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Early intensive behavioral intervention for children with autism: Parental therapeutic self-efficacy
Abstract
Several authors have suggested that the quality of therapist performance accounts for some of the variability in outcomes observed in early intensive behavioral intervention for children with autism. However, there is a distinct lack of theoretical and empirical work addressing therapist performance in this context. In the present study, we explored predictors of one variable, beliefs about one's efficacy in the therapeutic role, that may be related to therapist performance. Eighty-five UK mothers who were acting as therapists for their child's program completed a questionnaire survey. Results showed that program variables (e.g., number of hours of therapy each week, time since program started) were unrelated to maternal therapeutic self-efficacy. However, support received from the program, the severity of the child's autism, and maternal stress were significant predictors. Regression analysis also showed that maternal stress mediated the impact of support from the program and autism severity on maternal therapeutic self-efficacy. Limitations of the study, suggestions for future research, and practical implications are briefly discussed. In particular, we advocate a role for supervisors in analyzing and developing interventions for therapist behavior.
... As noted above, there is a distinct lack of research specifically exploring therapists' perceived self-efficacy for delivering home-based EIBI. Although there has been no direct investigation of the effects of perceived therapeutic selfefficacy on the quality of intervention delivery, one recent piece of research has examined sources of parents' perceived therapeutic self-efficacy for delivering home-based EIBI to their own children (Hastings & Symes, 2002 non-familial therapists find more severe child symptoms less stressful than parents because they are not continually exposed to the child in the same way that parents are. ...
... This is an important and necessary hurdle to overcome given the practical and theoretical implications of increased attention in this area. As noted above, researchers have already begun to investigate the potential impact of perceived therapeutic self-efficacy on procedural fidelity in home-based EIBI (Hastings & Symes, 2002). A 5-item measure of perceived therapeutic self-efficacy was adapted for this study from research investigating staff and parent self-efficacy for dealing with challenging behaviour exhibited by children with developmental disabilities living at home or attending school (Hastings & Brown, 2002a,b). ...
... This might suggest that supervisors and consultants should attend to therapists' beliefs and be prepared to challenge them if they appear to be of a counter-habilitative nature. Of course, some therapist beliefs, such as in the effectiveness of the intervention program or in their perceived therapeutic self-efficacy, may serve to improve procedural fidelity (Hastings & Johnson, 2001;Hastings & Symes, 2002). The data presented may be usefully translated into a reliable measure of therapists' confidence in their own skills, furthering our understanding of potential factors influencing therapist behaviour during sessions (cf. ...
p> The variability in outcomes observed in home-based EIBI is likely in part to be the result of the quality of therapist performance during intervention sessions. Therapist behaviour in this context is, however, poorly understood. Perceived therapeutic self-efficacy may be one factor responsible for governing therapist behaviour. Exploration of this factor is, at present, hampered by the lack of a valid and reliable measure of perceived therapeutic self-efficacy; the aim of the present thesis was to devise such a measure. To achieve this, it was necessary to identify barriers that therapists considered to impede their ability to deliver home-based EIBI. In the first study, 19 therapists delivering home-based EIBI to young children with autism in the South of England were interviewed. Barriers to intervention delivery included child factors such as challenging behaviour and lack of progress, supervision factors such as being observed during sessions, therapist factors such as emotional reactions to children’s behaviour, and factors related to the intervention such as advanced skill targets.
Following the identification of barriers to delivering home-based EIBI, two further questionnaire studies sought to clarify the nature of perceived therapeutic self-efficacy and explore predictors of therapists’ beliefs. Factor analyses of therapists’ responses identified two dimensions of perceived therapeutic self-efficacy relating to (i) teaching a child who is difficult to engage with and (ii) teaching a child whilst being observed. Subsequent regression analysis revealed the former dimension was predicted by therapists’ perceptions of their own experiences, general self-efficacy and supervision frequency. There was also evidence to suggest that general self-efficacy beliefs act as a protective factor in this domain when therapists experience difficulties. The latter dimension was predicted by therapists’ perceptions of their own experiences, general self-efficacy beliefs and knowledge of behavioural principles. </p
... Parents of children with ASD report disproportionately high levels of demand in their role as caregivers (Chan et al., 2018;Hayes & Watson, 2013;Parker et al., 2020). Many interventions, particularly for young children with ASD, also rely heavily on "parents as partners" (Estes et al., 2019;Hastings & Symes, 2002;Pickles et al., 2016;Vibert et al., 2020). And although the benefits of parent-mediated intervention in educational and therapeutic settings are well-established (Garbacz et al., 2016;Matson et al., 2009), the challenge of participating in and coordinating these services creates an additional level of intervention-based complexity for parents (Gentles et al., 2020;Schreibman et al., 2015). ...
... Despite the urgency of this issue, few studies examine parenting self-efficacy among families with ASD (Karst & Van Hecke, 2012), and those that exist have typically addressed the question in the context of individual, targeted interventions (e.g. Hastings & Symes, 2002;Iadarola et al., 2018;Keen et al., 2010;Kuhn & Carter, 2006;Shochet et al., 2019). Despite the engagement in multiple therapies that represents the typical experience of parents of children with ASD, these studies do not address potential sources of efficacy, or parental burden, across a diversity and range of interventions (Iadarola et al., 2018;Matson et al., 2009;Parker et al., 2020). ...
... confidence in the ability to carry out therapeutic goals) rather than parenting self-efficacy (e.g. Haslam et al., 2006;Hastings & Symes, 2002;May et al., 2015;Weiss et al., 2013). As conceptualized by Bandura (1997), self-efficacy is highly domain specific. ...
Parenting self-efficacy, described as the beliefs parents hold about their ability to successfully parent their children, has been shown to support parent and child well-being. Parents of children with autism spectrum disorder face disproportionately high levels of demand both as caregivers, and as partners in multiple, complex, intervention programs. This study examines the relationship between parents’ experiences with their child’s interventions—specifically their sense of involvement in treatment and satisfaction with intervention-related training—and their confidence in parenting a child with autism spectrum disorder, defined as autism-specific parenting self-efficacy. Participants ( N = 438, 93% mothers of children with autism spectrum disorder aged 2–17 years) completed our novel autism-specific parenting self-efficacy scale and rated their experience of involvement in their child’s interventions and satisfaction with intervention-related training across a range of common autism spectrum disorder–related treatments. Respondents also completed a caregiver burden scale. Findings indicate that parents who report greater involvement in their child’s interventions, and note greater satisfaction with intervention-related training, also report greater autism-specific parenting self-efficacy. Parents who report greater financial and social burden report lower autism-specific parenting self-efficacy. We propose that these results are important in creating intervention experiences that foster parental self-efficacy through involvement, productive training experiences, and addressing parental burden.
Lay abstract
What is already known about the topic? Parents of children with autism experience enormous challenges managing the complex needs of caring for their children. This includes coordinating multiple and complex therapies and acting as partners in treatment. Parenting self-efficacy is the confidence a person has in their ability to manage the tasks that are part of raising a child. People who have more confidence, or greater parenting self-efficacy, often feel less stressed and are more able to manage the demands of family life. This is particularly important for parents with children who have autism spectrum disorder, since they experience more parenting pressures. Although a lot is known about parenting self-efficacy in parents of neurotypical children, we do not know enough about how to help parents of children with autism spectrum disorder develop greater parenting self-efficacy. What this paper adds? This study shows that parents gain a greater sense of parenting self-efficacy when they feel more involved in their child’s therapy and are more satisfied with the training they receive as part of these therapies. We also find that feeling pressure related to being a caregiver of a child with autism spectrum disorder can undermine autism-specific parenting self-efficacy. However, parents’ sense of confidence was not limited by the severity of their child’s symptoms. Implications for practice, research, or policy The results suggest that there is an opportunity to help parents develop a greater sense of confidence in their ability to manage the complexities of raising a child with autism spectrum disorder by helping them feel more involved in treatment and by creating intervention-related training experiences that are more satisfying. Providers might also help by taking time to address the challenges and pressures that parents are experiencing, and helping them find ways to deal with these challenges. We suggest that there needs to be more research exploring how providers can best design interventions that support autism-specific parenting self-efficacy as a way of improving parental and child well-being.
... What little work has been done suggests that several parent, child, and environmental factors influence parents' therapeutic self-efficacy for children with ASD. For example, parenting stress, the severity of the child's autism, and the amount of support received from the program all predicted mothers' level of therapeutic self-efficacy in an early intensive behavioral intervention program (Hastings & Symes, 2002). ...
... This finding is surprising, given previous work indicating a relationship between PSE and child functioning. This could be due to the fact that most of the literature has found a relationship between PSE and child behavior problems specifically (Hastings & Brown, 2002;Hastings & Symes, 2002), which we did not measure in this study. Another explanation is that therapeutic self-efficacy is less related to child functioning than PSE. ...
... Therapeutic self-efficacy was also not related to group assignment (self-directed or therapist-assisted). This finding was unexpected given previous research indicating that parents' therapeutic self-efficacy in running their child's ABA program was positively related to their perceptions that they received the support they needed from a professional (Hastings & Symes, 2002). At the same time, in a previous investigation of the impact of this program on parent outcomes, we found similar improvements in parenting self-efficacy for parents in the therapistassisted and self-directed groups, suggesting that parents Table 3. Joint display for factors relating to parent self-efficacy. ...
Lay abstract:
Parental self-efficacy refers to parents' beliefs in their ability to successfully parent their child. Parental self-efficacy plays an important role in family outcomes when a child has autism spectrum disorder. It is important to consider therapeutic self-efficacy, one's feelings of self-efficacy regarding their implementation of an intervention, within parent-mediated interventions. The goal of this mixed methods study was to better understand factors that relate to parents' therapeutic self-efficacy when using a telehealth-based parent-mediated intervention. Participants were 51 parents of children with autism spectrum disorder between 17 and 83 months old. Parents had generally high therapeutic self-efficacy, and global parental self-efficacy was significantly related therapeutic self-efficacy. Parents' written reflections revealed four themes that related to their therapeutic self-efficacy: the importance of a good fit between the child's skills and the intervention, the importance of a good fit between the parent's interaction style and the intervention, environmental factors support intervention use, and the importance of the child's response to the intervention. Several themes differed for parents with higher and lower therapeutic self-efficacy. Findings suggest that global parental self-efficacy plays an important role in parental therapeutic self-efficacy in parent-mediated interventions. To support parents in learning, coaches should ask about the child's skills, parent's interaction style, environmental challenges, and child's response.
... EYDE uygulamalarında eğitim sunan kişiler olarak önemli bir görevleri olan eğitmenlerin bu tür eğitimleri nitelikli olarak sunabilmeleri için önem taşıyan bazı etmenler söz konusudur. Eğitmenlerin mesleki yeterliklere sahip olması, eğitmenlere eğitim ve danışmanlık hizmetinin sunulması ve mesleki doyumlarının yüksek olmasıEYDE uygulamalarının etkililiğini ve uygulama güvenirliğini olumlu etkileyen en önemli etmenler arasındadır (Hastings ve Symes, 2002;Love, Carr, LeBlanc ve Kisamore, 2013;Nickels, 2010;Peters-Scheffer, Didden, Korzilius ve Sturmey, 2013;Reichow, Barton, Boyd ve Hume, 2014).Ayrıca, eğitmenlerin kişilik özellikleri, ruh sağlığı ve stres düzeyleri gibi kişisel özelliklerinin de eğitmenlerin performanslarını etkileyebilmektedir(Hastings ve Symes, 2002;Scheuermann, Webber, Boutot ve Goodwin, 2003;Symes, Remington, Brown ve Hasting,2006 Symes, 2002;Peters-Scheffer, etal.2013;Symes et al.2006), eğitmenlerle ilgili araştırmaların yapılması önem kazanmıştır.EYDE eğitmenleriyle ilgili pek çok araştırmada eğitmenlere sunulan eğitim ve danışmanlık hizmetlerinin etkililiğinin nicel yöntemlerle incelendiği görülmektedir (Hasting ve Symes, 2002;Love et al. 2013;Peters-Scheffer, etal. ...
