Parent Training: Parent Support vs Parent Mediated Interventions

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Rabia S. Khan, M.S.

DrOmnibus

“If you have tears, prepare to share them now.”  William Shakespeare.

With the expansion of the autism spectrum diagnosis and improved methods of assessments has come an increase (1 in 58) in the prevalence of Autism Spectrum Disorder (ASD). This has resulted in a shortage of trained professionals to provide treatments and a greater need for other types of interventions. One cost-effective and evidence supported approach that is drawing increasing interest is parent training.

In the field of ASD, the exact definition of parent training is unclear. Bearss et al (2015) aims to clarify this in “Parent Training in Autism Spectrum Disorder: What’s in Name?”. The scholarly article provides a taxonomy for parent training programs for autism to characterize its various forms and demonstrate its effectiveness. To begin, Bearss and colleagues divided parent training into two categories: Parent Support (PS) and Parent Mediated Interventions (PMI).

Parent support helps the parent as a caregiver, indirectly benefiting the child. These treatments are broken down further into Care Coordination and Psycho-education. Children with ASD often require care from several health care providers such as Occupational Therapists, Board Certified Behavior Analysts, and Speech Therapists. Organizing appointments takes a significant amount of effort by the parents. Care coordination programs help “parents manage this by connecting them to medical behavioral, alternative education and medical treatments” (Bearss et al, 2015). Psychoeducation educates parents on ASD by providing up-to-date information, guidance about interventions, and realistic expectations for their children’s future. Parents commonly come away from parent training with behavior management strategies, techniques to enhance communication with their children, and decreased stress.

While parent support is knowledge focused, parent mediated intervention focuses on technique with the child being the direct beneficiary of treatments. The two types of PMI are PMI for Core Symptoms and PMI for Maladaptive Behavior. Each of these types are categorized as either primary, in which the parent is activity engaged from the onset of therapy, or complementary, during which the child works mostly with a therapist. Complementary PMI includes parent coaching to aid in the transition of techniques from therapist to caregiver. Hybrid programs involving elements of both types of PMI also exist.

PMI for Core Symptoms involves treatment with the goal of acquiring and improving skills in social interaction, communication, imitation, and play. To transfer learned skills to daily life as seamlessly as possible, most therapy is done in home involving a therapist coaching both parent and child.

PMI for Maladaptive Behavior aims to reduce disruptive behaviors that can cause a child with ASD to fall behind in acquiring important skills. Examples of disruptive behaviors are tantrums, aggression, noncompliance, self-injury, hyperactivity, property destruction, food refusal, sleep disturbance, and toileting problems. Principles of Applied Behavior Analysis (ABA) delivered by behaviorally trained therapists are commonly used. They are highly individualized, time-limited, target specific problems, and have varying degrees of parental involvement.

Since ASD covers a wide range of people with varying needs and skill levels, it is important to have a variety of treatment options to provide individualized care. Because of its many applications, parent training is an option for many children. Dr. Wetherby, a Director at the Autism Institute at Florida State University’s College of Medicine tells Autism Speaks, “We’ve tested a model that any early intervention system should be able to offer to all families of toddlers with autism. It’s affordable, and it’s efficient.”

In my over eight years of work experience; it’s always been challenging to keep track of parents training data and to examine before and after effects of training. Most of professionals tries to help parents with  techniques that will enhance a child’s social engagement, language, play and imitation skills. It is challenging to help parents set appropriate goals for their child, based on developmental milestones, family interests and therapy recommendations. Providing parents with consistent evidence- based training has always been my priority. Experience I gathered over the years came up with an idea of development of product which can address both needs and issues involved in parent training.

Keeping in mind PS and PMI model to help parents with ASD children; DrOmnibus provides an effective tool to address both needs and issues involved in Parent Training. The Dromnibus application is a ready to use resource for parent training. With the parent version of the app, ABA professionals can train parents on programs and their implementation. Therapist can assign trials, and programs to parents which allows them to take data on treatment plans. This, in turn, can increase reliability in data collection.  DrOmnibus Parent gives evidence-based reliable parent training data. It allows professionals to compare results before and after parent training. The video modeling feature of the app allows parents to record problem behaviors or model desirable behaviors to their children. In short, DrOmnibus provides ongoing support for parents to continue uninterrupted therapy services for children with ASD.

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References

Autism Speaks. (2012, July 25). Parent Training Program Shows Clear Gains for Toddlers with Autism. Retrieved from https://www.autismspeaks.org/science/science-news/parent-training-program-shows-clear-gains-toddlers-autism.

Bearss, K., Burrell, T., Steward, L., & Scahill, L. (2015). Parent Training in Autism Spectrum Disorder: What’s in a Name? Clin Child Fam Psychol Rev,18(2), 170-182. doi:10.1007/s10567-015-0179-5.

Rabia S. Khan, MS Applied Psychology, RBT Consultant DrOmnibus ABA Resource Application-USA. Rabia started in Applied Behavior Analysis (ABA) in 2006 while living in Pakistan.  She worked with children for seven years there, while earning her Master’s degree.  However, the limited training and practice opportunities, combined with her passion for helping children, lead her to seek out training in the U.S.  Since 2013, she has resided in Silicon Valley where she provides ABA services across a variety of settings.  Her long-term vision is to pursue a PhD in behavior analysis and to help grow the field of ABA both in the U.S. and in Pakistan.

*Paid content by DrOmnibus.

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