently engaged

in leisure activities for longer time periods.in leisure activities for longer time periods. A 10-year old helps unloading the dishwasher, A 10-year old helps unloading the dishwasher,

setting the table and folding towels.setting the table and folding towels. A 12-year old completes homework assignments with A 12-year old completes homework assignments with

minimal assistance. minimal assistance. A young teenager independently follows an activity A young teenager independently follows an activity

schedule to complete a workout (treadmill)schedule to complete a workout (treadmill) An older adolescent independently wakes up when An older adolescent independently wakes up when

his alarm clock rings, makes his bed, showers, and his alarm clock rings, makes his bed, showers, and shaves with minimal supervision. shaves with minimal supervision.

Behavioral Contracts Behavioral Contracts help the children:help the children:

Arrive at school with completed homework Arrive at school with completed homework assignments, school lunches THEY made assignments, school lunches THEY made the previous evening, wristwatches the previous evening, wristwatches (appointment-keeping skills), wallets, (appointment-keeping skills), wallets, notes from parents, vacuumed room etc. notes from parents, vacuumed room etc.

These independent performances are These independent performances are valued by parents and they expand the valued by parents and they expand the student’s opportunities to hold jobs in the student’s opportunities to hold jobs in the future. future.

Douglass Developmental Douglass Developmental Disabilities CenterDisabilities Center

(DDDC)(DDDC) Parent training sessions (first enrolled)Parent training sessions (first enrolled) Visits twice a month from a home-Visits twice a month from a home-

school consultant school consultant Focus of training sessions: principles Focus of training sessions: principles

of ABA, elaboration on behavioral of ABA, elaboration on behavioral teaching, and prioritizing goalsteaching, and prioritizing goals

Generalization checks and community Generalization checks and community based learning experiences.based learning experiences.

CommunicationCommunication

Weekly phone calls*Weekly phone calls* Exchanges of data*Exchanges of data* Monthly clinics*Monthly clinics* Support servicesSupport services Four times a year evening meetingsFour times a year evening meetings Yearly conference (Douglass Yearly conference (Douglass

Organization for Occupational and Organization for Occupational and Related Educational Services DOORS)Related Educational Services DOORS)

Summary of all 3 Summary of all 3 ProgramsPrograms

School visitation offered (some School visitation offered (some required)required)

Home visitations are doneHome visitations are done Parent meetings/clinics or support Parent meetings/clinics or support

groups offeredgroups offered Training is offered (or required)Training is offered (or required) *Satisfaction rating and concerns* *Satisfaction rating and concerns*

(not all)(not all)

Group Discussion Group Discussion

What is missing?What is missing?

Home Home ProgrammingProgramming

Purpose of Home Purpose of Home ProgrammingProgramming

Provides training and Provides training and support for parentssupport for parents

Promotes Promotes Generalization of Generalization of SkillsSkills

Teaches families to be Teaches families to be successful!successful!

1.1. Develop a relationshipDevelop a relationship

2.2. Design an Individualized Design an Individualized ProgramProgram

3.3. Begin instruction in school Begin instruction in school settingsetting

4.4. Begin a home baselineBegin a home baseline

5.5. Parents observe program at Parents observe program at schoolschool

6.6. Parents implement program at Parents implement program at schoolschool

7.7. Parents implement program at Parents implement program at homehome

8.8. Follow-up services providedFollow-up services provided

Components of a Home Components of a Home ProgramProgram

1.1. Develop a Parent-Home Programmer Develop a Parent-Home Programmer RelationshipRelationship

IntroductionIntroduction

Provide rationales Provide rationales

Describe components of home programmingDescribe components of home programming

ExpectationsExpectations

Frequency of visitsFrequency of visits

Discuss convenient times for home/school visitsDiscuss convenient times for home/school visits

Stress importance of collaborationStress importance of collaboration

Components of a Home Components of a Home ProgramProgram

2.2. Identify Target Behaviors & Identify Target Behaviors & Design an Individualized ProgramDesign an Individualized Program

Select annual goalsSelect annual goals

Prioritize goalsPrioritize goals

Under-promise and over-deliverUnder-promise and over-deliver

Obtain parental consent on all Obtain parental consent on all programsprograms

Components of a Home Components of a Home ProgramProgram

3.3. Begin instruction in school settingBegin instruction in school setting

Conduct BaselineConduct Baseline

Revise response Revise response

definition definition

Monitor performanceMonitor performance

Examine reinforcementExamine reinforcement

proceduresprocedures

Consider WHERE Consider WHERE

instructional procedure instructional procedure

will eventually be used. will eventually be used.