... EYDE uygulamalarında eğitim sunan kişiler olarak önemli bir görevleri olan eğitmenlerin bu tür eğitimleri nitelikli olarak sunabilmeleri için önem taşıyan bazı etmenler söz konusudur. Eğitmenlerin mesleki yeterliklere sahip olması, eğitmenlere eğitim ve danışmanlık hizmetinin sunulması ve mesleki doyumlarının yüksek olmasıEYDE uygulamalarının etkililiğini ve uygulama güvenirliğini olumlu etkileyen en önemli etmenler arasındadır (Hastings ve Symes, 2002;Love, Carr, LeBlanc ve Kisamore, 2013;Nickels, 2010;Peters-Scheffer, Didden, Korzilius ve Sturmey, 2013;Reichow, Barton, Boyd ve Hume, 2014).Ayrıca, eğitmenlerin kişilik özellikleri, ruh sağlığı ve stres düzeyleri gibi kişisel özelliklerinin de eğitmenlerin performanslarını etkileyebilmektedir(Hastings ve Symes, 2002;Scheuermann, Webber, Boutot ve Goodwin, 2003;Symes, Remington, Brown ve Hasting,2006 Symes, 2002;Peters-Scheffer, etal.2013;Symes et al.2006), eğitmenlerle ilgili araştırmaların yapılması önem kazanmıştır.EYDE eğitmenleriyle ilgili pek çok araştırmada eğitmenlere sunulan eğitim ve danışmanlık hizmetlerinin etkililiğinin nicel yöntemlerle incelendiği görülmektedir (Hasting ve Symes, 2002;Love et al. 2013;Peters-Scheffer, etal. ...
... EYDE uygulamalarında eğitim sunan kişiler olarak önemli bir görevleri olan eğitmenlerin bu tür eğitimleri nitelikli olarak sunabilmeleri için önem taşıyan bazı etmenler söz konusudur. Eğitmenlerin mesleki yeterliklere sahip olması, eğitmenlere eğitim ve danışmanlık hizmetinin sunulması ve mesleki doyumlarının yüksek olmasıEYDE uygulamalarının etkililiğini ve uygulama güvenirliğini olumlu etkileyen en önemli etmenler arasındadır (Hastings ve Symes, 2002;Love, Carr, LeBlanc ve Kisamore, 2013;Nickels, 2010;Peters-Scheffer, Didden, Korzilius ve Sturmey, 2013;Reichow, Barton, Boyd ve Hume, 2014).Ayrıca, eğitmenlerin kişilik özellikleri, ruh sağlığı ve stres düzeyleri gibi kişisel özelliklerinin de eğitmenlerin performanslarını etkileyebilmektedir(Hastings ve Symes, 2002;Scheuermann, Webber, Boutot ve Goodwin, 2003;Symes, Remington, Brown ve Hasting,2006 Symes, 2002;Peters-Scheffer, etal.2013;Symes et al.2006), eğitmenlerle ilgili araştırmaların yapılması önem kazanmıştır.EYDE eğitmenleriyle ilgili pek çok araştırmada eğitmenlere sunulan eğitim ve danışmanlık hizmetlerinin etkililiğinin nicel yöntemlerle incelendiği görülmektedir (Hasting ve Symes, 2002;Love et al. 2013;Peters-Scheffer, etal. ...
... Eftersom det som ovan nämnts ofta är föräldrarna som är co-terapeuter är det därför viktigt att titta på denna upplevelse hos föräldrarna. En studie (Hastings & Symes, 2002) som undersökt föräldraterapeut-self-efficacy hos mödrar som är co-terapeuter i ett Lovaas-program visar på tre områden som påverkar detta. De mödrar som har barn med gravare autism upplever sämre self-efficacy. ...
... Det finns mycket stöd för att det vore önskvärt för dessa föräldrar att ha en vidare gruppkontakt. Kombinationen av de resultat Olsson (2004) presenterat om ökad föräldrastress hos föräldrar till barn med ASD och forskning som visar på högre self-efficacy hos mödrar med lägre stress (Hastings & Symes, 2002) leder till att det är önskvärt att minska dessa stressnivåer. Särskilt viktigt blir detta när man ser på de forskningsresultat som visar att upplevd self-efficacy hos terapeuten, vilket i många fall är en förälder, är en av de faktorer som verkar påverka framgången hos IBT-program (Hastings & Symes, 2002). ...
... Kombinationen av de resultat Olsson (2004) presenterat om ökad föräldrastress hos föräldrar till barn med ASD och forskning som visar på högre self-efficacy hos mödrar med lägre stress (Hastings & Symes, 2002) leder till att det är önskvärt att minska dessa stressnivåer. Särskilt viktigt blir detta när man ser på de forskningsresultat som visar att upplevd self-efficacy hos terapeuten, vilket i många fall är en förälder, är en av de faktorer som verkar påverka framgången hos IBT-program (Hastings & Symes, 2002). Om föräldrarna fick tillgång till ett gruppforum skulle det säkerligen kunna ta udden av en del stress de upplever. ...
... PACT-G includes a large, well-characterised sample of children with 'core' autism, many of whom also have a learning disability. We expected to replicate previous findings that higher levels of child emotional and behavioural problems are associated with lower parent wellbeing (Salamone et al., 2019) and global ratings of parental self-efficacy (Hastings & Brown, 2002;Hastings & Symes, 2002). We also hypothesised that child characteristics, such as high autism symptom severity, low adaptive skills and low language levels would be associated with low parent wellbeing and parental self-efficacy. ...
... The results of recent reviews also provide consistent evidence for reduced parental stress and improved self-competence following behavioural parent interventions (Colalillo & Johnston, 2016;Tarver et al., 2019). In behavioural interventions, autism symptom severity has been shown to affect maternal efficacy when delivering therapy, which has a downstream effect on child therapy outcomes (Hastings & Symes, 2002). With growing evidence supporting the efficacy of parent-mediated interventions in autism (see Oono et al., 2013 for a systematic review), parents are increasingly taking on a therapy role. ...
Background
Many parents of children with autism have low levels of mental wellbeing, which may be related to low self-efficacy in the parenting role. Few studies have investigated the impact that child characteristics such as autism symptoms, development and functioning have on parental wellbeing and self-efficacy. In this study, we investigated associations between parental mental wellbeing, self-efficacy and child measures of behaviour and function, for families participating in the Paediatric Autism Communication Trial-Generalised (PACT-G).
Method
Parents of children with autism (N = 248, aged 2–11 years) completed self-report measures of mental wellbeing and self-efficacy. We used a range of parent-report and researcher administered assessments of autism symptoms, child development, emotional and behavioural difficulties, language and adaptive skills. Nonparametric tests (Spearman’s correlations) and multiple linear regression analyses were used to examine the associations between child characteristics and parent wellbeing and parental self-efficacy.
Results
Parent mental wellbeing and self-efficacy were highly related. Results of bivariate analyses showed significant negative associations between parent-reported child autism symptoms and parental self-efficacy. Higher child adaptive behaviour was also associated with better parental-self-efficacy. However, in a multivariate regression model, only high parent reported autism symptoms were associated with lower parental self-efficacy. Parent wellbeing was not related to any feature of the child’s profile.
Conclusion
These findings indicate that parent-reported autism symptoms are associated with parental self-efficacy, and that self-efficacy may be an important secondary outcome of interventions for children with autism.
... Hastings and colleagues [47,48], focusing on families, surveyed parents in the UK who were conducting Lovaas-style applied behavior analysis (ABA) therapy with their young children with autism. One paper noted perceived facilitative factors and barriers to implementation [47], while another was concerned with outcome variability and factors influencing therapist performance [48]. ...
... Hastings and colleagues [47,48], focusing on families, surveyed parents in the UK who were conducting Lovaas-style applied behavior analysis (ABA) therapy with their young children with autism. One paper noted perceived facilitative factors and barriers to implementation [47], while another was concerned with outcome variability and factors influencing therapist performance [48]. The authors found that mothers' perceptions of self-efficacy in the therapeutic role were higher when the child's autism was less severe, the program provided greater support, and maternal stress was lower. ...
Purpose of review This review focuses on papers published during the past year on early childhood intervention. We consider literature reviews, program descriptions, and empirical studies in two broad areas of early intervention: for children with developmental disabilities, and for children considered at-risk for developmental problems. Recent findings This year's empirical studies utilized a broad array of outcome variables, going beyond cognitive factors to include children's socio-emotional development and family functioning as well. The 'at-risk' studies made contributions in three areas: predictors of outcome, parent-child relationships, and comparisons and replications of programs. The developmental disability reviews and studies were concentrated on autism, with a methodological focus. Their conclusion was that despite much encouraging evidence for early intervention effectiveness with autism, there is still no one approach that meets accepted criteria for an empirically validated treatment. Summary Comprehensive early intervention programs can be quite effective for young children with developmental disabilities, as well as for children who are at risk due to biological or environmental factors. There is a need for additional development and evaluation of evidence-based treatments, as well as a further understanding of mediators and moderators of treatment outcome.
... D'autres études se sont plutôt centrées sur les caractéristiques personnelles des personnes qui appliquent le programme. (Hastings & Symes, 2002;Symes et al., 2006). Les résultats ont démontré qu'un faible niveau de stress chez les mèresthérapeutes serait lié à un sentiment d'efficacité plus grand, ce qui est positif pour maintenir l'intégrité du programme (Hasting & Symes, 2002). ...
... Deux études ont démontré que la sévérité des symptômes pouvait avoir un impact à la fois sur le sentiment d'efficacité du parent-thérapeute à appliquer le programme (Hastings & Symes, 2002) et sur la capacité des intervenants à l'administrer de façon fidèle (Symes et al., 2006). La progression positive de l'enfant face au traitement semble aussi jouer sur la qualité d'implantation du programme ICI et en faciliter l'implantation selon les parents de l'étude de Jonhson et . ...
Cette étude traite de la fidélité d’implantation du programme québécois d’intervention comportementale intensive (ICI) destiné aux enfants ayant un trouble envahissant du développement (TED), âgés de moins de six ans, suivis par des Centres de réadaptation en déficience intellectuelle et en troubles envahissants du développement (CRDITED). Pour ce faire, cette étude mixte utilise le questionnaire sur la fidélité d’implantation de Joly (2008), un questionnaire maison destiné aux acteurs oeuvrant au sein des CRDITED et portant sur l’implantation de certaines composantes du programme (selon le modèle d’évaluation proposé par Chen, 2005) et l’entrevue semi-structurée. L’échantillon est constitué de 96 professionnels (intervenants, superviseurs et coordonnateurs) rattachés au programme ICI et provenant de six CRDITED. Les résultats indiquent globalement un niveau de fidélité élevé malgré une grande variabilité dans les pratiques. Nonobstant le niveau élevé de fidélité rapporté, des différences significatives sont observées entre les centres en ce qui concerne l’adhésion, la participation de la clientèle et l’indice global de fidélité d’implantation. En ce qui concerne les facteurs associés à la fidélité d’implantation, des lacunes dans la documentation spécifique au programme ICI et dans la formation offerte aux intervenants sont rapportées. Les trois facteurs jugés les plus favorables à l’implantation du programme sont la formation sur les TED, la supervision des éducateurs et la collaboration avec les partenaires. Ceux jugés les plus nuisibles sont l’instabilité de l’équipe, le manque de formation en TED et l’absence de locaux adaptés. Les résultats sont discutés à la lumière des quelques travaux de recherche publiés en relation avec l’implantation de programmes semblables. Des recommandations sont faites visant à promouvoir la fidélité de l’implantation du programme et orienter les recherches futures.
... Policymakers and service providers should consider these insights to tailor support systems that address mental health and familial dynamics. Research suggests that children from families with lower overall functioning are less likely to experience the same positive outcomes from comparable treatment interventions (16,17). Therapeutic efforts should prioritize enhancing parental perspectives concerning their child's diagnosis, emotional parenting experience, marital contentment, and the role of siblings (18). ...
Background
Limited information exists on autistic service access and costs in Italy.
Objectives
This study aims to investigate access to educational, healthcare, social, and related services for autistic individuals in Italy as part of the Autism Spectrum Disorder in the European Union (ASDEU) project.
Methods
Italian carers of autistic individuals completed an online survey regarding services and costs in the 6 months before completion.
Results
Three hundred and three carers of autistic people participated in the survey. The majority of those receiving care were children, males, and lived at home with their parents. Autistic adults were often students (17%) or unemployed but willing to work (17%). Employed carers (49%) worked on average 32.23 ± 9.27 hours per week. A significant portion (82%) took work or school absences to care for autistic individuals, averaging 15.56 ± 14.70 days. On average, carers spent 58.84 ± 48.36 hours per week on caregiving duties. Fifty-five of the autistic individuals received some form of support, 5% utilized residential care, and 6% were hospitalized. Thirty-four percent received outpatient hospital care, and 20% underwent some form of autism-related psychopharmacological therapy. School support was primarily provided by support teachers (18.16 ± 7.02 hours/week). Educational psychologists (80.73%), psychomotor therapists/physiotherapists (53.85%), and speech therapists (50.91%) were frequently paid by carers who paid more per hour. Autistic children received support from educators (73.96 hours/week), group therapy (32.36 hours/week), and speech therapists (31.19 hours/week). Psychologists (76.00%) and counseling/individual therapists (89.13%) were often paid by carers. Carers reported high costs for psychiatrists and psychologists, with frequent use of psychiatric services (8 ± 8 times in 6 months).
Conclusions
Carers’ perspectives on the access and costs of services for autistic individuals in Italy can provide insights into areas for improvement in the delivery of autism services.
