1. Effects of Parent-Mediated Referent-Based Instruction: A Verbal Behavior Training Package for Young Children with Autism
- Author
-
Janet Sanchez Enriquez
- Abstract
Autism Spectrum Disorders (ASD) are characterized by pervasive impairments, inhibiting social interaction and learning opportunities, often with ensuing behavior challenges (American Psychiatric Association, 2000). Studies estimate that 25-30% of children with ASD do not develop flexible and consistent language (Hinzen et al., 2020; Schaeffer et al., 2023; Tager-Flusberg, 2016;). Communication skills are essential to supporting individuals with ASD to communicate their needs, navigate their chosen environments independently, and establish relationships (Kim et al., 2014). Over the last two decades, advocacy and research organizations in the field of ASD have emphasized the identification and implementation of evidence-based practices and programs. Fortunately, over the past four decades, researchers have identified several practices to address social communication challenges (Chakrabarti, 2017). Naturalistic teaching (NT) and parent-mediated intervention (PMI) are two practices derived from applied behavior analysis that are evidence-based and highly effective language acquisition methods. Extensive research has confirmed the success of these interventions in improving communication, social interaction, and overall developmental outcomes in children with ASD. Caregiver-implemented interventions, often facilitated via coaching, provide families with supportive practice to increase their children's language within natural contexts (Tomeny et al., 2019). By equipping parents with tools, strategies, and support, these interventions leverage the strength of the family unit to facilitate language-rich learning opportunities and connections Binnendyk & Lucyshyn, 2009; Brookman-Frazee, 2004; Dunlap et al., 2006; Kashinath et al., 2006; Lucyshyn et al., 2007; Moes & Frea, 2002). Despite these empirically-supported communication models for ASD and solid evidence supporting NT and PMI, insufficient access to high-quality interventions remains a barrier for families. Barriers such as inequalities in access to services, challenges in customizing training, schedule constraints, and family pressures remain significant concerns for caregivers. In addition, existing programs may be inaccessible to rural populations, inadequately tailored to the cultural and linguistic needs of families, or not economically feasible for those with limited resources (Fleming et al., 2011; Ingersoll et al., 2020). The purpose of this study was to examine the effects of a naturalistic caregiver coaching package on the accuracy of parents' implementation of Referent-Based Instruction (RBI), evaluate their children's verbal behavior repertoires subsequent to intervention, and explore caregivers' experiences in participating in RBI. Results suggest that caregivers improved their fidelity and implementation of RBI procedures following the introduction of the coaching package. Child participants' communicative repertoires increased after caregivers participated in the intervention, and they reported their experiences in this training as highly positive. This study makes several contributions to the parent training and coaching literature, first by showing that a combination of short parent training, virtual coaching interventions, and customized caregiver resources can improve RBI implementation and support communication development for young children with ASD. Second, this study illustrated RBI's extended utility by involving caregivers in everyday routines and activities within their natural environments. These findings recommend that service providers, practitioners, and researchers consider naturalistic teaching models, such as Parent-Mediated RBI, for training and intervention. Lastly, reflecting upon the fact that participants in this study were Mexican citizens where ASD support services are scarce, the outcomes of this study provide potential options for underserved communities, contributing to the development, expansion, and evaluation of virtual service delivery options. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]
- Published
- 2023