PLAN accordingly.PLAN accordingly.

Components of a Home Components of a Home ProgramProgram

4.4. Begin a home baselineBegin a home baseline Revise individualized program for home settingRevise individualized program for home setting

Prepare necessary materialsPrepare necessary materials Data sheetsData sheets

Reinforcement systemReinforcement system

Stop watch / timerStop watch / timer

Clipboard Clipboard

Train parents on data collection Train parents on data collection Response definitionsResponse definitions

Practice data collection with them (role play)Practice data collection with them (role play)

Take IOATake IOA

Components of a Home Components of a Home ProgramProgram

5.5. Parents observe program in Parents observe program in schoolschool

BEFOREBEFORE parents arrive parents arrive::

1.1. Make sure to fine-tune individualized Make sure to fine-tune individualized

program if necessaryprogram if necessary

2.2. Observe learner’s performanceObserve learner’s performance

3.3. Anticipate possible questionsAnticipate possible questions

Components of a Home Components of a Home ProgramProgram

5.5. Parents observe program in Parents observe program in schoolschool

Meet with parents privatelyMeet with parents privately Show current data / progress in programShow current data / progress in program

Explain what they will be observingExplain what they will be observing

Have parents OBSERVE programHave parents OBSERVE program Explain what they are watchingExplain what they are watching

Focus on what teacher is doing with learnerFocus on what teacher is doing with learner

Provide rationalesProvide rationales

Review data collection procedureReview data collection procedure

Components of a Home Components of a Home ProgramProgram

5.5. Parents observe program in Parents observe program in

schoolschool

AFTERAFTER parents observe: parents observe:

1.1. Invite / answer questionsInvite / answer questions

2.2. Schedule next school Schedule next school

visitvisit

Components of a Home Components of a Home ProgramProgram

6.6. Parents implement program at Parents implement program at schoolschool

7.7. Praise parents for their participationPraise parents for their participation

8.8. Model the procedure & invite questionsModel the procedure & invite questions

9.9. Parent delivers intervention procedureParent delivers intervention procedure

10.10. Praise parent’s appropriate performancesPraise parent’s appropriate performances

11.11. Describe ineffective behaviorDescribe ineffective behavior

12.12. Provide rationales for changeProvide rationales for change

Components of a Home Components of a Home ProgramProgram

6.6. Parents implement program at Parents implement program at schoolschool

7.7. Describe an alternate, effective behavior & Describe an alternate, effective behavior &

describe rationalesdescribe rationales

8.8. Request acknowledgement throughout training Request acknowledgement throughout training

interactioninteraction

9.9. If needed, model the desired behavior again If needed, model the desired behavior again

and have parent practice againand have parent practice again

10.10. Provide feedbackProvide feedback

11.11. Schedule next home visitSchedule next home visit

Components of a Home Components of a Home ProgramProgram

7.7. Parents implement program at Parents implement program at homehome

1.1. Briefly review measurement and teaching Briefly review measurement and teaching

proceduresprocedures

2.2. Model the procedure & invite questionsModel the procedure & invite questions

3.3. Have parents deliver the intervention procedureHave parents deliver the intervention procedure

4.4. Provide feedback & rationales for changeProvide feedback & rationales for change

5.5. Request acknowledgement & invite questionsRequest acknowledgement & invite questions

Components of a Home Components of a Home ProgramProgram

7.7. Parents implement program at homeParents implement program at home

6.6. Repeat sequence multiple times if neededRepeat sequence multiple times if needed

7.7. Take IOA data if possibleTake IOA data if possible

8.8. Express appreciation for their Express appreciation for their

continued supportcontinued support

9.9. Schedule next home visitSchedule next home visit

Components of a Home Components of a Home ProgramProgram

8.8. Provide follow-up servicesProvide follow-up services

9.9. Review data on learner’s performance.Review data on learner’s performance.

10.10. Invite questions about data collection, response Invite questions about data collection, response definition, or intervention procedure.definition, or intervention procedure.