... However, it is stated that this number is approximately 352.000 people, including different types and moderate levels, based on the associations involved in studies conducted on autism support (Federation of Autism Associations, 2019). resistance of their self-efficacy (Weiss et al., 2013), on the intensity of care and its sustainability (Hastings & Symes, 2002), on other supportive functions related to being a family (Jackson, Pinto-Martin, Deatrick, Boyd, & Souders, 2022), stress coping styles and problem-solving skills (Strauss et al., 2022) affecting family life in many ways, including life satisfaction, physical health and planning of external activities related to home life (Taylor, Luk, & Leadbitter, 2021). In this context, the physical-psychological wellbeing of parents in the face of autism is determined whether they exhibit sufficient parental involvement behavior towards struggling with the problem (Clarke & Fung, 2022). ...
The aim of this study is to examine the relationship between selfefficacy levels, family resilience perceptions and quality of life of parents with autistic children aged 4-6. The research was carried out with the screening method. A total of 330 parents with autistic children between the ages of 4-6 were contacted, and the Parent Self-Efficacy Scale (PSES), Quality of Life in Autism Inventory (QoLiA), and Family Resilience Scale (FRS), which were
determined as the data collection tools, were applied. Data
analyzes were performed using intermediary variance analysis and MANOVA, Two-Way ANOVA, and Correlation analysis.
According to the results of the research, it was found that the level of resilience and the perception of parental self-efficacy were explanatory on the perception of quality of life. In addition, it was observed that the level of resilience also changed depending on the age of the families and an additional disease their children had. Economic conditions had a direct impact on self- efficacy (SE) and quality of life (QoL). The findings were evaluated as the data to be used within the scope of psychological counseling to be provided to families with disabled children, and in line with family education and guidance in the field of special education.
... While ABA is a field of practice with delineated educational tracts such as a board-certified behavior analyst (BCBA), ABA methods may also be adopted by other professionals such as teachers and speech-language pathologists. Notwithstanding controversy about ethical concerns regarding intervention practices, foundational theories, and potential traumatic effects of ABA intervention (Sandoval-Norton, Shkedy, and Shkedy 2019; Wilkenfeld and McCarthy 2020), ABA receives support from practitioners in the ABA field, other healthcare disciplines, and from families of individuals receiving services (Foxx 2008;Grindle et al. 2009;Griffith, Fletcher, and Hastings 2012;Hastings and Symes 2002;Makrygianni et al. 2018). Despite ABA's prevalence, there has been significant criticism of the treatment. ...
Reddit discourse surrounding treatments for autistic individuals is easily accessible. Multiple Reddit threads discuss Applied Behavior Analysis (ABA) as one option. Such content impacts decision-making despite the absence of gatekeeping mechanisms to identify misinformation. Using a cross-sectional design, this study explores perceptions of ABA-based interventions shared on Reddit by exploring posts' content, stance and evidence used to support claims. Posts examined generally lacked support of scientific evidence. Additionally, perspectives on ABA were influenced by personal experiences with the intervention. This data provides insight to support healthcare professionals and families engaged in shared decision making regarding intervention choices.
... A potential explanation for the minimal increase in self-efficacy is that caregivers in OPT-In-Early did not have the opportunity to receive reinforcement, feedback, or validation from any providers because they were not observed with their children during the OPT-In-Early program. Indeed, other studies found that higher amounts of support from intervention providers are associated with increased caregiver self-efficacy (Hastings & Symes, 2002;Ingersoll et al., 2016;Russell & Ingersoll, 2021). Additionally, this study used a global measure of parental self-efficacy. ...
Online Parent Training in Early Behavioral Intervention (OPT-In-Early) is a self-directed resource for caregivers of autistic children. Sixty-three parent–child dyads from three states in were randomized to the OPT-In-Early or treatment as usual group. Parents in both groups completed baseline and post-treatment visits, which were targeted for 4 months apart but allowed to go up to 6 months. Compared to parents in the treatment as usual group, parents randomized to OPT-In-Early learned more evidence-based intervention principles from baseline to post-treatment and were rated by observers blind to group and time as increasing their use of these strategies during brief semi-structured interactions with their children. Parent participation in OPT-In-Early did not significantly influence children’s social communication as coded from one observation session. Results suggest that parents acquired knowledge and skills in intervention techniques from OPT-In-Early. Longer trials may be needed for gains in child behavior.
Lay abstract
Early intervention can help children learn language and improve social communication. However, many barriers, including the expense of services and an insufficient number of providers, prohibit families from accessing services when their children are young. We developed a comprehensive online program for caregivers of autistic children. The program, Online Parent Training in Early Behavioral Intervention (OPT-In-Early), uses text and video demonstrations to teach caregivers effective methods for improving their children’s language, social, and adaptive skills (e.g. using utensils, toilet training), and reducing their children’s disruptive behavior. Sixty-three parents from three states participated in the study. Half of the parents received access to the OPT-In-Early program. After 4 months, parents who had access to the OPT-In-Early program learned more effective intervention strategies, and started using these strategies during interactions with their children, than parents who did not receive access to the program. Parent participation in OPT-In-Early did not significantly influence children’s social communication compared to children whose parents did not have access to OPT-In-Early. A longer duration of parents using learned intervention skills with their children may be needed for children’s social communication skills to improve.
... While there are many child and parent factors that contribute to parenting stress, increasing parental self-efficacy can mitigate some of these factors, particularly child factors (Shiri et al., 2020) as has been detailed in the above studies. In addition to this, parental stress and parental self-efficacy are strongly correlated (Hastings & Symes, 2002), therefore, if self-efficacy is increased stress is decreased (Iadarola et al., 2018) and lower stress levels can optimize treatment outcomes for children with autism (Osborne et al., 2008). ...
Autism spectrum disorder is a complex and heterogenous, neurodevelopmental disorder.
Applied behavior analysis (ABA) is a common treatment modality for children with
autism with marked improvements demonstrated in communication, social, and adaptive
functioning. The most common implementation of ABA is a practitioner-led model,
whereby a paraprofessional directly implements treatment with the oversight of a Board
Certified Behavior Analyst®. Parent mediated treatments are another model proving to
be efficacious for children with autism and their parents. While this model is applied in
therapeutic treatments such as speech pathology, early intervention, and other behavioral
approaches (e.g., ESDM, PRT), parent mediated treatment has not been widely applied in
the field of ABA. For this reason, this study, with a foundation in behavioral theory and
Bandura’s unifying theory of behavior change, investigated the effectiveness of a parent
mediated approach knowns as parent-led ABA. To evaluate this, an archival analysis was
conducted for children with autism who received parent-led ABA and practitioner-led
ABA as a comparison. Results of this analysis revealed parent-led ABA to be no different
in treatment outcome to practitioner delivered treatment. Specifically, while both parentled
ABA and practitioner-led ABA demonstrated a significant change in outcome on both
the Vineland-3 (ps < .05) and the VB-MAPP (p < .05), there were no significant group
differences observed (ps > .05). This produces positive social change as parents are
taught to implement an efficacious treatment for their child, which can have a daily and
lifelong impact for these families by positively impacting parenting skills, increasing
parent’s self-efficacy, and ultimately making a lasting impact in their child’s life.
... Secondary Outcome Measures: Caregiver-All of the following measures were completed by caregivers about themselves: 1) The Parenting Stress Index (PSI-4 SF; Abidin, 2012): Analyses utilized the Parental Distress (PD), Parent-Child Dysfunctional Interaction (P-CDI), and Difficult Child (DC) subscales, and the Total Stress scale, with higher scores indicating higher stress levels; 2) The Difficult Behavior Self-Efficacy Scale (DBSES; (Hastings & Brown, 2002;Hastings & Symes, 2002): Five items related to feelings of self-efficacy (e.g., confidence, control, satisfaction) in managing challenging behaviors, with higher scores indicating greater self-efficacy. ...
Lay abstract:
Emotion dysregulation (ED) impacts mental health symptoms and well-being in autistic individuals. In prior work, we developed the Emotion Awareness and Skills Enhancement (EASE) to improve emotion dysregulation with autistic adolescents (aged 12-17). The study team partnered with autistic individuals, their caregivers, and expert clinicians to adapt EASE for autistic adolescents and adults with co-occurring intellectual disability and autistic elementary-aged children, groups that often benefit from caregiver support in treatment. In three phases, we (1) gathered caregiver and expert feedback to adapt the original EASE program for autistic adults with intellectual disability, (2) revised the treatment after using it with six autistic adults with intellectual disability, and (3) tested the newly developed caregiver-client team-based treatment, called EASE-Teams, in a small group of 10 autistic individuals with and without intellectual disability (aged 7-25). Families found EASE-Teams to be acceptable and helpful. We found improvements in emotion dysregulation and mental health symptoms for autistic participants. Caregivers reported less stress from their child's dysregulation after participating. These results show that EASE-Teams can be appropriate for different developmental and cognitive needs. Future studies will need to test the benefits of the treatment in community clinics.
... Parents' perceived self-efficacy strongly predicts parents' involvement in their children's EIBI programs (Solish & Perry, 2008). Though increased parental self-efficacy is beneficial for children's outcomes (Karst & van Hecke, 2012;Solish & Perry, 2008), the unique impairments common to ASD place parents of children with this disorder at risk for lower levels of self-efficacy (Hastings & Symes, 2002;Jones & Prinz, 2005;Karst & van Hecke, 2012), while parents themselves may share some of their children's difficulties (Karst & van Hecke, 2012). The lack of clarity around the diagnosis and vast array of interventions advertised for ASD may also contribute to parents' uncertainty about the best approaches to raising their children (Karst & van Heck, 2012). ...
Early Intensive Behavioural Intervention (EIBI) is effective for preschoolers with autism spectrum disorder (ASD). Parental measures are rarely included in EIBI effectiveness studies, yet parental distress and lower self-efficacy are associated with poorer child outcomes. Parents of preschoolers with ASD (N = 485) were surveyed at baseline (T1), one-year post-intervention (T2), and school entry (T3) about family distress/crisis, parental self-efficacy, and satisfaction with services in two Canadian provinces. Family distress/crisis decreased and parental self-efficacy increased from T1 to T2. Increases in self-efficacy were largely maintained at T3. Parents were highly satisfied with services. Greater satisfaction for those residing in the province utilizing a parent-coaching model suggests that parent involvement is associated with positive parent outcomes.
... Though it is widely agreed that early diagnosis and early intervention lead to improved developmental trajectories for children with ASD (Butter, Wynn, & Mulick, 2003;Sandbank et al., 2020), the relative effectiveness of various interventions remains unclear. There is little consensus about the intensity (i.e., frequency and duration) of therapeutic sessions, or the synergistic benefits that multiple therapies may provide (Boyd et al., 2014;Hastings & Symes, 2002;Landa, 2018). The heterogeneity of ASD makes it likely that a subset of children will respond to one intervention, while others may derive benefit from an alternative approach (Masi, DeMayo, Glozier, & Guastella, 2017). ...
Background
Autism spectrum disorder (ASD) is a complex neurological condition with increasing prevalence. Few tools accurately predict the developmental trajectory of children with ASD. Such tools would allow clinicians to provide accurate prognoses and track the efficacy of therapeutic interventions. Salivary RNAs that reflect the genetic-environmental interactions underlying ASD may provide objective measures of symptom severity and developmental outcomes. This study investigated whether salivary RNAs previously identified in childhood ASD remain perturbed in older children. We also explored whether RNA candidates changed with therapeutic intervention.
Method
A case-control design was used to characterize levels of 78 saliva RNA candidates among 96 children (48 ASD, 48 non-ASD, mean age: 11 years). Thirty-one children (22 ASD, 9 non-ASD developmental delay, mean age: 4 years) were followed longitudinally to explore changes of RNA candidates during early intervention. Saliva RNA and standardized behavioral assessments were collected for each participant. Associations between candidate RNAs and behavioral scores were determined in both groups via Spearman Correlation. Changes in candidate RNAs across two time-points were assessed in the younger cohort via Wilcoxon rank-sum test.
Results
Seven RNAs were associated with VABS-II and BASC scores in the older group ([R] >0.25, FDR < 0.15). Within the younger cohort, 12 RNAs displayed significant changes over time (FDR < 0.05). Three microRNAs were associated with behavioral scores and changed over time (miR-182−5p, miR-146b-5p, miR-374a-5p).
Conclusion
Several salivary RNAs are strongly associated with autistic behaviors in older individuals with ASD and change as early as three months after therapy initiation in younger children. These molecules could be used to track treatment effectiveness and provide prognoses. Further validation is necessary.
