Autism Speaks Family Services Grant. Final Report. Spanish Parent Training Program. April 2013

Transcription

1 Autism Speaks Family Services Grant Final Report Spanish Parent Training Program April 2013 Dorothea C. Lerman, Ph.D., BCBA-D, Professor of Psychology Mia N. Caccavale, Graduate Assistant Myrene C. Dickinson, Graduate Assistant University of Houston-Clear Lake

2 Project Objectives Teach Spanish speaking parents how to teach skills to their children diagnosed with autism spectrum disorders (ASD) using Applied Behavior Analysis (ABA) principles. Train at least 12 parents on how to use ABA principles with their children. Provide parents with the skills and materials that they need to teach their children. Provide the parents with a safe environment to discuss any questions and concerns about their child and the ABA principles they were learning. Teach at least four bilingual (Spanish-speaking) mental health professionals who provide services to families of children diagnosed with ASD how to teach parents these skills using ABA principles. Provide the parents with English proficiency instruction (ESL) to help them build their reading, writing, and speaking skills to better help their child. Project Steps In February 2012, Dr. Lerman and the graduate assistants developed and distributed an informational packet and recruitment materials in Spanish (i.e., description of training activities, requirements, and timeline) for the training program. The packet was distributed to local mental health agencies, special education departments at area school districts, clinics, and agencies providing services for ASD children and their families. In March and April 2012, Dr. Lerman and the graduate assistants screened and qualified potential program participants, answered questions regarding the program and provided additional information as needed. In May 2012, the educational materials needed for the training program were purchased, and materials (i.e. PowerPoints, handouts, outcome surveys etc.) were finalized. Christine Paul, Director of the UHCL Foreign Language Department, selected an instructor to work with the participants for the ESL component of the program. Also, in May 2012, the graduate students called parents who were selected to begin the first training session in June 2012 to determine whether or not they were still interested and available, as well as schedule their individual sessions. The first 7-week training program started on June 11, On this day, parents were given an English assessment to determine their level of proficiency in reading, writing, and speaking. A weekly, two hour group session occurred once per week. The first hour consisted of an English class, and the second hour consisted of a group lecture and discussion. The

3 graduate student leading the group meeting presented PowerPoint lectures that covered the general principles that were going to be discussed in the parents individual training sessions that week. Each parent and child had a one and a half hour individual session with the graduate students per week. During this time, the skills taught and teaching strategies were individualized for each child. The first group of parents attended these weekly group and individual meetings through June and July The parents were provided with materials (i.e. flashcards, workbooks, board games) to work with their children on skills specific to each child. At the conclusion of the first training program, the parents were given another English assessment to determine if their English had improved. The parents also were asked to complete satisfaction surveys about the both the ABA and English portions of the program. These were then compiled by the graduate student. During July and August 2012, Dr. Lerman and her graduate assistants developed an informational packet, application, and training manual for the professional training component of the program. In August 2012, parents were selected to participate in the second training program. The parents were called to confirm, and they were called back in September to discuss and schedule when they would come in for their individual session. In late August and early September, professionals were contacted to participate in the second training program. Prior to the second training program, Dr. Lerman and the graduate students met with the professionals to determine if they were interested and available to participate in the training program. The second training program started on September 18, 2012 and occurred as described above with some additions and changes. An additional week was added for the ABA portion of the parent training program in order for parents to fill out paperwork and not take away from time during the program. Also, the last English class consisted of two hours -- one hour for class and one hour for assessment. Throughout September, October, and November 2012, parents attended weekly group and individual meetings. The parents were provided with materials (i.e. flashcards, workbooks, board games) to work with their children on skills specific to each child. During the second program, two bilingual professionals participated in the program and were assigned to work with a family, along with the graduate student trainer. The professionals had a one-hour individual session with the graduate student prior to their individual session with the parent and child each week. In the individual sessions with the family, the graduate students were present to provide information, clarification, and feedback to the professionals and the parent, when necessary.

