Antill (2020) ABA Centrada Na Família
Antill (2020) ABA Centrada Na Família
Antill (2020) ABA Centrada Na Família
research-article2019
ISCXXX10.1177/1053451219842240Intervention in School and ClinicAntill
Technology Trends
Cathy Newman Thomas, Associate Editor
Intervention in School and Clinic 2020, Vol. 55(3) 185–191
© Hammill Institute on Disabilities 2019
Article reuse guidelines: sagepub.com/journals-permissions
DOI: 10.1177/1053451219842240
https://doi.org/10.1177/1053451219842240
isc.sagepub.com
Abstract
Applied behavior analysis (ABA) services can improve the quality of life for individuals with autism spectrum disorder
(ASD). However, not all children receive services based in ABA. The disconnect between available services and accessing
services may be the result of families experiencing barriers. Online parent training addresses many of these barriers by
connecting families with service providers that they otherwise would not have access to. Furthermore, this approach allows
for a family centered approach that empowers parents. A combination of parent training modules and video conferencing
sessions allow parents to learn techniques and try them out with the support of a service provider. This article provides
service providers with guidelines and suggestions for developing and providing services online.
Keywords
Applied behavior analysis, autism, distance education, early intervention, parent training
Researchers have identified early intervention services as discrete trial training, reinforcement, prompting, shaping,
an important factor in the development of children with antecedent-based interventions, and modeling (Baer, Wolf,
autism spectrum disorder (ASD; Wong et al., 2015). & Risley, 1968; Cooper, Heron, & Heward, 2007; Wong
Services based in applied behavior analysis (ABA) are the et al., 2015). Services are typically provided by profession-
most widely used evidence-based practice for children with als, and funding resources (e.g., insurance, Medicaid) may
ASD (Peters-Scheffer, Didden, Korzilius, & Sturmey, set specific requirements of who must provide those services
2011). Unfortunately, families face barriers in accessing in order for reimbursement to be provided (Leaf et al., 2017).
evidence-based services due to knowledge of services, loca- Depending on the individual barriers that a family may face,
tion, availability of service providers, and cost (Cason, such as location, transportation, and availability of service
Behl, & Ringwalt, 2012; Cole et al., 2016; DeMoss, Clem, providers, it may be difficult for families to access services
& Wilson, 2012; Heitzman-Powell, Buzhardt, Rusinko, & even when they have insurance or Medicaid coverage.
Miller, 2014; H. Meadan & Daczewitz, 2014; J. Meadan Teachers, paraprofessionals, parents, and other family mem-
et al., 2016). The utilization of file sharing and video con- bers can learn to implement techniques and interventions
ferencing platforms provide service providers with the based in ABA (Sarokoff & Sturmey, 2008). In fact, they are
opportunity to disseminate parent training and increase most likely already implementing strategies without know-
access to services. File sharing platforms allow service pro- ing the names of the strategies (Cooper, 1982). Therefore,
viders to share training modules and documents with fami- one potential solution to increase access to services is to
lies through secure email platforms. Video conferencing
platforms allow service providers and families to communi- 1
Early Childhood, Multilingual, and Special Education, University of
cate via a web camera from remote locations.
Nevada, Las Vegas, Las Vegas, NV, USA
Corresponding Author:
Current Model Kendra Antill, MEd, Department of Early Childhood, Multilingual, and
Special Education, University of Nevada, Las Vegas, 4505 S. Maryland
Services based in ABA facilitate positive behavior change Parkway, MS 3014, Las Vegas, NV 89154-3014, USA.
through systematic application of behavioral principles, Email: antillk@unlv.nevada.edu
186 Intervention in School and Clinic 55(3)
increase parent training. Research has demonstrated that to needs of the child and family, and follow-up (Ingersoll,
parents can learn and implement interventions with their Shannon, Berger, Pickard, & Holtz, 2017; Vismara et al.,
children (Kasari, Gulsrud, Paparella, Hellemann, & Berry, 2013). Instead of being a linear progression, parent training
2015; Wainer & Ingersoll, 2012). This article provides sug- should be a continuous cycle of training, feedback, and
gestions and guidelines for providing parent training online. implementation. Furthermore, service providers should
consider the child’s natural environment, incorporate oppor-
tunities for collaboration, and follow guidelines of adult
Parent Involvement
learning principles (Knowles, Holton, & Swanson, 2014;
Decades of research have provided support for the impor- Woods & Lindeman, 2008). For a checklist of components
tance of empowering and training parents to implement to consider when developing online parent training, refer to
interventions (Dunst, 1985; Dunst, Hamby, Trivette, Raab, Figure 1. In addition to recommended components, service
& Bruder, 2000). Furthermore, research has demonstrated providers should consider technical and legal requirements
that techniques based in ABA can be learned and imple- to providing parent training online.