... However, survey data and non-randomized trials provide preliminary evidence of a relationship between the number of hours of comprehensive intervention (intensity) and parent experiences; parents of young children with ASD may experience less stress and less depression when their children receive more hours of intervention (Osborne et al., 2008;Schwichtenberg & Poehlmann, 2007). A non-randomized study explored parental sense of efficacy in the context of an applied behavioral analysis (ABA) program for children with ASD and found that parental stress, child symptom severity, and level of program support were related to parental sense of efficacy (Hastings & Symes, 2002). Given that comprehensive interventions range from approaches that have systematic, curriculum-based roles for parents as part of the intervention to interventions that have no formalized role for parents, there may be significant effects of these style differences on parent efficacy. ...
Lay abstract:
This is a study of the secondary effects of interventions for young children with autism on their parents. Specifically, we were interested in the impact on parent's sense of efficacy, or how confident and competent a parent feels about themselves as a parent. We tested three ideas: (1) that the style of the intervention, whether it was more or less structured and whether the parent had a more or less formal role, would impact a parent's sense of efficacy; (2) that the intensity of the intervention, how many hours per week the intervention was delivered, would impact parental efficacy; and (3) that the parent's level of stress prior to intervention would impact how intensity and style effected efficacy. We randomly assigned 87 children with autism, age 13-30 months, into one of four conditions: 15 versus 25 intervention hours crossed with two different styles of intervention. We used statistical tests to examine these ideas. We found that parental efficacy was related to intervention intensity but not style. Parents with higher stress at the beginning of a 1-year, home-based, comprehensive intervention program had a higher sense of parenting efficacy if their child received lower intensity intervention; parents with lower stress at baseline had a higher sense of efficacy if their child received higher intensity intervention. If a parent can emerge from the process of diagnosis and early intervention with an increased sense that they can make a difference in their child's life (i.e. increased sense of efficacy), it may set the stage for meeting the long-term demands of parenting a child with autism.
... Therapist self-efficacy A rating scale adapted from previous research on parents' self-efficacy on their abilities as a therapist was used (Hastings & Symes, 2002). The rating scale consisted of five items and was translated into Mandarin. ...
The purpose of the present study was to evaluate the effectiveness of a video modeling (VM) procedure at teaching three staff members who were working with children with autism spectrum disorder (ASD) to implement a token economy, use an error correction procedure, and conduct a multiple stimulus without replacement preference assessment. The study was conducted at a summer camp for children with ASD located on a university campus and at a school for students with special needs in mainland China. All participants successfully generalized instructional skills learned during the VM intervention to sessions with children with ASD. Maintenance of instructional skills was also seen during follow-up. These results indicate VM to be an economical and effective approach to training staff to implement various behavioral strategies. Moreover, the validity of VM as an effective intervention for staff training is increased by inclusion of blind ratings by five Board Certified Behavior Analysts. K E Y W O R D S behavioral procedures, China, staff implementation, video modeling, video modeling with voiceover instructions and on-screen text
... (23,35,36) The findings of the studies on parents with autistic children revealed that stress, depression, familial and social support, parents' mental and physical health, feeling of guilt due to child's disease, participation in care programs, and being supported by professionals were effective in selfefficacy and subsequently parental competence of parents with autistic children. (37,38) On the other hand, other studies indicated that parents' self-efficacy had an impact on their parenting behaviors. It is evident that parents' behaviors and competence could, in turn, affect children's social, emotional, and educational growth and development. ...
Objectives:
This work aimed to define and assess the parental competence of parents with autistic children.
Methods:
This study was conducted through a systematic review. The search was done in databases, including Cochrane Library, PubMed, CINAHL, Science Direct, Wiley Scopus, Pro Quest, Web of Science, Elsevier, Google Scholar, and Ovid by using keywords, like "children, autism, parenting, competence, and scale" from 1974 to 2019. Inclusion criteria were that the article should be quantitative, qualitative, and mixed-method studies in nursing, psychology, and medicine; the full text of the article should be available and the article should be in English or Persian.
Results:
Competence among these parents was affected by more factors and they reported lower competence compared to other parents. Moreover, only two instruments were available to assess parenting competence, which were not designed for parents of autistic children. Variables and factors affecting parenting competence has not been examined well in parents of children with autism, and no specialized instrument is available to evaluate parenting competence in parents with autistic children either.
Conclusions:
Although parental competence has been known as the main element to improve the quality of care, it has been studied restrictively from the viewpoints of the parents of children with autism. Therefore, the development of this concept is highly essential for clinical application and investigating its outcomes support.
... Behavior therapists as a group also experience occupational burnout and procedural drift as a result of the intensive nature of the multitasking involved in data collection procedures during long hours of intense one-to-one personalized sessions. [33][34][35][36] Furthermore, there is concern among all key players (e.g., parents/caregivers, clients, supervisors, and behavior analysts) regarding not only the relatively high turnover, but also the unreliability, of some therapists in the field. 37 Hurt et al point out that when there are changes in the individuals providing ABA therapy, the children with ASD lose precious time and consistent progress. ...
Social robots interact with people through social interactions, physical assistance, and therapy delivery. Socially assistive robots (SARs) are specifically intended to assist in a therapeutic way to help build social behavior skills. One area where SARs have gained significant attention is in the treatment and diagnosis of autism spectrum disorder. With the increase in rates of individuals diagnosed with autism spectrum disorder, there is an increasing need for equitable and accessible applied behavior analysis (ABA) therapy services. Current barriers for sufficient access to therapy include high administrative burden, burnout rates on the part of ABA therapists, and affordability of services. One way to reduce administrative burden is to automate procedures using computer-based interventions, including SARs. SARs have the potential to increase client engagement, while at the same time making it possible for therapists to provide a more interactive session for their client. We argue that there is benefit to clients, therapists, scientists, and to the general public if behavior analysts can work with robotic design engineers for further research and development on SARs. Such collaboration is necessary for ensuring that robust SAR designs are embedded in conceptually systematic approaches to ABA, while at the same time integrating relevant engineering design considerations. This technological integration is important for the field of ABA to move forward as robotics become more commonplace, and to effectively address the cost, quality, and access considerations involved.
... De plus, la révision du programme permet d'éviter la routine de l'intervention (Symes, Remington, Brown & Hasting, 2004). Le superviseur ne fait pas que concevoir et réviser la programmation, c'est aussi à lui de communiquer avec son équipe pour le choix des approches les plus appropriées à chaque enfant (Hastings & Symes, 2002). Encore une fois, c'est dans la forme que prend la supervision que des différences sont constatées, notamment en ce qui concerne la fréquence et les modalités de supervision (lieux, personnes présentes). ...
L’objectif est de décrire l’intervention comportementale intensive (ICI) offerte au Québec aux enfants autistes. Neuf professionnels de cinq centres ont participé à des entretiens semi-structurés. L’analyse de contenu a révélé des thématiques communes, dont l’identification des besoins, l’intervention auprès de l’enfant, la supervision, le réajustement de l’intervention, mais aussi des spécificités dans chaque centre, liées à l’organisation institutionnelle ou à l’expertise des professionnels.
... Consequently, to improve EIBI delivery quality, that is, the accuracy of performing procedures and techniques according to best practice, regular supervision is considered mandatory, and recommendations have been published that describe how supervision should be designed to shape effective treatment (Bibby, Eikeseth, Martin, Mudford, & Reeves, 2002;Davis, Smith, & Donahoe, 2002;Eikeseth, 2010;Eikeseth, Hayward, Gale, Gitlesen, & Eldevik, 2009;Gibson, Grey, & Hastings, 2009;Grey, Honan, McClean, & Daly, 2005;Hastings & Symes, 2002;Jahr, 1998;LeBlanc & Luiselli, 2016;Symes, Remington, Brown, & Hastings, 2006). To protect consumers of behavior analysis services worldwide, the mission of the Behavior Analyst Certification Board (BACB; https://bacb.com/) is to officiate as a standard setting organization by systematically establishing, promoting, and disseminating professional standards. ...
Early intensive behavioral intervention (EIBI) is widely applied in young children with autism spectrum disorder. Little research has addressed the significance of adherence to EIBI practices for treatment outcomes. The York Measure of Quality of Intensive Behavioral Intervention (YMQI) was designed to assess EIBI quality delivery in Ontario, Canada. The objective of this study was to examine the cross-cultural validity of the YMQI in a clinical Swedish community sample of 30 boys and four girls with autism aged 2.5 to 6 years. Internal consistency was alpha = .87 for the full scale YMQI. Interrater reliability among three raters on 97 video-recorded therapy sequences was .71 (intraclass correlation coefficient [ICC]), and intrarater reliability of two raters re-scoring 15 sequences after 6 months was ICC = .87. The convergent validity of the YMQI with EIBI expert ratings was r = .49. Findings endorse the psychometric properties of the YMQI and its usability outside of Anglo-Saxon countries.
... De plus, la révision du programme permet d'éviter la routine de l'intervention (Symes, Remington, Brown & Hasting, 2004). Le superviseur ne fait pas que concevoir et réviser la programmation, c'est aussi à lui de communiquer avec son équipe pour le choix des approches les plus appropriées à chaque enfant (Hastings & Symes, 2002). Encore une fois, c'est dans la forme que prend la supervision que des différences sont constatées, notamment en ce qui concerne la fréquence et les modalités de supervision (lieux, personnes présentes). ...
The aim of this study is to describe the Early Intensive Behavioral Intervention (IBI) offered in Quebec to children with autism. Nine professionals from five centers participated in semi- structured interviews. Content analysis revealed common themes, including needs identification, intervention with the child, supervision, the readjustment of the intervention, but also the specificities of each Center, linked to the institutional organization or professional expertise.
... Since parents or primary care givers usually spend the greatest amount of time interacting with their children, they are in the best position to intervene and capitalise on their children's neuroplasticity. Educating parents to become therapists for their children with ASD is not a new concept [30][31][32][33][34][35] and this approach may have lasting effects on early intervention outcomes [36][37][38][39]. Coaching parents to effectively engage, scaffold, prompt and reinforce communication and language can provide them with powerful skill-set for supporting their young children's development and learning. ...
Background
Evidence for early intensive behavioural interventions (EIBI) by therapists as an effective treatment for children with an Autism Spectrum Disorder (ASD) is growing. High-intensity and sustained delivery of quality EIBI is expensive. The TOBY (Therapy Outcomes by You) Playpad is an App-based platform delivering EIBI to facilitate learning for young children with ASD, while enabling parents to become co-therapists. Intervention targets include increasing joint attention, imitation and communication of children with ASD. The primary aim of the study presented in this protocol is to determine the effectiveness of the TOBY App in reducing ASD symptoms when used as a complement to conventional EIBI. The secondary aim is to examine parental attributes as a result of TOBY App use.
Methods and design
Children aged less than 4;3 years diagnosed with ASD and parents will be recruited into this single-blind, randomised controlled trial using a pragmatic approach. Eligible participants will be randomised to the treatment group ‘TOBY therapy + therapy as usual’ or, the control group ‘therapy as usual’ for six months. The treatment will be provided by the TOBY App and parent where a combination of learning environments such as on-iPad child only (solo), partner (with parent) and off-iPad – Natural Environment (with parent) Tasks will be implemented. Parents in the treatment group will participate in a TOBY training workshop. Treatment fidelity will be monitored via an App-based reporting system and parent diaries. The primary outcome measure is the Autism Treatment Evaluation Checklist. The secondary outcome measures involve diagnostics, functional and developmental assessments, including parent questionnaires at baseline (T0), three months (T1) and six months (T2).
Discussion
This trial will determine the effectiveness of the TOBY App as a therapeutic complement to other early interventions children with ASD receive. The trial will also determine the feasibility of a parent delivered early intervention using the iPad as an educational platform, and assess the impact of the TOBY App on parents’ self-efficacy and empowerment in an effort to reduce children’s ASD symptoms. The outcomes of this trial may have EIBI services implications for newly diagnosed children with ASD and parents.
Trial registration
ACTRN12614000738628 retrospectively registered on 1st of July, 2014. UTN: U1111-1158-6423.
... Eikeseth and colleagues 9 found a positive correlation between a supervisor's tutorial style (including the extent of supervision) with EIBI outcomes. [10][11][12][13][14] Moreover, other findings indicate that effective supervision is characterized by a combination of theoretical and practical guidance 15 , as well as personal support perceived by the supervisee. 16 It is known from psychotherapy research with adults that treatment outcomes are affected by a therapist's level of allegiance to the method applied. ...
Aim:
Early intensive behavioural intervention (EIBI) for children with autism spectrum disorder (ASD) is often delivered using a community model. Behaviour modification experts train and supervise non-experts (e.g. preschool personnel) to teach children according to applied behaviour analysis principles in their natural environment. Several factors predict EIBI outcomes in ASD, for example, knowledge of EIBI and EIBI allegiance among trainers. The aim of the present study was to survey levels of knowledge about and allegiance towards EIBI.
