A parent advice package for family shopping trips: development and evaluation

A University-Based Social Services Parent-Training Model: A Telehealth Adaptation During the COVID-19 Pandemic

With the COVID-19 pandemic resulting in social-distancing recommendations, many service providers find themselves altering the way they must provide medically necessary therapy. Even with the advent of more advanced telehealth technologies, the implementation of behavioral programming falls mainly on the caregivers of the clients that are served. This crisis brings to light ethical dilemmas and upends the current ways many programs may have been implemented across the world. As a result, a reevaluation of how these services are delivered is in order. This article reviews how a university-based, state-funded service delivery program (USSDP) provided essential and necessary services during the COVID-19 pandemic. Specifically, the purpose of this article is to describe how the USSDP quickly adopted a telehealth care model in a program that previously had not delivered services in this modality. Ethical, contextual, and competency-based factors are reviewed in the context of this organization, followed by a dialogue on broader generalization suggestions utilizing an active support model of care within telehealth restrictions.

Impacting Pediatric Primary Care: Opportunities and Challenges for Behavioral Research in a Shifting Healthcare Landscape

Behavior analysts have long recognized the potential of a partnership with pediatric medicine as an opportunity to expand the influence of behavior analysis and positively impact population health. Despite significant achievements in this domain, the impact of behavioral science on the daily practice of pediatrics has been limited. In this commentary, the authors argue that the current health care and research environments are ripe for a renewed focus on behavioral modification in pediatric primary care, with a particular emphasis on the study of high-frequency, low-intensity problems. They provide some analysis of why behavioral pediatrics has failed to gain traction in primary care, describe aspects of the current primary care practice and research landscapes that provide opportunities for an expanded portfolio of research, identify several exemplars from the behavior analytic literature that have influenced pediatric primary care or have the potential to do so, and make recommendations for producing influential data.

Assessing Dissemination Capability

Disseminating packaged behavioral intervention programs appears to be an increasingly important objective in the field of applied behavior analysis. An exportable training package, designed to teach helping skills to community service workers, was evaluated with two social service agencies. The package was mailed to a community proctor who administered the materials without direct instructional contact with the experimenters. The results showed that the percentage of specified trainee target behaviors increased after the training package was introduced. Ratings of trainee performance by independent community service workers correlated with behavior observations of trainee performance. This study illustrates a method for assessing the effectiveness of behavioral interventions to be disseminated to potential consumers.

Parents as Therapists

The present article reviews the behavioral parent training literature from 1975 to 1981. Both case studies and group investigations are included. The content and training methods of the parent intervention literature for children and adolescents are summarized. Methodological and clinical concerns are addressed, most notably generalization issues, the lack of parental observational data, the obtrusiveness of behavioral observation measures, and the need to identify critical characteristics of parents of clinic-referred children. The present status of this area is summarized and future research directions are suggested.

Parent Consultation

We tested the effectiveness of a self-help manual-based homework intervention program for parents on children's homework problems as implemented through behavioral consultation. Parents were selected through local school psychologists' nominations based on the children's histories ofincomplete homework completion and through advertisements in the local supermarkets and newspapers. Two sets of parents were provided with a manual and instructed to implement the treatment across two academic subject areas. The effectiveness of the intervention was assessed through a multiple baseline design with homework accuracy and completion rates as the primary dependent variables. The results indicated that one child demonstrated improved homework accuracy and completion rates within one academic area during the intervention. Also, one parent reported a perceived improvement in daily homework behaviors as assessed through a daily parent rating scale. However, both sets of parents reported overall improvement in homework behavior during treatment evaluation and a three-month follow-up assessment with the Homework Problem Checklist. At the completion of the intervention, the parents and children reported having positive perceptions of the manual-based homework program. The conclusions of previous research are discussed in light of our results.