4 During the last individual sessions with the professionals, the graduate assistant provided the professionals with an electronic copy of all materials that were used throughout the training program. During November and December 2012, the graduate students reviewed materials and made edits to PowerPoints and handouts and compiled results of outcome surveys filled out by the parents from the second training group. In addition, parents were chosen and finalized for the final training group. In December, Dr. Lerman and the graduate students met with two additional bilingual professionals to discuss their interest in participating in the final parent training group. They were provided with training materials prior to starting the training program. In early January 2013, parents and professionals were called to set up their individual session times with the graduate assistant for the third parent training program. The first group session of the final training program group was on January 15, At this meeting, the parents took an English assessment, as well as, filled out paperwork about the program pertaining to their children. Throughout January, February, and March 2013, parents attended weekly group and individual meetings. The parents were provided with materials (i.e. flashcards, workbooks, board games) to work with their children on skills specific to each child. Prior to the professional s individual meetings with the parents (each was assigned one family to work with), they met with the graduate assistant to discuss the material that was provided during the group sessions and what would be covered during the individual session with the family that day. During the individual session with the professional and the parent, the graduate assistant would provide feedback to the professional and parent, when needed. The professional conducted the training with the parent, but the graduate students were present for any questions and clarification that was needed. During the last individual sessions with the professionals, the graduate assistant provided the professionals with an electronic copy of all materials that were used throughout the training program. After all training groups were completed, ABA professionals observed pre- and posttraining videos of the parents working with their children and rated the parents on their use of the skills taught. At the conclusion of the last training group, Dr. Lerman and the graduate assistants completed any paperwork that needed to be finished prior to submitting to Autism Speaks.

5 Project Outcomes Teaching Skills A total of 14 parents participated in the parent training program, four during the first session and five during the second and third sessions. At the beginning of the training, all parents scored low in their teaching skills. According to our direct measurement of the parents skills while working with their children, the parents averaged 28% correct prior to training. By the conclusion of the training program, all parents had made improvement in their teaching skills. The parents averaged 67% correct at the end of training. On average, the parents taught their children 5.5 skills at a time, and the parents noted that the children mastered or made a lot of progress in 3.8, on average. Parents completed outcome surveys so that we could determine how prepared they felt before and after the programs to implement the procedures that we taught them (i.e., providing instructions, reinforcement, handling problem behavior). On a 5-point scale (with higher numbers indicating greater preparedness), the average parent rating for the skills was 1.6 before the program and 4.2 after the program concluded. The average acceptability of the teaching strategies used was rated a 5.6 on a scale of one to six (with higher number indicating greater acceptability). ABA professionals watched pre- and post-training videos of the parents working with their children. Using a scale of 1 to 5, they rated how effectively the parents (a) prepared the materials, (b) delivered instructions, prompts, and reinforcement, (c) managed problem behavior, and (d) collected data. Overall, the parents averaged 1.17 prior to training and 2.86 at the conclusion of training. Professionals A total of four professionals were trained during the parent training program. Two professionals were trained during the second training group, and two professionals were trained during the third training group. The results of the outcome satisfaction surveys for the professionals averaged 5.71 on a scale of one to six. Outcome Opinions

6 This was a great program for the parents. It seemed that the parents were really starting to get a hang of the ABA principles as they were leaving the program. It would have been helpful for the parents and the children to have a few extra weeks or an additional session with the parent trainer each week to really have more of an understanding of the ABA principles and feel confident upon leaving the program. Additionally, it would have been helpful for the parents to have a few extra weeks of English classes. Some parents had improved their listening and speaking skills, but it is thought that a few extra weeks would have improved more parents speaking and listening skills. It was great to teach professionals that were unfamiliar with ABA principles. Although, they needed to be in the program for an additional 7 weeks of training. The material was dense, and it would have been helpful for them to do the training a second time. This may have helped their confidence level upon exiting the program. All the professionals expressed that they learned a lot, but thought that going through the program again would have helped them gain a better understanding of some concepts, especially because they planned to use ABA principles that they learned in the training program to teach parents of children that they work with. English Assessments There were 14 families that participated in the parent training program. Out of those 14 parents, 12 of them completed an English assessment prior to each training session and 9 completed the assessment at the conclusion of their participation in the training. The parents were assessed based on their listening and speaking skills. There were three levels for each listening and speaking skills -- beginning, intermediate, advanced -- and were based on the parents scores. According to the pretest, 8 parents had beginning listening skills, 2 had intermediate listening skills, and 2 had advanced listening skills. Six parents had beginning speaking skills, 2 parents had intermediate speaking skills, and 3 parents had advanced speaking skills. Of the 10 parents who completed both pre- and post-tests, the pretest showed that 7 parents had beginning listening skills, 2 had intermediate listening skills, and 1 had advanced listening skills. Six parents had beginning speaking skills, 2 parents had intermediate speaking skills, and 2 parents had advanced speaking skills. The posttest scores showed that 4 parents had beginning listening skills, and 6 parents had intermediate listening skills. Five parents had beginning speaking skills, 4 parents had intermediate speaking skills, and 1 parent had advanced speaking skills.

7 When comparing the pre-tests to the post-tests, 4 parents improved in one area (listening), and 1 parent improved in both listening and speaking. Three parents scored the same in both listening and speaking, and 2 parents scored lower in both speaking and listening. On a satisfaction survey completed by the parents at the end of the training, the English portion of the program was rated, on average, a 4.34 on a scale of one to five (with the higher number indicating greater satisfaction).