Methods:
Formal knowledge of EIBI and EIBI allegiance was surveyed in supervised preschool staff conducting EIBI (n = 33), preschool staff not involved in EIBI (n = 26), behaviour modification experts (n = 60), school staff (n = 25) and parents of children with ASD (n = 150) [N = 294]. A 27-item (15 knowledge and 12 allegiance questions) online questionnaire was collected.
Results:
Supervised preschool staff conducting EIBI had more knowledge than preschool staff not using EIBI, but they were not more allegiant. Compared with behaviour modification experts, the supervised EIBI preschool staff group showed markedly less knowledge and allegiance.
Conclusions:
Findings indicate potential for improvement regarding formal knowledge levels of preschool staff delivering EIBI to children with ASD in real-world settings. In addition, fostering EIBI allegiance might be prioritized when teaching EIBI among non-experts. Broadly increased EIBI knowledge levels among all preschool teachers should be achieved by adding behaviour modification techniques to common university curricula in preschool education. Allegiance of preschool personnel might be accomplished by EIBI supervisors meeting skepticism in practice with conveyance of evidence-based principles and discussions of ethical issues.
... The scale has been shown to have high internal reliability, ranging from .84 to .97, when used with biological parents (Hastings & Brown, 2002a, 2002b, Hastings & Symes, 2002 and ...
Aims: Children who experience abuse and neglect prior to being fostered and/or adopted are
a particularly vulnerable group within society and more research is required to better
understand the outcomes for these young people. In relation to this population, this thesis
had three aims: to review the impact of attachment based interventions, to evaluate the role of
foster carer factors in the provision of quality placements and to assess foster carer and social
worker agreement on ratings of placement quality.
Methods: Aims are addressed separately in three journal articles. A systematic review of
attachment based interventions is presented in journal article 1. The findings from a
quantitative cross sectional study involving foster carers (n=91) and social workers (n=87)
are presented in journal articles 2 and 3. Correlation and multiple regression analyses explore
the relationship between foster carer self-efficacy, coping, attributions and placement quality.
The weighted kappa statistic is used to explore the agreement between ratings of placement
quality within foster carer/social worker dyads.
Results: The systematic review indicated that there is some support for the positive impact of
attachment based interventions, particularly with young children (0-6 years) in
foster/adoptive care. There are significant limitations of the research in this area and further
research is required to establish the efficacy of such interventions. Foster carer self-efficacy
emerged as a significant predictor of placement quality. Due to a number of measurement
and statistical issues, this finding requires replication. Agreement between foster carers and
social workers regarding placement quality was slight to fair, indicating the presence of some
discrepancies.
Conclusions: The results are discussed in relation to previous research with this population
of children/young people. Findings from the systematic review suggest the importance of
further intervention studies and the results from the empirical study highlight possible areas
for intervention, namely foster carer self-efficacy. A number of issues in relation to future
research are raised, specifically the development of a standardized measure of placement
quality and the impact of systemic issues, such as foster carer/social worker communication
on children and young people’s outcomes.
... O senso de autoeficácia é um tema investigado em diversos campos da Psicologia, nos quais os pesquisadores têm verificado associação com variáveis como o estresse, vícios, controle da dor, fobias, relações entre pais e filhos com deficiência e desempenho atlético (Farkas, & Valdéz, 2010;Salvetti, & Pimenta, 2007;Cabrera, Anzano, Sánchez, & Méndez, 2011;Schmidt, & Bosa, 2007;Leite, Drachler, Centeno, Pinheiro, & Silveira, 2002;Hasting, & Symes, 2002;Keefe, & cols. 1997). ...
In this study we aim at investigating the association of the feeling of self-efficacy with academic performance, learning difficulties, gender and age of children in the early grades of elementary school. The sample was composed of 406 children (56% girls), aged 7 to 10 years, enrolled in a school in the metropolitan area of Florianópolis/SC. The instruments used were the Academic Performance Test (TDE) and Sense of self-efficacy Assessment Guide (RASAE). Statistically significant association was found between self-efficacy and academic performance for all levels of school skills and those with the best performance had higher self-efficacy (p <0.001). Regarding the results between gender, girls were more self-efficacy than boys (p <0,05). Children of different age groups (7-8 and 9-10 years) had similar levels of self-efficacy. The results suggest that actions which target the increase of self-efficacy are directed especially to boys and groups with low academic performance. This produces impacts on the motivation and school learning.
... Other studies have noted that levels of maternal stress are associated with worse maternal well-being, and less engagement in treatments, or intervention programs (Dale et al., 2006). High maternal stress, as well as levels of support received from the intervention programs, and the severity of the child's ASC, predict worse attributions of parental therapeutic self-efficacy (Hastings & Symes, 2002), and greater negative emotional reactions, and more threat-related appraisals to videotaped scenes of adolescents with ASC engaged in everyday activities (Fong, 1991). A relative lack of involvement and engagement with the intervention may exacerbate the stressrelated problems experienced by the parents, and lead to the development of a 'vicious circle', or degenerative cycle. ...
The role of the family in Autistic Spectrum Conditions (ASC) has a controversial history, but current research has identified a number of key relationships between the behaviors of the child with ASC and parenting stress and styles. The current review highlights a number of relationships between parenting stress, parenting behaviors, and child behavior problems in ASC samples, and identifies areas where current research is lacking. In particular, the following concerns need to be addressed: whether high parenting stress levels impact negatively on child outcomes following interventions for ASC; the nature of the relationship between parenting stress and child behavior problems over time; whether parenting stress impacts on parenting behaviors, and the types of parenting behaviors that are influential for subsequent child behavior problems in the context of ASC; whether any association between parenting behaviors and child behavior problems is a direct one; and whether the contact and communication experiences of parents with professionals leading up to, and during, the diagnostic process is of particular significance. The results of such examinations may well have practical implications for the development of future interventions for ASC.
... [2] Parents are important collaborators in planning for and implementing interventions for ASD. Training of parents as a therapist has been known to decrease parental stress [3,4] and improve child intelligence quotient (IQ), adaptive behavior, language, and socialization-communication. [5][6][7][8] Evidence base of the effectiveness of parent mediated interventions in the well-educated and resourceful community has been established resulting in recommendations of their involvement. ...
Context:
Parents of children with autism spectrum disorders (ASD) in India face a host of challenges, while seeking care which ranges from unavailability of information to difficulty in availing services.
Aims:
To develop a psycho-education intervention module for parents of children with ASD and to study its impact on parent stress and knowledge.
Settings and design:
Child Guidance Clinic Department of Psychiatry, Government Medical College and Hospital, Chandigarh. Interventional study.
Methodology:
Parents of children diagnosed with ASD as per Diagnostic and Statistical Manual of Mental Disorders, 4(th) Edition criteria, recruited through consecutive sampling. Total number of 18 participants participated in the two phase study. Phase I included preparation of a parent training module through a four stage process and Phase II was evaluation of impact of the final version of the module on parental stress and knowledge.
Statistical analysis:
Wilcoxon Signed-Rank test using SPSS version 17.0.
Results:
There was an improvement in all the domains of parenting stress and knowledge. Social stress score and total stress score showed significant improvement.
Conclusions:
Parent psycho-education intervention module on ASD decreases parenting stress, and improves knowledge about ASD. Psycho-education intervention module is a feasible and acceptable way of parent empowerment.
... It also important to note that there are other possible mechanisms that may be associated with adolescents' drinking behavior that were not included in this study, including alcohol advertisements (Hastings & Symes, 2002); peer influences (Chein, Albert, O'Brien, Uckert, & Steinberg, 2010); and parental factors, such as approval (Mrug & McCay, 2013) or monitoring (Stanley et al., 2011). Future studies could include these factors to better understand the overall effects of alcohol outlet density on adolescent alcohol use. ...
We investigated the association between alcohol outlet density and adolescent alcohol use, including whether this association differed by sociodemographic characteristics. We geocoded and mapped active license data from the year 2011 to calculate the number of outlets within multiple circular buffers of varying sizes (density), centered at households of adolescents ages 10-16 (n = 2,724). We examined 2 indicators of alcohol use: any lifetime use, but not in past month, and any past month heavy use. Cross-sectional hierarchal multivariate regression analyses were used to examine associations between alcohol outlet density and alcohol use, including the potential moderating effect of age, gender, race/ethnicity, and socioeconomic status. Analyses controlled for neighborhood-level socioeconomic status and accounted for census tract-level clustering. A higher number of on- and off-premise outlets within 0.10, 0.25, and 0.50 miles around the respondents' homes was associated with higher odds of being a heavy drinker. In addition, the number of on-premise outlets within the 0.25-mile radius was associated with greater odds of lifetime drinking. For on-premise outlets where minors were not allowed (clubs/bars), we observed a positive and significant association between clubs/bars within the 0.25-mile buffer zone and higher odds of both lifetime and heavy drinking. Findings suggest that youth who are exposed to higher densities of on-premise alcohol outlets are at risk for both lifetime use and recent heavy use. It is critical to advocate for stricter laws limiting the number of alcohol outlets in neighborhoods, including clubs/bars where minors are restricted, and putting into place more stringent enforcement of age identification requirements to limit distribution of alcohol to minors. (PsycINFO Database Record
... Social support, or resources available through family and the community, is often lacking (Dababnah & Parish, 2013). Finally, self-efficacy, or belief in one's ability to achieve goals, is affected by factors such as the severity of the child's ASD (Rezendes & Scarpa, 2011), level of professional support (Hastings & Symes, 2002), and availability of early intervention (Reichow & Wolery, 2009). Ungar (2011) suggested that resilience relies above all on access to resources relevant to one's culture. ...
This qualitative study investigated how resilience functions in the context of daily occupations for mothers of children with autism spectrum disorder (ASD). Fourteen mothers of children with ASD participated in two focus groups that were used to elicit stories of the mothers' resilience in daily occupations. A constant comparative method was used for data analysis. A model of resilience in daily occupations of mothers of children with ASD was developed consisting of four categories: (1) creating and re-creating accepting conditions, (2) finding solutions, (3) striving for balance among daily occupations, and (4) thinking about the child's future. Sources of resilience were found to reside in both the mothers themselves and their social environments. Occupational therapy practitioners can use these findings in developing supportive approaches aimed at mothers, family members, and other people in the lives of children with ASD.
... Alanyazın incelendiğinde, uygulama boyunca ekip üyelerinde görülen değişimlere yönelik doğrudan bir çalışma yapılmadığı görülmektedir. Sadece eğitmenlerin kendi yeterliklerine ilişkin algılamaları (Hasting ve Symes, 2002) ve uygulama güvenirliği kapsamında eğitmen ve danışmanlık veren uzmanların nitelikleri (Birnbrauer ve Leach, 1993;Symes ve diğ., 2006) konularında araştırmalara rastlanmıştır. ...
Yoğun davranışsal eğitim, otizm tanılı çocuklar üzerindeki etkileri bilimsel araştırma bulgularıyla desteklenmiş bir uygulamadır. Otistik Çocuklar için Davranışsal Eğitim Programı (OÇİDEP) Türkiye’de bu tür eğitim sunmak üzere geliştirilen öncü programlar arasında yer almaktadır. Bu araştırmada OÇİDEP ev uygulamasının bir çocukla yürütülme süreci incelenmiştir. Araştırma, program uygulama sürecinin incelenmesi amacıyla yürütülen, nicel veri toplama ve analiz tekniklerini de içeren bir nitel araştırmadır. Araştırmanın katılımcısı dokuz yaşında, otizm tanılı bir erkek çocuktur. Bulgular; (a) OÇİDEP ev uygulamasının planlama aşamasında belirlenen genel ilkelerde değişiklikler ya da uyarlamalar yapılarak yürütülebildiğini, (b) uygulama boyunca çeşitli davranış ve öğretim sorunları yaşandığını ve bu sorunlara yönelik uygun önlemler alınarak yürütmenin sürdürüldüğünü, (c)
uygulama süresince OÇİDEP ekip üyelerinin bilgi ve becerilerinde artışlar olduğunu, (d) OÇİDEP ev uygulaması katılımcısında program içinde ve dışında çeşitli gelişmeler görüldüğünü, (e) ekip
üyelerinin ve ailenin OÇİDEP’in çocukların gelişimine önemli katkılarda bulunan, ancak, belirli unsurlara dikkat edilerek uygulanması gereken bir program olduğu yönünde görüşleri olduğunu göstermiştir.
Intensive Behavioral Intervention (IBI) is an evidence-based practice for children with autism. Intensive Behavioral Home Intervention Program called OCIDEP is one of the first IBI-type programs in Turkey. The purpose of the present study was to investigate the implementation process of the OCIDEP home program with one nine-years- old boy with autism. During the study both qualitative and quantitative data collection and analysis methods were systematically utilized on a regular basis.
Findings of the study were as follows: (a) some of the guidelines did not work or had to be modified, (b) some behavioral and instructional problems occurred during implementation and they were nsolved by various methods, (c) team members made various progress, (d) the participant showed progress in the developmental areas included in the program as well as not included in the program, (e) team members and parents were very impressed overall with the progress of the participant. Moreover, all stakeholders believed that several guidelines should be considered while implementing such programs.
