Virtual provision of behavioral analysis skills applied to parents of children with autism spectrum disorders

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The results of a clinical trial published in the Applied Behavior Analysis Journal support the feasibility and effectiveness of a virtual program to teach the principles of Applied Behavior Analysis (ABA) to parents of children with Autism Spectrum Disorder (ASD).

Although study data supports the use of ABA to improve the social and language skills of children with ASD, many children cannot access treatment due to “geographic, economic and time barriers.” The present study aimed to examine the feasibility of training parents to implement ABA on their own, rather than requiring clinic or facility visits.

The study randomized the parents of a child with ASD between treatment (virtual training) or a control (waiting list). Parents on the waiting list were offered access to the virtual program after the end of the study. Administered via a virtual private network, the training program consisted of 9 multimedia modules, each lasting 35 to 60 minutes. The modules covered the principles of behavior analysis, skill acquisition procedures and behavior reduction procedures.


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Parents’ implementation of ABA skills was assessed in game-based virtual work and training environments at 2 times: baseline (pretest) and after completion of training (posttest). A trained clinician used behavioral implementation of skills for work activities (BISWA) and behavioral implementation of skills for play activities (BISPA) dependent measures to assess parent implementation in a simulated virtual environment. Parents in treatment condition were also asked to describe their experiences with virtual ABA.

A total of 25 parents completed the study, of which 21 (84%) were women. The parents’ ages ranged from 26 to 46 years old. Overall, 13 families were assigned to the treatment group and 12 were assigned to the waiting list (control) group.

At baseline, the mean percentage of correctly implemented ABA opportunities on the BISWA was low in the treatment (35% ± 17%) and control (35% ± 15%) groups. The percentage of opportunities implemented correctly was significantly higher at post-test for the treatment group (99% ± 2%), but not for the control group (35% ± 19%).

On BISPA, similar trends were observed. The implementation of the pretest was poor in the treatment (14% ± 10%) and control (9% ± 10%) groups. At post-test, the percentage of correctly implemented opportunities was significantly higher in the treatment group (92% ± 12%), but unchanged in the control group (13% ± 9%).

Parents in the treatment condition showed an improvement in the percentage of skills mastered on BISWA (15 ± 9 to 93 ± 12) and BISPA (0% to 80% ± 29%) during the study. The same was not seen in parents with the controlling condition. The average satisfaction rating with the virtual training program was 6.6 out of 7 possible (range 6.3 to 6.5). Everyone enrolled in the training program indicated that they would recommend the program to others. These data support the feasibility of a virtual ABA training program for parents. Compared to the control group, parents in treatment condition showed better skill implementation during virtual role-play sessions.

Limitations of the study include the small sample size and the fact that parents’ skills were measured in a role-play scenario, rather than directly with their child. However, research suggests that post-workout performance with a buddy is strongly correlated with performance with a child. “The results add to the growing literature on the effectiveness and acceptability of virtual ABA training,” the investigators wrote.

Reference

Fisher WW, Luczynski KC, Blowers AP, et al. A randomized clinical trial of a virtual training program to teach applied behavior analysis skills to parents of children with autism spectrum disorders. J Appl Anal Behavior. 2020; 53 (4): 1856-1875.


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