Practicality and Considerations

Transcription

1 Applied Behavior Analysis in The Home: Practicality and Considerations Keri Spielmann, MS BCBA Cynthia Renner

2 Learning Objectives: 1. Identify the differences between home and school settings 2. Strategies and considerations when empowering parents to incorporate Applied Behavior Analysis into their daily life 3. Practitioner considerations when selecting appropriate goals in the home

3 Applied Behavior Analysis in the School vs. Home School Home Structured / predictable environment Daily set schedule of classes Set group of peers Goal selection governed by IEP Clearly defined boundaries Unpredictable Environment Family dynamic Time Management Goal Selection governed by parent concerns Broadened boundaries

4 Maintaining Professional Boundaries Define the scope of responsibilities Siblings Babysitting Maintain confidentiality Do not accept invitations to family events outside of therapy sessions Limit personal conversations Gifts

5 Core Principles Do no harm Respect autonomy Being just/truthful According dignity Treating others with caring and compassion Pursuit of excellence Accepting responsibility Bailey & Burch, 2011

6 Daily Interactions with Family Dual Relationships and Conflicts of Interest (1.06) (b) A behavior analyst refrains from entering into or promising a personal, scientific, professional, financial, or other relationship with any such person if it appears likely that such a relationship reasonably might impair the behavior analyst s objectivity or otherwise interfere with the behavior analyst s ability to effectively perform his or her functions as a behavior analyst, or might harm or exploit the other party. (c) If a behavior analyst finds that, due to unforeseen factors, a potentially harmful multiple relationship has arisen (i.e., one in which the reasonable possibility of conflict of interest or undue influence is present), the behavior analyst attempts to resolve it with due regard for the best interests of the affected person and maximal compliance with these Guidelines.

7 Purpose of the home program: Empower the parents Teach new skills

8 Empowering the Parents : Perspective Listen Perspective Mothers are the primary caregivers for children with disabilities and therefore most subject to the challenges of their disability (Gray and Holden, 1992) Abbeduto, Seltzer, Shattuck et al (2004) : Compare three groups of parents; Downs Syndrome, Autism and Fragile X Most consistent predictors of maternal psychological well being are extent and severity of child behavioral symptoms. Origin and long-term outcomes How long has the child had the diagnosis, how old is the child, do they have siblings?

9 Empowering the Parents : Perspective Perspective cont Mothers of children with ASD have greater reported levels of stress and depression, lower social support, less positive view of their children s future and more distant relationships in comparison to other groups Center for Epidemiological Depression Scale Questionnaire of Resources and Stress (Pessimism on achieving Self Sufficiency) Positive Affect Index Closeness of the mother child relationship Multidimensional Coping Inventory Responding to stressful events Autism Behavioral Checklist Symptoms of behavior

10 Empowering the Parents : Educate Understanding the function of their behavior Not making judgments Educating Modeling Take baby steps behavior changes slowly over time Have no fear of perfection, you ll never reach it - Salvador Dali Long history of reinforcement for parent and child Increase success with small goals Provide steady praise/feedback to the parents Parents have best interest of the child in mind

11 Empowering the Parent What reinforces the parent? Self-stimulatory behaviors impede ability to relate/learn/participate in family dynamic Increasing specific goals in variety of settings Small assignments to work on until next meeting Communicate success as a team Awareness and generalization of skill acquisition Empirically Validated Treatments! National Standards Report Navigating the world of special education

12 Target Selection : Functional Input from the family Functional goals Academic goals vs. family participation Increase independence and family participation Community participation Look at all aspects of the day Routines Eating Leisure Skills Sibling play Down time Formal assessments keep goals individualized Consider other therapies the child is receiving Liaison between providers can increase generalization of skill

13 References Abbeduto, L., Seltzer, M., Shatuck, P., Krauss, M., Orsmond, G., & Murphy, M. (2004). Psychological wellbeing and coping of mothers of youths with autism, down syndrome, or fragile X syndrome. American Journal on Mental Retardation, 109, Bailey, J. & Burch, M. (2011). Ethics for Behavior Analysts 2 nd Edition. Routledge: NY. Gray, D. E., & Holden, W. J. (1992). Psycho-social wellbeing among parents of children with autism. Australia and New Zealand Journal of Developmental Disabilities, 18,