... Findings regarding the fidelity of parent-implemented treatment are mixed. Some studies urge caution when using PT models, as efficacy can be hindered by the quality of parent-implemented treatment, especially as compared with clinician-implemented models (Bibby et al. 2001; Mudford et al. 2001; Symes et al. 2006). Other studies have conversely found high fidelity in PT models (e.g., Koegel et al. 2002; Koegel et al. 1996; Koegel et al. 1991; Laski et al. 1988). ...
The number of individuals with autism spectrum disorders (ASD) diagnoses is increasing rapidly, indicating a need for multi-faceted interventions. The addition of a parent training component to cognitive-behavioral therapy (CBT) has been effectively used to treat a variety of psychological disorders in children to support generalization of skills and to reduce the burden of intensive therapy by using parents as co-therapists. We review these treatments as applied to childhood anxiety, oppositional/conduct, and attention-deficit/hyperactivity problems, as well as ASD-specific treatments that combine CBT with a parent component. The Stress and Anger Management Program, a 9-week emotion regulation treatment for school-aged children with high-functioning ASD, is described here as one example of a group CBT intervention that includes parent training.
... We could find only five studies that addressed this question; four with ABA therapists who worked on home programmes and one with ABA therapists who worked in schools. Hastings and Symes (2002) collected data from 85 mothers who were also part-time therapists for their child's home ABA programme. They found that support from the child's home programme team was associated with increased self-reported therapeutic efficacy, whereas increased child autism symptoms and mothers' increased stress were associated with lower self-reported efficacy. ...
Background: Little is known about the work-related well-being of applied behaviour analysis (ABA) therapists who work in school-based contexts and deliver ABA interventions to children with autism. Methods: A questionnaire on work-related stress (burnout), general distress, perceived supervisor support and coping was completed by 45 ABA therapists across six schools in the UK. Results: Around 42% of ABA therapists reported low levels of personal accomplishment at work, 13% reported high levels of emotional exhaustion and 40% met criteria for experiencing high levels of general distress. Wishful thinking coping was predictive of higher emotional exhaustion burnout and depersonalisation, and lower personal accomplishment. Conclusions: Given that a wishful thinking approach to coping may contribute to experiencing stress at work, it is important to consider support interventions for ABA therapists that may enhance their well-being. Mindfulness and acceptance-based strategies in particular may be relevant to the support of ABA therapist well-being.
... Parental belief in EIBI program efficacy was determined using the Belief in Intensive Behavioral Intervention (BIBI) scale. The BIBI is a 13 item scale, measuring the independent factors of ''General Beliefs in the interventions efficacy'' and ''The Belief that this method is appropriate and beneficial specifically for My Child'' (Hastings & Johnson, 2001;Hastings & Symes, 2002;Solish & Perry, 2008). This scale was converted to a Likert scale (0 = strongly disagree, to 4 = strongly agree). ...
Little is known on how the conceptual description of Shared Decision Making (SDM) accomplishes clinical practice in the context of lifetime disabilities as in particular Autism Spectrum Disorders (ASD), when intervention is long-lasting and requires constant family involvement. This study aimed mainly to investigate to what extent the staff's competence in SDM contributes to positive child and parent improvement when involving parents in Early Intensive Behavior Interventions (EIBI). It was also geared to verify whether SDM staff competence contributes to a child's treatment responsiveness. A total of 25 young children with ASD (23 male, 3 female, age range 34-92 months, mean age 51.4±13.6) were included in the study. Of these, nine children were allocated to a Parent Involvement condition accompanied by SDM Staff Training (PI-SDM), and eight children to a Parent Inclusion in Treatment Delivery Only condition without SDM Staff Training (PI-DO). Nine months treatment outcomes of severity, developmental and adaptive measures were compared to Treatment As Usual (n=8). PI-SDM was associated with improvement of autistic symptoms (p≤.05), adaptive functioning (p≤.01) and developmental outcome (p≤.01), as well as parent (p≤.05) and staff competence (p≤.001). The magnitude of outcome was inferior in the PI-PO and TAU group. A Reliable Change was identified in more than 40% of children included in PI-SDM, while PI-PO (>20%) and TAU (>12%) let to little Reliable Change and partially skill deterioration. Staff's SDM skill competence predicts reduced parental stress (β=-.500, p≤.05) and contributes significantly to a positive treatment responder trajectory (p≤.01), besides lower severity (p≤.05), higher adaptive (p≤.01) and communication skills (p≤.05). The study indicates that parent inclusion should be conceptualized as a collaborative partnership model rather than as adherence in treatment provision, based on a target SDM staff training that may constitute an external contributor to treatment responsiveness and positive child as well as parent outcome.
Copyright © 2014 Elsevier Ltd. All rights reserved.
Research has shown that parents of children with autism spectrum disorder (ASD) experience high levels of anxiety. The type of disorder and demographic characteristics of the parents can affect anxiety levels. However, parent counseling programs can have a positive impact on parents' effectiveness in their role, which can positively affect their mental health. This study aims to investigate the anxiety levels of parents of children with autism, the impact of counseling programs on parental anxiety, and how demographic characteristics of the parents can affect anxiety levels. The sample consisted of 101 parents of children with ASD attending primary schools across Greece. The data for this study was collected through a questionnaire which included demographic information, questions about the counseling intervention, and the Parenting Stress Index Short-Form scale. The results indicated that the overall level of parental stress was relatively high and that the parents' demographic characteristics influenced the subscales of the Parenting Stress scale. The parents with higher education levels experienced the highest levels of distress, and the highest levels of dysfunctional interaction were observed in parents over 40 years of age and in divorced or unmarried parents. Nearly half of the participants in the study had undergone counseling therapy, which had a predominantly positive impact on improving parent-child interaction. The findings suggest that demographic factors significantly affect levels of parental anxiety and that parents who expressed a desire to enhance their role as caregivers through counseling therapy also reported higher levels of anxiety. Overall, the results highlight the potential benefits of counseling therapy in addressing dysfunctional parent-child interactions and improving parental well-being.
Negli ultimi due decenni la valutazione dei sistemi scolastici ha visto un crescente interesse, anche
rispetto al concetto di inclusione scolastica, che risulta sottorappresentata.
Lo scopo del lavoro è fornire un quadro sulla valutazione dell'inclusione scolastica e sugli strumenti
per misurarne gli effetti e l'impatto a livello europeo, guardando a tutti gli attori coinvolti in questo
processo così complesso.
La ricerca sviluppata all’interno di un progetto di ricerca europeo, è stata condotta a partire dallo
strumento PICOS (Methley, Campbell, Chew-Graham, McNally e Cheraghi-Sohi, 2014), per strutturare
una revisione della letteratura e per identificarne i focus.
Otto articoli sono stati inclusi e analizzati narrativamente nella sintesi qualitativa. Gli studi sono stati
organizzati intorno a cinque categorie che hanno permesso di codificarli rispetto alle tematiche e
alle questioni ancora aperte.
La revisione evidenzia la necessità di stabilire criteri e indicatori di valutazione comuni per l’inclusione
scolastica, al fine di costruire una collaborazione efficace a tutti i livelli del sistema educativo
(politica, leadership e utenti finali).
Per
هدفت الدراسة لوضع برنامج تدريبي لتنمية بعض المهارات النفسية والاجتماعية للطالبات المعاقات عقليا المدمجات ببرامج التربية الفكرية بمدينة تبوك، واستخدمت الباحثة المنهج التجريبي على عينة قوامها (60) طالبة، حددت بدرجة ذكاء (50-70) درجة، تراوحت أعمارهن بين (11-14) سنة، وقامت الباحثة بتصميم أدوات الدراسة، توصلت النتائج إلى وجود فروق ذات دلالة إحصائية في مستوى المهارات النفسية والاجتماعية للطالبات المعاقات عقليا بالمجموعتين التجريبية والضابطة بعد الانتهاء من تطبيق البرنامج لصالح المجموعة التجريبية، كما وجدت فروق ذات دلالة إحصائية في مستوى المهارات النفسية والاجتماعية للطالبات المعاقات عقليا بالمجموعة التجريبية قبل وبعد تطبيق البرنامج المقترح عليهن لصالح القياس البعدي، كذلك لا توجد فروق ذات دلالة إحصائية في مستوى المهارات النفسية والاجتماعية للطالبات المعاقات عقليا بالمجموعة التجريبية في (الدراسة التتبعية)، وقد تمت مناقشة النتائج وسرد عدد من التوصيات والبحوث العلمية المقترحة.
Active school travel (AST) is an important source of physical activity for children and a conceptual understanding of AST is necessary to inform promotion efforts. The aim of this paper is to provide a conceptual analysis of AST. All currently identified AST formulations include intra-individual variables which are often recommended as intervention targets. However, existing literature lacks clarity on precisely how these intra-individual variables might shape specific AST interventions. Moreover, evaluative studies of AST interventions typically fail to specify an underpinning theory or model. To address this limitation, the Behavioural Ecological Model (BEM), not previously addressed in AST, is presented to guide this area of research. Based on specific examples, we draw attention to the role of potential antecedents and potential reinforcers of AST, as well as potential reinforcers of motorised travel. Antecedents and reinforcers may help to explain choices of school travel mode, and to inform and increase intervention options to promote AST. Consistent with the BEM, the provision of more immediate consequences, such as fun and material prizes, is an evidence-based strategy for increasing AST which is likely to be low-cost and easier to deliver than alternative interventions. This approach to the study of AST is expected to contribute to similar analyses in this and other areas of behaviour change research, and to a more useful discussion and treatment of theoretical and conceptual behavioural models.
In the past, the behaviours and personalities of mothers have been identified as potential causes of autism. More recently, other etiological hypotheses have been used to explain autism spectrum disorder, suggesting that this specific type of mother-blaming is now uncommon. However, some authors have pointed out that mothers are still being held responsible for their children’s condition and behaviours, as they are now expected to extensively promote their children’s development. The present article explores contemporary forms of mother-blaming experienced by thirteen mothers of children with autism spectrum disorder. The results are discussed in relation to the consequences of mother-blaming, such as social isolation and health related problems. It is hoped that this article will encourage social workers and professionals to understand the mothers’ perspectives and to recognize the importance of supporting them without generating or increasing mother-blaming.
This chapter describes what we know about the burdens families face because a child is diagnosed with ASD. The chapter is deliberately one-sided focusing only on burdens. Parents of children with ASD earn less money, have higher expenses, have higher stress, smaller support networks, more anxiety, and considerable difficulties accessing child care, after-school care, and community services, as well as obtaining needed services at school. We estimate that raising a child with ASD costs at least twice the cost of raising a typically developing child. In practice, burdens in various domains of life are highly interrelated; thus, it is not unusual that a burden in one area (e.g., child care) may result in additional burdens in other areas (e.g., employment, schooling). Wise policy design takes into account the compounding impact of numerous burdens across multiple, often disconnected, systems; the wide heterogeneity of ASD; and the family ecology.
This chapter examines the relationships between parents and their child with an autism spectrum disorder (ASD), focusing particularly on parenting stress and limit-setting behaviors. It summarizes the literature on the “lived experience” of parents of children with ASD and places these experiences in relation to models describing interactions between parenting stress, parenting behaviors, and child behaviors. The literature suggests there is no intrinsic difference between parents of children with ASD and typically developing children. Rather, parents of children with ASD experience very high stress, which disposes them to focus on negative aspects of their child’s behavior and sometimes to use less positive-parenting practices, which, in turn, affect the problem behaviors of children.
Parental influence in child development in children with autism spectrum disorder is increasingly recognized as important. The primary aim of this systematic mixed method review was to systematically examine the psychological constructs of competence, control, and self-efficacy in the autism literature to assess their relevance for understanding self-perceptions of parents of children with autism. This review illustrates that self-efficacy can be merged into competence and the emergence of the coherence construct. Competence, control, and coherence are vitally important core concepts for understanding parents of children with autism. A unified nomenclature based upon the overarching concept of self-perception would organize the most pivotal constructs much more clearly and reduce redundancies. Specifically, the concept of “parental self-perception” is the most promising candidate for this superordinate concept.
A pesquisa apresentada neste artigo teve por objetivo replicar o experimento sobre formação de conceitos proposto por Vigotski. O experimento investigava o desenvolvimento e a organização do pensamento conceitual na população adulta. Na presente pesquisa a amostra foi composta por 20 estudantes universitários de diversos cursos, de idades entre 18 e 24 anos. O instrumento de coleta de dados foi um conjunto de vinte e dois blocos de madeira de cores, formas, alturas e larguras diferentes que tinham em sua base palavras sem um significado previamente conhecido pelos participantes, e este significado o experimento deveria identificar. A aplicação do instrumento foi registrada em vídeo para posterior análise. Observou-se na aplicação do instrumento que não houve regularidade em relação às etapas percorridas durante a formação do conceito, mas foi possível identificar o papel da linguagem no processo de generalização.