11.11. Take data on learner’s performance and obtain Take data on learner’s performance and obtain IOA.IOA.

12.12. Observe parent implementing program and Observe parent implementing program and provide additional training if necessary.provide additional training if necessary.

13.13. Discuss importance of regular data collection.Discuss importance of regular data collection.

14.14. Thank parents and schedule next visit.Thank parents and schedule next visit.

TIPS for TeachersTIPS for Teachers

BE PREPAREDBE PREPARED

BE BE

PROFESSIONALPROFESSIONAL

REMAIN REMAIN

FOCUSEDFOCUSED

TIPS for ParentsTIPS for Parents

Be consistentBe consistent Prepare materials and environment Prepare materials and environment

in advancein advance Give simple, clear directionsGive simple, clear directions Reward your child immediatelyReward your child immediately Use physical guidance if necessaryUse physical guidance if necessary Ignore off-task behaviors and praise Ignore off-task behaviors and praise

appropriate behaviorsappropriate behaviors

Parent TrainingParent Training(Ingersoll & Dvortcsak, 2006)(Ingersoll & Dvortcsak, 2006)

Used a 5 step teaching approach to train Used a 5 step teaching approach to train parents to provide the intervention: Building parents to provide the intervention: Building rapport, reviewing information, modeling rapport, reviewing information, modeling techniques, providing feedback and building techniques, providing feedback and building independence.independence.

Showed an increase in parent satisfaction with Showed an increase in parent satisfaction with improvement in children, but there was no improvement in children, but there was no data to indicate concrete proof of such.data to indicate concrete proof of such.

Model similar to Wolf, et al (1995) The Model similar to Wolf, et al (1995) The teaching-family model: The teaching teaching-family model: The teaching interaction elements.interaction elements.

Building RapportBuilding Rapport Make eye contact and use balanced Make eye contact and use balanced

turns in conversation.turns in conversation. Be competent and confident, but not Be competent and confident, but not

egotisticalegotistical Point out what the parent is doing Point out what the parent is doing

correctlycorrectly Acknowledge parent’s feeling of guilt Acknowledge parent’s feeling of guilt

and/or frustrationand/or frustration Listen to parent’s concernsListen to parent’s concerns Remain professionalRemain professional Avoid alliances with one parent against Avoid alliances with one parent against

the otherthe other

Reviewing InformationReviewing Information

Present only a few techniques at a Present only a few techniques at a timetime

Give rationale behind the techniqueGive rationale behind the technique Describe the critical elements of Describe the critical elements of

techniquetechnique Check for understandingCheck for understanding Discuss how the technique can be Discuss how the technique can be

used to target child’s goalsused to target child’s goals

Modeling TechniquesModeling Techniques

Model the technique with the child Model the technique with the child while the parent watcheswhile the parent watches

Make sure the modeling takes up no Make sure the modeling takes up no more than 25% or the sessionmore than 25% or the session

Use role-playing with the parent if he Use role-playing with the parent if he or she is having difficulty using the or she is having difficulty using the technique with the childtechnique with the child

Providing FeedbackProviding Feedback

Provide feedback that is succinct but Provide feedback that is succinct but specificspecific

Focus more on the positive than Focus more on the positive than corrective feedbackcorrective feedback

Respond to almost everything the Respond to almost everything the parent does (at least one comment parent does (at least one comment every minute)every minute)

Give feedback on only a limited Give feedback on only a limited number of techniques per sessionnumber of techniques per session

Building Building IndependenceIndependence

Discuss how to use the technique at Discuss how to use the technique at homehome

Assign homeworkAssign homework Increase the amount of time the parent Increase the amount of time the parent

is working with the childis working with the child Decrease feedback and proximity to the Decrease feedback and proximity to the

parent and child as soon as possibleparent and child as soon as possible Have the parent practice across Have the parent practice across

different settings and activitiesdifferent settings and activities

What wouldWhat would YOUYOU do?do?