Participatory action research designs in applied disability and rehabilitation science: protecting against threats to social validity

Researchers and disability advocates have been debating consumer involvement in disability and rehabilitation science since at least 1972. Despite the length of this debate, much confusion remains. Consumer involvement may represent a spirit of democracy or even empowerment, but as a tool of science, it is necessary to understand how to judge its application. To realize consumer involvement as a design element in science, researchers need a framework for understanding how it can contribute to the scientific process. The thesis of this article is that a primary scientific function of consumer involvement is to reduce threats to the social validity of research, the extent to which those expected to use or benefit from research products judge them as useful and actually use them. Social validity has traditionally not been treated with the same rigor as concerns for internal and external validity. This article presents a framework that describes 7 threats to social validity and explains how 15 forms of consumer involvement protect against those threats. We also suggest procedures for reporting and reviewing consumer involvement in proposals and manuscripts. This framework offers tools familiar to all scientists for identifying threats to the quality of research, and for judging the effectiveness of strategies for protecting against those threats. It may also enhance the standing of consumer involvement strategies as tools for protecting research quality by organizing them in a way that allows for systematic criticism of their effectiveness and subsequent improvement.

Trends in the measurement of social validity

Since its inception in the mid-1970s, social validity has provided applied behavior analysts with a critical measure of the social impact and importance of their interventions. Recent discussion, however, has questioned the use of this construct in regard to the frequency and types of social validty measures employed in research. Despite the ensuing discussion, virtually no quantitative information has been made available to frame various perspectives and opinions. The purpose of this report is to present a content analysis of social validity measures used over the previous 20 years. Social validity was assessed along three dimensions: (a) type of assessment, (b) focus of assessment, and (c) time of assessment. Articles published in the Journal of Applied Behavior Analysis (1968-1990) and Behavior Modification (1977-1990) were surveyed. The results of the content analysis indicate that current applications of social validation procedures are presented in 20% of the articles surveyed. The majority of articles used subjective evaluation of outcomes following intervention to assess social validity. In addition, the data indicated that normative comparison was a rarely used method of social validation and that its use has been decreasing over time.

From innovation to standard practice: developing and disseminating behavioral procedures

This paper proposes a three-stage continuum for discussing the development and dissemination of behavioral technology. At the level of behavioral techniques, researchers need only establish a functional relationship between technologically defined intervention procedures and socially significant target behaviors. Dissemination is conducted for informational purposes only, and the purposes and details surrounding subsequent use of the technique are left to the discretion of the user. At the level of behavioral demonstration, a collection of socially acceptable intervention procedures is refined and standardized and must be shown to produce behavior changes across a number of subjects. Here dissemination is conducted, in large part, to generate support for provision of services. At the level of behavioral models, procedural descriptions must be useroriented. Additionally, model effects must be obtainable by agents not associated with their development and must compare favorably with other treatment or service alternatives. The purpose of dissemination at this level is to obtain adoptions and replications of the model. Details of development and dissemination of behavioral technology at each of these three levels are discussed.

A survey of parent training manuals

Twenty-six commercially available parent training manuals were surveyed with the goal of providing helpful information to the professional for selection of manuals. Included were manuals for parents as well as manuals for professionals for use in conducting individual or group treatment. The following information was given for all manuals: the characteristics of the target populations for whom the manuals were intended, readability levels, use made of technical language, provision of glossary, organization and format of the book, availability of supplementary materials such as leaders' guides, and references to reviews by other authors. In an additional section, the research literature dealing with evaluation of these manuals was reviewed and summarized as a means of acquainting the reader with the available scientific information on their effectiveness. A report on the status of each manual in terms of evaluation was provided in tabular form. The evaluation of manuals by conduct of empirical research to determine their usefulness to the consumer was emphasized.

Turning the table on advice programs for parents: Using placemats to enhance family interaction at restaurants

There are many opportunities in a family's daily routine to enrich the interactions among its members. One such opportunity arises at family restaurants. Surveys of restaurant personnel and customers suggested the possibility of enriching family interactions by redesigning indigenous materials such as table placemats. Accordingly, we developed Table-Talk placemats that provided conversational topics and illustrated games in which the entire family could participate. After some testing of these placemats in a preschool, a field experiment was conducted with families dining in restaurants. Table-Talk placements occasioned more social and educational dialogue among family members than either traditional-placemat or no-material conditions. Social validation ratings provided by mental health counselors and the parents suggested that Table-Talk placemats occasioned healthy and enjoyable interactions among family members.