Objective. Coparenting quality has been linked to both parenting stress and parenting self-efficacy in families of typically developing children, but little is known about relations between these factors in families where there is a child with an autism spectrum disorder (ASD). This study employed structural equation modeling to explore relations among coparenting quality, autism-specific parenting self-efficacy, and parenting stress in mothers and fathers of children with an ASD. Design. A cohort of biological mothers (n =80) and fathers (n = 72) who were caring for their young child (age < 13) with a diagnosed ASD self-completed validated surveys assessing parenting stress, coparenting quality, and autism-specific parenting self-efficacy. Results. Both mothers and fathers reported high and similar levels of parenting stress which shared predictive relations with both coparenting quality and autism-specific parenting self-efficacy. Structural equation modelling demonstrated that the relations between perceptions of autism-specific parenting self-efficacy and parenting stress were mediated by coparenting quality. Conclusion. Coparenting quality shares an important relation with parenting stress in both mothers and fathers of children with an ASD, and enhanced perceptions of autism-specific parenting self-efficacy are unlikely to influence parenting stress when parents experience poor quality coparenting.
Autism is a serious psychological disorder with onset in early childhood. Autistic children show minimal emotional attachment, absent or abnormal speech, retarded IQ, ritualistic behaviors, aggression, and self-injury. The prognosis is very poor, and medical therapies have not proven effective. This article reports the results of behavior modification treatment for two groups of similarly constituted, young autistic children. Follow-up data from an intensive, long-term experimental treatment group (n = 19) showed that 47% achieved normal intellectual and educational functioning, with normal-range IQ scores and successful first grade performance in public schools. Another 40% were mildly retarded and assigned to special classes for the language delayed, and only 10% were profoundly retarded and assigned to classes for the autistic/retarded. In contrast, only 2% of the control-group children (n = 40) achieved normal educational and intellectual functioning; 45% were mildly retarded and placed in language-delayed classes, and 53% were severely retarded and placed in autistic/retarded classes.
In this article, we attempt to distinguish between the properties of moderator and mediator variables at a number of levels. First, we seek to make theorists and researchers aware of the importance of not using the terms moderator and mediator interchangeably by carefully elaborating, both conceptually and strategically, the many ways in which moderators and mediators differ. We then go beyond this largely pedagogical function and delineate the conceptual and strategic implications of making use of such distinctions with regard to a wide range of phenomena, including control and stress, attitudes, and personality traits. We also provide a specific compendium of analytic procedures appropriate for making the most effective use of the moderator and mediator distinction, both separately and in terms of a broader causal system that includes both moderators and mediators. (46 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
In this article, we attempt to distinguish between the properties of moderator and mediator variables at a number of levels. First, we seek to make theorists and researchers aware of the importance of not using the terms moderator and mediator interchangeably by carefully elaborating, both conceptually and strategically, the many ways in which moderators and mediators differ. We then go beyond this largely pedagogical function and delineate the conceptual and strategic implications of making use of such distinctions with regard to a wide range of phenomena, including control and stress, attitudes, and personality traits. We also provide a specific compendium of analytic procedures appropriate for making the most effective use of the moderator and mediator distinction, both separately and in terms of a broader causal system that includes both moderators and mediators.
The measurement of stress in families of developmentally delayed or mentally retarded children has been a difficult task. The Questionnaire on Resources and Stress (QRS, Holroyd, 1974) was designed to answer this need, but the length and psychometric weaknesses of this instrument have interfered with more widespread usage. In the present investigation, data from 289 QRSs were item analyzed, and 52 items emerged as most reliable, forming a short form of the QRS. These items were factor analyzed, and four distinct factors were found: Parent and Family Problems, Pessimism, Child Characteristics, and Physical Incapacitation. The correlation between the total scores of the QRS and this short form was .997. In Study 2 initial efforts at concurrent validation of this short form were reported.
The psychometric properties of a 5-item subcomponent (DEP5) of Factor 1, Parent and Family Problems, of the Friedrich Questionnaire on Resources and Stress were examined to determine whether these items formed a depression subcomponent of the larger family stress factor. Data were pooled from two samples numbering more than 450 respondents. Internal analyses established that the DEP5 had adequate internal reliability and stability over 2 years. Furthermore, confirmatory factor analyses indicated that the DEP5 measured depressive reactions as distinct from other parent and family problems. These results should be useful to researchers who want to reanalyze the Questionnaire on Resources and Stress data specifically for depressive reactions. Also, the technique for disaggregating global instruments can be applied to other variables.
From archival records, we assessed outcomes achieved by preschoolers with both severe mental retardation and autistic features: (a) an experimental group (n = 11), which received intensive behavioral treatment, and (b) a comparison group (n = 10), which received minimal treatment. At intake (mean CA = 3.08 years), the groups did not differ significantly on any variable. At follow-up children in the experimental group obtained a higher mean IQ and evinced more expressive speech than did those in the comparison group. Behavior problems diminished in both groups. Results indicate that intensively treated children achieved clinically meaningful gains relative to the comparison group but remained quite delayed.
This study evaluated the impact of intensive behavioral treatment on the development of young autistic children. The treatment reported in this study was home based and was implemented by parents of autistic children with the assistance of community-based clinicians. Although treatment was unable to be observed directly, parents reported that therapy was based on methods developed by Lovaas et al. (1981). Treatment differed from that described in previous reports of intensive behavior therapy for this population in that it was implemented outside an academic setting and for a shorter period. In addition, children received fewer hours per week of therapy than in previous reports. Children in the experimental treatment group were pairwise matched to children in a control group (who received conventional school-based and brief one-on-one interventions) on the basis of pretreatment chronological and mental age, diagnosis (autism vs. PDD), and length of treatment. The groups did not differ on pretreatment IQ. Children receiving the experimental treatment had significantly higher posttreatment IQ scores. Smaller, but still statistically significant effects on symptom severity were also found, though experimental subjects still met diagnostic criteria for autism or PDD.
The predictive power of age and IQ at time of admission to an intensive treatment program using applied behavior analysis were examined in a 4- to 6-year follow-up of educational placement. Twenty-seven children with autistic disorder who were between the ages of 31 and 65 months and had IQs on the Stanford Binet between 35 and 109 at time of admission to the Douglass Developmental Disabilities Center were followed up 4 to 6 years after they left the preschool. The results showed that having a higher IQ at intake (M = 78) and being of younger age (M = 42 months) were both predictive of being in a regular education class after discharge, whereas having a lower IQ (M = 46) and being older at intake (M = 54 months) were closely related to placement in a special education classroom. The results are interpreted as pointing to the need for very early intervention for children with Autistic Disorder. It is also emphasized that older children and those with lower IQs in the present study showed measurable gains in IQ from treatment. The data should not be taken to suggest that children older than 4 years of age do not merit high quality treatment.
Applied behavior analysts have developed many effective interventions for common childhood problems and have repeatedly demonstrated that childhood behavior responds to properly managed contingencies. The success of these interventions is dependent upon their basic effectiveness, as demonstrated in the literature, their precise delivery by the clinician to the parent, and adherence to or consistent implementation of the intervention. Unfortunately, arranging the consistent implementation of effective parenting strategies is a significant challenge for behavior analysts who work in homes, schools, and outpatient or primary care clinics. Much has been done to address issues of adherence or implementation in the clinic, but relatively little has been done to increase our understanding of the contingencies that affect parental adherence beyond the supervised clinic environment. An analysis of the contingencies that strengthen or weaken adherence might suggest strategies to improve implementation outside the clinic setting. What follows is an analysis of the variables associated with adherence by parents to recommendations designed to solve common childhood problems.
Self-efficacy has been identified in the general parenting literature as an important variable affecting parent outcomes. In the present study, 26 mothers and 20 fathers of children with autism reported on their self-efficacy, anxiety, and depression. Teachers rated the behavior problems of the children. Regression analyses showed that self-efficacy mediated the effect of child behavior problems on mothers' anxiety and depression, but there was no evidence that it functioned as a mediator for fathers. However, there was evidence that self-efficacy moderated the effect of child behavior problems on fathers' anxiety. No evidence for the moderating effect of self-efficacy was apparent for mothers. Methodological issues and the theoretical and practical implications of these results are discussed
Parent-managed behavioral interventions for young children with autism are under-researched. We analyzed data from 66 children served by 25 different early intervention consultants. After a mean of 31.6 months of intervention IQ scores had not changed (N = 22). Vineland adaptive behavior scores had increased significantly by 8.9 points (N = 21). No children aged > 72 months attained normal functioning, i.e., IQ > 85 and unassisted mainstream school placement (N = 42). Progress for 60 children across 12 months was found for mental age (5.4 months), adaptive behavior (9.7 months), and language (5.1 months). The interventions did not reproduce results from clinic-based professionally directed programs. The effectiveness of the parent-managed intervention model as it has developed and the adequacy of professional services in that model are discussed.
The potential for burnout among workers in developmental disabilities has been a frequent concern. In the present study, self-reported levels of burnout (Maslach Burnout Inventory scores) were correlated with measures of staff activity and commonly cited behavioral effects of burnout. Seventy-nine direct care staff from five facilities serving the developmentally disabled were given the MBI and a brief questionnaire. Data were also collected on absenteeism and tardiness and a time sampling procedure was employed to assess staff activity. Of 102 correlations between the MBI and demographic, self-report, and behavioral measures, only 5 were statisticaly significant at the .05 level. Of 55 correlations among 11 staff activities, 22 were statistically significant. The activity correlations revealed two distinct patterns. The two activities involving positive direct client contact were negatively correlated with the four activities involving negative client contact or the absence of client contact. Staff who engaged in much negative client contact were also likely to avoid client contact and engage in little positive client contact. Staff exhibiting such behavior patterns would be described as burned out with respect to job performance. Given the limited relationship between self-reports of burnout and staff performance, it would seem prudent to include some direct observation of staff behavior in burnout research.
The Autism Behavior Checklist (ABC), an assessment instrument for autistic individuals, was evaluated in a group of 157 subjects, 94 clinically autistic and 63 nonautistic. The two groups differed significantly in ratings of pathology. Both false positive and false negative diagnostic classifications were made when the results of the checklist were compared with clinical diagnosis. Effects of developmental level and age were observed. The ABC appears to have merit as a screening instrument, though results of the checklist alone cannot be taken as establishing a diagnosis of autism. Important issues of reliability and validity remain to be addressed.
Parents are becoming influential stimulators and shapers of public policy in regard to educational services for their children. Increasingly, this advocacy has created a controversy about the role of applied behavior analysis as a foundation for early intensive behavioral intervention in autism. Uncertainties exist in policy regarding the role of behavior analysis in early intervention and the capacity of behavior analysis to field a trained work force. Based on contacts with parents of children with autism and information available in a variety of forms on the Internet, there is a rising demand for fundamentally better early intervention services that are available and accessible, provide active intervention, and are based on principles of behavior analysis. Contemporary movements in special and early education, however, appear to be nonconducive to scientifically based treatments, and school districts seem hostile to an increasing role for behavior analysis and to the establishment of services that are responsive to changing parental priorities for the education of their children with autism and related disorders.
The influence that children's behavior has on changing the behavior, cognitions, or affect of adults is an important but often overlooked factor in clinical interventions with children. Children's behavior often plays a prominent role in maintaining patterns of adult-child interactions that are detrimental to the child's healthy psychological adjustment. Recognition of such child-effects holds important implications for improving assessment and follow-through in adult-mediated behavior change programs. This recognition also suggests that children can act as the primary change agent in certain interventions, a strategy that may serve to empower children while enhancing their perceptions of control. In general, the concept of reciprocal influence in adult-child interactions underscores the importance of the emerging concept of behavioral family therapy.
This study compared the treatment outcomes of nine autistic children who began receiving intensive behavioral intervention prior to 60 months of age with outcomes for nine other children who entered the same intervention program after 60 months of age. The 18 children in the sample included all of the children served by the Princeton Child Development Institute's day school and treatment program during the period 1975–83 who were diagnosed autistic and who had either (a) achieved positive discharge or (b) been enrolled in the program for 24 months or longer and continued to receive program services. Age at program entry was found to be strongly related to positive treatment outcome (i.e., to children's continued residence with their natural parents and attendance at public school classes). This investigation underlines the importance of early behavioral intervention for autistic children.