mented by parents (Heitzman-Powell et al., 2014;
Subramaniam et al., 2016; Wainer & Ingersoll, 2012). In
Special Considerations
addition, when parents are taught to implement interven-
tions, they are more likely to continue interventions after Delivering parent training via video conferencing services
services end (Hanft & Pilkington, 2000; Woods, Wilcox, requires internet or cellular access and an electronic device
Friedman, & Murch, 2011). Typically, parent interventions with video recording capabilities. Furthermore, accessing
are conducted in person, making it difficult for families and utilizing video conferencing and online training
experiencing barriers to participate (Kasari et al., 2015; H. requires technological skills that may need to be addressed
Meadan & Daczewitz, 2014). Researchers have addressed before parent training can start. For example, parents may
this issue by providing parent training through distance edu- need to be trained how to login to video conferencing plat-
cation models (Heitzman-Powell et al., 2014; H. Meadan & forms. Therefore, consideration of family familiarity with
Daczewitz, 2014; J. Meadan et al., 2016; Pickard, Wainer, technology is an important step in providing parent train-
Bailey, & Ingersoll, 2016; Subramaniam et al., 2016; ing online.
Vismara, McCormick, Young, Nadhan, & Monlux, 2013). In addition to training parents to use the technology,
service providers need to be aware of security precau-
tions to take when personal information is shared online.
Distance Education Models File sharing and video conferencing platforms should use
Online training disseminated via file-sharing platforms can security measures that are in compliance with the Health
alleviate the constraints of attending in-person trainings. Insurance Portability and Accountability Act (HIPAA,
Training videos, presentation software such as PowerPoint, 1996). Service providers can check HIPAA requirements
interactive activities, specific parent training curriculum, and submit compliance questions by accessing the U.S.
and learning modules can be shared with parents remotely Department of Health and Human Services website (U.S.
(Heitzman-Powell et al., 2014; H. Meadan & Daczewitz, Department of Health and Human Services, n.d.). In
2014). Parents can access training materials at their conve- addition, it is important that professionals are cautious
nience using tablets, smartphones, or computers with when recommending parent training and e-coaching. For
Internet or cellular access. One limitation to providing example, some children may engage in self-injurious
training through file sharing platforms instead of in person behaviors (e.g., head banging, skin picking) that require
is the loss of real-time interaction between parents and immediate, in-person intervention. This column provides
trainers (Pickard et al., 2016; Wainer & Ingersoll, 2012). suggestions to providing ABA-based training to families
However, the addition of video conferencing allows for ser- remotely that can be useful to service providers, includ-
vice providers to provide feedback and have parents try ing board-certified behavior analysts (BCBA) and uni-
interventions in real time (Cole et al., 2016; Vismara et al., versity professionals.
2013). The following guide was created service providers to
use when considering and developing parent training
Material Development
programs.
Providing online parent training may require the develop-
ment of content; however, the development of training
Recommended Components material can be alleviated by utilizing resources already in
Effective parent training disseminated remotely should existence. For example, service providers can use internet
include opportunities for feedback, specific training related modules such as Autism Focused Intervention Resources
Antill 187
and Modules (AFIRM; https://afirm.fpg.unc.edu/afirm- child’s natural environment (Cooper, 1981). Indirect data
modules). Furthermore, service providers can access and consist of data collected through interviews and behavior
share training videos available on video-sharing websites rating scales (Cooper et al., 2007). To further illustrate the
(e.g., YouTube). In addition to sharing training modules and process, the following scenario is described.
videos, service providers should incorporate try-and-apply A family living in a rural area contacted a service pro-
activities that allow parents to implement interventions vider. The service provider sent a survey with questions
techniques with their child. A try-and-apply activity can about the family’s routines, concerns about the child’s
involve the parent collecting data, incorporating environ- behavior, and possible areas that the family would like to
mental supports into the home, or running discrete trials. focus (see Figure 2). The service provider reviewed the
responses before the intake session. During the intake
session, the service provider was able to gain more
Initial Intake insight on the family’s needs by clarifying responses
Before the family begins online parent training, an intake from the questionnaire and asking additional questions.