A parent asks if you can provide training to their new A parent asks if you can provide training to their new

nanny.nanny.

A parent gives you a gift to thank you for all that A parent gives you a gift to thank you for all that

you’ve done for their child.you’ve done for their child.

A parent begins to talk to you about private issues.A parent begins to talk to you about private issues.

The parent blames themselves or others for their The parent blames themselves or others for their

child’s disability.child’s disability.

Parent verbally agrees to corrective feedback, but Parent verbally agrees to corrective feedback, but

fails to follow through.fails to follow through.

Parent requests aversive procedures.Parent requests aversive procedures.

Would a similar training model Would a similar training model work in countries where the work in countries where the

resources are not as abundant?resources are not as abundant? Autism is on the rise in many countries that do not Autism is on the rise in many countries that do not

have an appropriate number of professionals to have an appropriate number of professionals to help sufficiently. These countries include India, help sufficiently. These countries include India, Malaysia and China.Malaysia and China.

China has between 400,00 and 800,000 children China has between 400,00 and 800,000 children with autism. (Yanqing, 2006)with autism. (Yanqing, 2006)

The development of social welfare and social The development of social welfare and social insurance systems are far behind. Due to this, insurance systems are far behind. Due to this, once a child is diagnosed, the parents (or primary once a child is diagnosed, the parents (or primary caregiver) not the government or the community, caregiver) not the government or the community, take the responsibility for the child’s rehabilitation. take the responsibility for the child’s rehabilitation. (Yanqing, 2006)(Yanqing, 2006)

ChinaChina (cont.)(cont.)

Autism diagnosis was first introduced in Autism diagnosis was first introduced in

1982. Main focus was diagnosis and 1982. Main focus was diagnosis and

clinical appearances. clinical appearances.

Starting from the year 2000, more people Starting from the year 2000, more people

were interested in rehabilitation. were interested in rehabilitation.

Now ABA is extensively used for children Now ABA is extensively used for children

with autism in China.with autism in China.

ABA

Training parents and professionals Training parents and professionals to help children with autism in to help children with autism in

ChinaChina(Yanqing, 2006)(Yanqing, 2006)

Professionals were trained to train parents.Professionals were trained to train parents. Parents were trained by professionalsParents were trained by professionals

Review and clarification of the training Review and clarification of the training information.information.

Hand-in-hand instruction of training skills Hand-in-hand instruction of training skills (modeling techniques ) with feedback.(modeling techniques ) with feedback.

Parents were given the option of extended Parents were given the option of extended feedback via videotaping. Intensive in the feedback via videotaping. Intensive in the beginning then faded out as parents beginning then faded out as parents progressed in their training procedures.progressed in their training procedures.

Training parents Training parents (cont)(cont)

(Yanqing, 2006)(Yanqing, 2006) 37 out of 56 families who did not choose to 37 out of 56 families who did not choose to

receive follow up feedback, stopped their receive follow up feedback, stopped their instruction to their children after 1 week instruction to their children after 1 week due to problematic behaviors. 11 families due to problematic behaviors. 11 families chose to receive follow up, and have been chose to receive follow up, and have been very successful in training their children very successful in training their children and are satisfied with the process and and are satisfied with the process and outcome.outcome.

Follow up (extended feedback) is extremely Follow up (extended feedback) is extremely important to maintain skills and should be important to maintain skills and should be gradually faded to insure independence.gradually faded to insure independence.

Feedback = success!

Spousal FeedbackSpousal Feedback(Harris et al., 1998)(Harris et al., 1998)

Explores the possibility of spousal feedback Explores the possibility of spousal feedback as a cost-efficient alternative to providing as a cost-efficient alternative to providing in-home feedback.in-home feedback.