The effects of problem behavior displayed by two groups of children with developmental disabilities was investigated. One group of children exhibited problem behavior under conditions of low adult attention and was referred to as the attention-seeking or AS behavior profile group. A second group of children exhibited problem behavior under conditions of high adult attention and was referred to as the socially avoidant or SA behavior profile group. A third group of nonproblem children (NP) was examined for comparison purposes. Pairs of children were placed in a teaching situation, and the effects of child problem behavior upon adult instructional behavior were measured. Results indicated that child behavior affected adult behavior and that different child behavior profiles affected adults differentially. Adults responded to the problem behaviors of the AS behavior profile group by increasing attention, providing higher levels of physical contact, and presenting academic tasks that required continuous adult-child interaction. Conversely, the same adults responded to the problem behaviors of the SA behavior profile group by reducing attention, providing lower levels of physical contact, and presenting academic tasks that required little adult-child interaction. The data indicated that these child effects were powerful, immediate, and durable. Theoretical implications concerning reciprocal social influence and the operant theory of child problem behavior are discussed. Applied implications concerning treatment selection and maintenance are also explored.
Applied behavior analysts have focused on how adults can influence the problem behavior of children using a variety of behavior modification strategies. A related question, virtually unexplored, is how the behavior problems of children influence adults. This child-effects concept was explored empirically in a study involving 12 adults who were asked to teach four pairs of children in which one member of the pair exhibited problem behavior and the other typically did not. Results demonstrated that problem children displayed tantrums, aggression, and self-injury contingent on adult instructional attempts but not at other times, whereas nonproblem children showed little or no problem behavior at any time. Importantly, from a child-effects perspective, adults engaged in teaching activities with nonproblem children more often than with problem children. Also, when an adult worked with a problem child, the breadth of instruction was more limited and typically involved those tasks associated with lower rates of behavior problems. The implications of these results are discussed with respect to theories of escape behavior, current assessment practices, and intervention issues related to maintenance. The existence of child effects suggests that problem behavior may be better understood when it is conceptualized as involving a process of reciprocal influence between adult and child.
The psychometric properties of the Autism Behavior Checklist (ABC; Krug, Arick, & Almond, 1980a, 1980b), a 57-item screening checklist for autism was investigated. Professional Informants completed the ABC on 67 autistic and 56 mentally retarded and learning-disabled children. The autistic children were the total population of autistic children aged 6-15 in two circumscribed suburban and rural regions. Using the total score, the ABC accurately discriminated 91% of the children, with 87% of the autistic and 96% of the nonautistic group correctly classified. Moreover, the accuracy of classification was virtually identical when only the more heavily weighted checklist items were used. A 3-factor model accounted for 32% of the total variance in the checklist. Seventeen items loaded .4 or more on Factor 1, 12 items loaded on Factor 2, and 10 items loaded on Factor 3. The present results fail to provide empirical support for a single unidimensional scale for autism. Also, there is little support for subdividing the checklist into five subscales based on symptom areas.
Reliability and validity of three commonly used autism scales, the Autism Behavior Checklist (Krug, Arick, & Almond, 1980), the Real Life Rating Scale (Freeman, Ritvo, Yokota, & Ritvo, 1986), and the Childhood Autism Rating Scale (Schopler, Reichler, & Renner, 1988), were investigated. Data analyses were based on completed protocols for 24 children or adolescents who met DSM-III-R criteria for pervasive developmental disorders. First, to replicate previous findings, interrater reliability of each of the two direct observational scales was assessed. Second, correlations between pairs of the three scales were calculated. Third, diagnostic classifications based on autism scale cutoff scores were compared to classifications based on DSM-III-R criteria. Fourth, relationships between autism scale scores and adaptive behavior scores were investigated. Results and implications for the use of these scales in the assessment of autistic behaviors are discussed.
Autism is a serious psychological disorder with onset in early childhood. Autistic children show minimal emotional attachment, absent or abnormal speech, retarded IQ, ritualistic behaviors, aggression, and self-injury. The prognosis is very poor, and medical therapies have not proven effective. This article reports the results of behavior modification treatment for two groups of similarly constituted, young autistic children. Follow-up data from an intensive, long-term experimental treatment group ( n = 19) showed that 47% achieved normal intellectual and educational functioning, with normal-range IQ scores and successful first grade performance in public schools. Another 40% were mildly retarded and assigned to special classes for the language delayed, and only 10% were profoundly retarded and assigned to classes for the autistic/retarded. In contrast, only 2% of the control-group children ( n = 40) achieved normal educational and intellectual functioning; 45% were mildly retarded and placed in language-delayed classes, and 53% were severely retarded and placed in autistic/retarded classes. (31 ref)
An autism checklist was developed with behaviors selected from a variety of checklists and instruments used to identify autism. Content validity of the behaviors was established, and 3000 of the checklists were sent throughout the United States and Canada to professionals acquainted with handicapped children. 1049 checklists completed on individuals 18 months to 35 years old were returned. A chi-square analysis indicated that 55 of the 57 behaviors listed were significant predictors of autism (P<0.001) when compared to severe mental retardation. A weighted score, determined by statistics (4 indicating the highest predictor of autism, 1 the lowest), was assigned to each other.
After a very intensive behavioral intervention, an experimental group of 19 preschool-age children with autism achieved less restrictive school placements and higher IQs than did a control group of 19 similar children by age (Lovaas, 1987). The present study followed-up this finding by assessing subjects at a mean age of 11.5 years. Results showed that the experimental group preserved its gains over the control group. The 9 experimental subjects who had achieved the best outcomes at age 7 received particularly extensive evaluations indicating that 8 of them were indistinguishable from average children on tests of intelligence and adaptive behavior. Thus, behavioral treatment may produce long-lasting and significant gains for many young children with autism.
Maintenance of behavior change has been considered a crucial, through largely unrealized, goal of behavioral interventions. One often overlooked factor is that before interventions can be successful and durable, the intervention protocol must be implemented as planned. This study investigated the effects of child behavior problems on the maintenance of intervention fidelity by teachers across two intervention protocols: escape extinction and functional communication training. A high rate of behavior problems during escape extinction appeared to punish teachers' efforts, and fidelity deteriorated. In contrast, there was a low rate of behavior problems during functional communication training. Teachers maintained high protocol fidelity and those sessions were less stressful and more productive. We propose that intervention protocols can be differentiated by the costs associated with implementing them faithfully. Protocols designed to be user friendly will be more likely to produce high fidelity, and therefore, durable intervention gains.
Direct care staff working in six residential group homes for people with intellectual disability were asked to complete a questionnaire which asked for information on levels of stress (anxiety and depression), the types of demand experienced by the staff, the support they received and the constraints they faced at work. Staff were also observed at work using a schedule which detailed who they interacted with, the content and type of interaction, and what activities staff were involved in. Measurement of workers' anxiety and depression levels confirmed management assessments of staff stress levels in the homes: two residential group homes were classified as 'low stress' and four as 'high stress'. A number of differences emerged between the two groups. Staff in the high stress homes reported greater demands and less support than those in the low stress homes. Higher levels of interaction were found between staff and residents in low stress houses, where more of the interaction was given as assistance and positive interactions. However, activities in higher-stress group homes appeared to be more community oriented, with staff spending a much greater amount of time out of the house. The importance of these results for both staff and residents is discussed, and suggestions for further work are made.
We examined parent-directed, intensive early intervention for children with Pervasive Developmental Disorder. Children's parents recruited paraprofessional therapists and requested consultations on how to implement the UCLA treatment model in their homes (Smith & Lovaas, 1998). Parents and therapists then received six one-day workshops over a five-month period, with additional consultations for the next 2-3 years. Six boys participated (intake age 35-45 months, intake IQ 45-60). The study addressed 1) the children's skill acquisition during the first five months of treatment; 2) outcome 2-3 years later; 3) treatment quality; and 4) parents' impressions. Five of 6 children rapidly acquired skills when treatment began, but only 2 clearly improved on standardized tests at the 2-3 year follow-up. Therapists usually employed correct treatment procedures but were less consistent than therapists employed at a clinic. Parents reported high satisfaction with treatment. These mixed results highlight the need for multimodal assessment of parent-directed treatment.
Early intensive behavioral intervention for autism has attracted controversy since Lovaas (1987) reported that 47% of his experimental group attained normal functioning. We summarize child and program data from 75 children receiving EIBI in the UK. The majority of children (57%) started treatment later than in Lovaas (1987), and 16% did not exceed his minimum IQ criterion. Children experienced fewer hours of treatment (mean of 32 hours vs. 40 hours per week), and their programs received relatively infrequent supervision. 21% of programs received supervision from individuals currently accredited as competent to provide Lovaas's treatment. No child started early enough, and received 40 hours per week, and had accredited supervision. Due to these variations from his model, Lovaas (1987) findings are unlikely to be replicated for this sample of children.
There is increasing international interest in intensive home-based behavioral intervention for children with autism. In the present study, 141 UK parents conducting such interventions completed a questionnaire addressing issues of stress, coping, and support. Regression analyses showed that parents' stress levels were predicted mainly by psychological rather than demographic variables. In particular, adaptive coping strategies, informal social support sources, and beliefs about the efficacy of the intervention were associated with lower reported stress and higher levels of autism symptomatology were associated with higher reported stress. There was also evidence that the use of Passive Appraisal coping and beliefs about the efficacy of the interventions moderated the effects of autism symptomatology on parents' pessimism. Implications of these findings for future research and for the support of families engaged in intensive home-based behavioral intervention are discussed.
Background Theoretical models and emerging empirical data suggest that the emotional reactions of staff to challenging behaviours may affect their responses to challenging behaviours and their psychological well-being. However, there have been few studies focusing on factors related to staff emotional reactions.
Methods Seventy staff working in educational environments with children with intellectual disability and/or autism completed a self-report questionnaire that measured demographic factors, behavioural causal beliefs, behavioural knowledge, perceived self-efficacy, and emotional reactions to challenging behaviours.
Results Regression analyses revealed that behavioural causal beliefs were a positive predictor, and self-efficacy and behavioural knowledge were negative predictors of negative emotional reactions to challenging behaviours. Staff with formal qualifications also reported more negative emotional reactions. No other demographic factors emerged as significant predictors.
Conclusions The results suggest that behavioural causal beliefs, low self-efficacy and low behavioural knowledge may make staff vulnerable to experiencing negative emotional reactions to challenging behaviours. Researchers and clinicians need to address these issues in staff who work with people with challenging behaviours.
Although international interest in intensive home-based early behavioural intervention for children with autism is increasing, there is little or no published research on the experiences of families conducting these programmes.
One hundred and forty-one UK parents conducting Lovaas-style interventions with their young child with autism were asked to identify factors that acted as facilitative factors and barriers to the implementation of these programmes. Parents responded to written questions contained within a questionnaire survey, and their responses were subjected to a content analysis procedure.
Several of the facilitative factors and barriers were found to be similar. For example, a supportive therapy team was the most frequently cited facilitative factor, and problems recruiting and maintaining a suitable team was the most frequently reported barrier. Other factors seemed to be more independent constructs. For example, an important barrier was the lack of time and personal energy, but plenty of time and energy was not cited as a facilitative factor.
The practical implications of these results for families and for services supporting families engaged in intensive early behavioural intervention are discussed. In addition, more general implications for the designers of behavioural intervention programmes are identified.
Self-efficacy has been identified in the general parenting literature as an important variable affecting parent outcomes. In the present study, 26 mothers and 20 fathers of children with autism reported on their self-efficacy, anxiety, and depression. Teachers rated the behavior problems of the children. Regression analyses showed that self-efficacy mediated the effect of child behavior problems on mothers' anxiety and depression, but there was no evidence that it functioned as a mediator for fathers. However, there was evidence that self-efficacy moderated the effect of child behavior problems on fathers' anxiety. No evidence for the moderating effect of self-efficacy was apparent for mothers. Methodological issues and the theoretical and practical implications of these results are discussed.
Parent-managed behavioral interventions for young children with autism are under-researched. We analysed data from 66 children served by 25 different early intervention consultants. After a mean of 31.6 months of intervention, IQ scores had not changed (N = 22). Vineland adaptive behavior scores had increased significantly by 8.9 points (N = 21). No children aged >72 months attained normal functioning, i.e., IQ > 85 and unassisted mainstream school placement (N = 42). Progress for 60 children across 12 months was found for mental age (5.4 months), adaptive behavior (9.7 months), and language (5.1 months). The interventions did not reproduce results from clinic-based professionally directed programs. The effectiveness of the parent-managed intervention model as it has developed and the adequacy of professional services in that model are discussed.
The relationship between student behavior change and teacher reactions to the change was investigated. One fifth-grade teacher served as the subject and two students in her class were employed as teacher change agents. In a multiple baseline design, the students' disruptive behavior (the independent variable) was modified without the teacher's knowledge. The teacher's reactions toward the students (the dependent variable) was monitored on several dimensions including: teacher behavior, teacher attitude toward students, and the quality of teacher verbal statements. Results indicated that student behavior change influenced the teacher's behavior. Implications are that students possess potent reinforcing properties for teachers and that students should be trained to be effective students.
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