session should occur to access the needs of the family and Furthermore, the service provider provided the parents
the child. If possible, intake sessions should occur in per- with behavior rating scales and checklists such as the
son. By conducting the intake session in person, the service Vineland Adaptive Behavior Scales (Sparrow, Cicchetti,
provider has the opportunity to interact with the family in & Saulnier, 2016).
the natural environment. However, if this is not feasible, the After completing the interview, rating scales, and
intake session could be conducted through video conferenc- checklists, the family interacted with their child as they
ing. Whether in person or via video conference, service pro- normally would for 15 minutes of play. While observing
viders should establish rapport with the family and ask the family and child interact, the service provider was able
questions to understand the routines, customs, and culture to take notes of how the parents and child interacted.
of the family (Knowles et al., 2014; Woods & Lindeman, During the observation, the child engaged in tantrum
2008). This allows the service provider to provide the fam- behavior several times. After discussing the interaction,
ily with supports that are culturally relevant and realistic. the service provider and family determined that decreas-
During the initial intake session, service providers should ing tantrum behavior and teaching a more appropriate
conduct a functional behavior assessment by collecting replacement skill was the top priority. The service pro-
direct and indirect data (Gresham, Watson, & Skinner, vider helped the family create an operational definition by
2001). Direct data refer to data collected in real time, in the using measurable terms to describe the tantrum behavior.
188 Intervention in School and Clinic 55(3)
Family Questionnaire
Directions: Please fill out the following questionnaire to the best of your ability. Provide specific and detailed responses. This
information is instrumental in providing us with enough background information to move forward and gain insight into your
unique needs.
12. List at least two goals that you wish for your child to meet.
Figure 2. Sample questionnaire to provide parents during intake process. Questionnaires are an opportunity to ask questions that
provide additional insight to formal assessments.
Furthermore, the service provider and family determined The service provider used the questionnaire, information
what would and would not count as tantrum behavior. For gathered from the intake session, behavior scales, and anec-
example, crying without dropping to the floor was not dotal data to hypothesize the function of the behavior.
counted as tantrum behavior. The parents were then pro- Through this process, the service provider and parent devel-
vided with a learning module on how to record antecedent, oped a behavior intervention plan to decrease the tantrum
behavior, consequence (A-B-C) data (Cooper et al., 2007). behavior and increase more appropriate replacement behav-
The parents recorded data over a week, then sent the data ior. By developing the behavior plan with the parents, the
to the service provider. service provider was able to develop a plan that would be
Antill 189
Dear ________________,
I really liked how you incorporated the use of (technique from module). I specifically liked how you (name 1-3 strengths of the technique implemented).
I have shared (name of video/power point) to further support your use of (strategy). I would suggest that you try (list several suggestions for parent
to work on). Overall, you are doing a fantastic job in (list 1-3 strengths about parent intervention). Please let me know if you have any questions or
concerns.
Best,
____________________.
realistically implemented within the home. In addition to video conferences with families, service providers could also
developing a behavior plan, the service provider shared a submit written feedback. Feedback should be positive,
series of training modules on functions of behaviors, ante- acknowledge parent strengths, and provide suggestions. For
cedent interventions, and reinforcement. An example of the a sample feedback template, refer to Figure 3. As new con-
module sequence is provided in Table 1. cerns and topics are addressed, the cycle would continue.
Instructions: Use the following scale to rate your agreement with the statements provided in this survey.
1. Strongly disagree
2. Disagree
3. Agree
4. Strongly agree
Access to Training
1. The online parent training was easy to access. 1 2 3 4
2. I was provided with sufficient training to access the online parent training. 1 2 3 4
3. The e-coaching sessions were easy to access. 1 2 3 4
4. I was provided with sufficient training to conduct e-coaching sessions. 1 2 3 4
Training Content
5. The training content provided was organized and easy to understand. 1 2 3 4
6. I have increased my knowledge of concepts based in ABA as a result of the online training 1 2 3 4
modules.
7. It was easy to implement strategies and techniques learned from the online modules. 1 2 3 4
8. My child’s behavior has improved as a result of implementing strategies and techniques 1 2 3 4
learned from the online modules.
E-coaching Sessions
9. My trainer provided me with constructive and useful feedback during the e-coaching ses- 1 2 3 4
sions.
10. The e-coaching sessions provided me with the opportunity to ask questions and clarify my 1 2 3 4
knowledge of ABA-based strategies.
11. The e-coaching sessions increased my knowledge of ABA-based strategies and my ability 1 2 3 4
to implement them.
12. My child’s behavior has improved as a result of strategies and techniques learned from the 1 2 3 4
e-coaching sessions.
Figure 4. Sample survey to measure social validity of online parent training.
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