Parent-implemented interventions for children with developmental disabilities and delays : challenging behavior and parenting stress.

Abstract

In Study 1, we synthesized the current literature on challenging behavior interventions in community settings and evaluated the intervention effects using the What Works Clearinghouse Single-Case Design Standards (WWC, 2020). The systematic literature review identified 16 studies that evaluated the efficacy of challenging behavior intervention in community settings for children with developmental disabilities. The majority of the studies implemented the challenging behavior interventions in food-based settings (e.g., restaurants and cafeterias), and parents were the primary implementers of these interventions. Of 23 experiments, only one experiment met WWC SCD Standards. In Study 2, we evaluated the effect of parent-implemented functional communication training (FCT) for three participants using a nonconcurrent multiple baseline design. We coached parents of children with developmental delays to implement FCT in the home via telehealth. The study results showed that the parents accurately implemented the assessment and intervention procedures with coaching via telehealth. In addition, parent-implemented FCT effectively reduced challenging behavior and increased manding. In Study 3, we examined the correlation between the Total Stress score, Parental Distress, Parent-Child Dysfunctional Interaction, and Difficult Child subscales of the Parenting Stress Index-4-Short Form (PSI-4-SF) and the Daily Living Skills domain, Internalizing subdomain, Externalizing subdomain, and Critical Items subdomain of the Vineland Adaptive Behavior Scale, Third Edition (Vineland-3). We also examined the correlation between the PSI-4-SF subscales and the child’s age. Finally, we examined whether scores on PSI-4-SF subscales differed based on child diagnosis and family’s socioeconomic status (SES). The study results showed that higher scores on the Externalizing subdomain of the Vineland-3 were significantly correlated with higher scores on the Parent-Child Dysfunctional Interaction subscale of the PSI-4-SF. In addition, higher scores on the Internalizing subdomain of the Vineland-3 were significantly correlated with higher scores on the Difficult Child subscale of the PSI-4-SF. Finally, the Total Stress score and scores on the Difficult Child subscale of the PSI-4-SF differed significantly between the two SES groups. However, due to the relatively small sample size (i.e., 20 families), the results should be interpreted with caution, and there is a need for additional research.