3 husband-and-wife dyads.3 husband-and-wife dyads. Didactic presentations of the instructional Didactic presentations of the instructional

material.material. Parents trained in both how to appropriately Parents trained in both how to appropriately

give as well as receive feedback.give as well as receive feedback. 5 out of 6 participants showed improvement 5 out of 6 participants showed improvement

in teaching performance after spousal in teaching performance after spousal feedback component was implemented.feedback component was implemented.

Spousal Spousal FeedbackFeedback

How a mother feels about this possibility?How a mother feels about this possibility? Could this be a feasible option? Yes! (Harris, et Could this be a feasible option? Yes! (Harris, et

al., 1998)al., 1998) One advantage is more naturally occurring One advantage is more naturally occurring

opportunities to observe and give feedback.opportunities to observe and give feedback. One key component is the feedback training (how One key component is the feedback training (how

to give and receive) the participants received. to give and receive) the participants received. Future study to explore could be a staff member Future study to explore could be a staff member

initially providing the feedback (modeling it) and initially providing the feedback (modeling it) and then training the parents to assume the then training the parents to assume the responsibility.responsibility.

Things to considerThings to consideri.e. Interesting Readingi.e. Interesting Reading

Different cultures: (Different cultures: (Santareli, Koegel, Santareli, Koegel, Casas & Koegel, 2001; Casas & Koegel, 2001; Elder, Valcante, Elder, Valcante, Won & Zylis, 2003). Won & Zylis, 2003).

Maintance and Generalization: Maintance and Generalization: (Crockett, Fleming, Doepke & Stevens, (Crockett, Fleming, Doepke & Stevens, 2005; Koegel, Glahn & Nieminen, 1978). 2005; Koegel, Glahn & Nieminen, 1978).

Agreement on behaviors to target: Agreement on behaviors to target: (McClannahan, Krantz & McGee, 1982)(McClannahan, Krantz & McGee, 1982)

Parent Feedback Parent Feedback SummarySummary

Praise what the parent is doing Praise what the parent is doing correctly (at least 75% positive correctly (at least 75% positive feedback to 25% corrective feedback)feedback to 25% corrective feedback)

Make sure feedback is behavior Make sure feedback is behavior specific and try to focus on a limited specific and try to focus on a limited number of techniques per session.number of techniques per session.

What not to doWhat not to do

Parent Feedback Parent Feedback Summary Summary (cont.)(cont.)

Start with a dense amount of Start with a dense amount of feedback and then fade to create feedback and then fade to create independenceindependence

Attempt to have the parents work as Attempt to have the parents work as a team and do not form alliances a team and do not form alliances with one over the other with one over the other

Use child based rationales when Use child based rationales when giving feedbackgiving feedback

SurveysSurveys

Consumer evaluation- school specific (ex. Consumer evaluation- school specific (ex. E:\consumer eval parent questionaire.doc)E:\consumer eval parent questionaire.doc)

What training would you like to receive? What training would you like to receive? (ex. E:\What parents like to be trained (ex. E:\What parents like to be trained on.doc)on.doc)

Effectiveness of training (ex. E:\Training Effectiveness of training (ex. E:\Training Satisfaction Survey.doc)Satisfaction Survey.doc)

Satisfaction-child specific (ex. E:\PCDI Satisfaction-child specific (ex. E:\PCDI Satisfaction Rating.doc) Satisfaction Rating.doc)

Parent InterviewParent Interview

Gloria’s daughter is 9 years old Gloria’s daughter is 9 years old (diagnosed at 3) and has been in 3 private (diagnosed at 3) and has been in 3 private schools since diagnosis. Comments on schools since diagnosis. Comments on parent training offered from these parent training offered from these schools. schools.

Should there be a home/parent training Should there be a home/parent training piece offered to parents from the school piece offered to parents from the school their child attends? their child attends?

How she prefers to be trained.How she prefers to be trained. How to get proper training.How to get proper training.

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