Some promising dimensions for behavioral community technology

In recent years, the search for effective and replicable approaches to planned change in communities has escalated. Applied behavior analysts have participated in these efforts to remedy existing community problems and to increase the capacities of community residents to meet their goals. Examples of behavioral technologies for community settings are described and their advantages are noted. Criteria for more contextually appropriate community technologies are suggested and strategies for developing behavioral methods according to these criteria are described. This paper outlines some promising dimensions for behavioral community technology and discusses several possible limitations to a behavioral approach to addressing societal problems.

Reducing preschoolers' disruptive behavior in public with a brief parent discussion group

This study examined the efficacy of a brief 2-h discussion group for parents of preschool children that show disruptive behavior on shopping trips. Forty-six parents with children aged 2-6 years were randomly assigned to either the intervention condition or a waitlist control group. Significant intervention effects were found for measures of problem child behavior, dysfunctional parenting styles and parents' confidence in the parenting role. No group differences were found for parental adjustment or conflict over parenting. Intervention gains were maintained at 6-month follow-up. Results are discussed within a primary care and public health framework.

Reduction of severe behavior problems in the community using a multicomponent treatment approach

Problem behavior often prevents community integration of people with developmental disabilities. Therefore, we evaluated a multicomponent approach for remediating problem behavior in public community settings (specifically, supermarkets). We selected treatments based on hypotheses about the variables controlling the problem behavior (hypothesis-driven model). The multicomponent intervention included choice making, embedding, functional communication training, building tolerance for delay of reinforcement, and presenting discriminative stimuli for nonproblem behavior. Treatment progress was monitored using measures of latency and task completion rather than traditional measures of frequency and time sampling. Results showed substantial increases in task completion and duration of time spent in supermarkets without problem behavior. Outcomes were socially validated by group-home staff and cashiers. We discuss how the intervention approach taken can resolve some of the issues involved in assessing, measuring, and treating problem behavior in the community.

Facilitating generalization. The effectiveness of improved parental report procedures

The effectiveness of two procedures for promoting the generalization of adaptive skills across settings by mentally retarded clients was evaluated. Participants were 10 mentally retarded clients of a community day training center. Observations of self-care and domestic skills acquired at the center were conducted at home, on the percentage of steps of each skill task analysis completed correctly. Parents of one group received written instructions describing how to practice the skills with their offspring at home. A second group received remediation training at home by center staff. A multiple-baseline design across participants and behaviors was used to evaluate the effectiveness of the two procedures. In addition, a cost analysis of each procedure was conducted. Results indicated that the parent report and home remediation procedures were both effective in increasing correct skill completion. However, the home remediation procedure cost more, with increased costs attributed to training time. The parent report procedure was, therefore, the preferred procedure.

Dining out with children: effectiveness of a parent advice package on pre-meal in appropriate behavior

The effectiveness of an advice package designed to restructure the restaurant environment and encourage parent praise was examined. Experiment 1 assessed the usefulness of the package when used with experimenter assistance. Videotapes were used to record the target child's behavior. Pre-meal inappropriate behavior decreased an average of 51% across target children. Mealtime inappropriate behavior and parent praise and disapproval were also measured. Experiment 2 was designed to determine whether families could implement the package without experimenter assistance and whether effects obtained would generalize to a different restaurant. Data were taken in vivo. Nine families were randomly assigned to one of three groups. Group assignment determined the order in which families went to two restaurants, the number of dinners each family participated in, and the point at which parents received the advice package. The order in which the families went to the two restaurants as well as the number of baseline meals was counterbalanced. Results of Experiment 2 showed that, when using the advice package, parents in all sequences were able to decrease pre-meal inappropriate behavior of their children, and that these effects generalized to a second restaurant.

Parent behavioral training for problem children: an examination of studies using multiple outcome measures

The purpose of the present paper was to review parent training studies that have used multiple outcome measures to evaluate treatment effectiveness. Twenty-four studies were identified which used at least two of the following three measures: independent observer-collected data, parent-collected data, and parent-completed questionnaire data. A description of the instruments and procedures used with each assessment technique was presented. The results indicated that all three outcome measures have yielded positive results; however, parent-collected data and parent questionnaire data were associated with more positive outcome results than data collected by independent observers. Limitations of each assessment procedure were discussed and recommendations about which measures to use were made.