Training parents to increase adaptive behaviours in autistic children

Abstract

Four experiments were conducted to evaluate naturalistic training with autistic children in homes and in a community setting. Experiments 1 and 2 aimed to describe 12 parents and 13 children (11 autistic and two developmentally delayed) by means of twice weekly behavioural observations over long durations. A momentary time sampling procedure was used. The behaviours mainly studied were positive consequences, prompts, proximity, language (parent) and appropriate activity, self stimulation and language (child). The experimental designs employed withdrawals or baseline-treatment (A-B) replications. The baseline instructed parents to arrange equipment for the child and to interact as usual, these setting events being scheduled throughout all phases. The first intervention programmed an instructional package (increased positive consequences, decreased proximity, with or without prompts) with brief feedback and the second programmed instructions to increase positive consequences. In both experiments those children who obtained percentage levels of activity less than 70 over baselines all increased activity as a result of parents implementing the training. For the other subjects the baseline setting events were sufficient to engage the children adequately. The majority of parents did not fade their proximity to the child and any decreases in proximity were seldom maintained. Similar behavioural observations were conducted with three trained parents and their autistic children over six months in the third, a multiple baseline, experiment. In the baseline parents were instructed to train child activity in homes, or to behave as usual in the shopping setting. Then instructions were delivered, lagged over three subjects in homes and one subject when shopping, requesting parents to target child language by providing positive consequences for this. The second intervention, for parents to increase positive consequences on child language, was also introduced across three subject-settings. For the remaining subject dyad at home the intervention scheduled incidental teaching by the parent of child language. Instructed response generalization occurred for parents in homes coinciding with some increases in parent and child language. Different results were shown for the mute child and in the shopping setting. In the fourth experiment two parents and their autistic daughter participated for 20 months with weekly observations conducted in three settings (mealtime, mother activity and father activity). The experimental design contained multiple baseline and withdrawal conditions. The baseline was followed by two antecedent interventions introduced sequentially into the three settings. The first antecedent intervention targetted spouse presence for the training parent, and the second instructed parents to plan session goals conjointly. Thirdly a skills intervention was introduced simultaneously into the three settings (spouse presence and support, incidental teaching and interrupting with the child). A withdrawal and final intervention followed, then followups after three, six and fifteen months. Overall these results illustrated the importance of supportive spouse antecedents for both parents to implement increased positive consequences and thus achieve increases in child appropriate behaviours despite differences between parents.