By Trelaina S. Butler
Florida International University
Providing early interventions contributes to the success of many young children with autism as it helps them gain the skills and abilities necessary to increase their communication, independent functioning skills, and social-emotional skills; while also decreasing problem behaviors. Parent involvement in the implementation of interventions is crucial to the development of the young child, and it increases family-school partnerships. However, parents often lack support from schools and are more stressed than parents of typical developing children due to their ineffective parenting skills of children with ASD. This issue of NASET’s Autism Spectrum Disorder series was written by Trelaina S. Butler from Florida International University. Her paper supports and encourages parents to collaborate with teachers and professionals to help them implement strategies in the home setting.
Abstract
Providing early interventions contributes to the success of many young children with autism as it helps them gain the skills and abilities necessary to increase their communication, independent functioning skills, and social-emotional skills; while also decreasing problem behaviors. Parent involvement in the implementation of interventions is crucial to the development of the young child, and it increases family-school partnerships. However, parents often lack support from schools and are more stressed than parents of typical developing children due to their ineffective parenting skills of children with ASD. This paper supports and encourages parents to collaborate with teachers and professionals to help them implement strategies in the home setting.
Keywords:Autism Spectrum Disorder, Parent Involvement, Parent Implemented Intervention, Parent-Child Interaction Therapy
The Effectiveness of Parent Involvement in the Implementation of Intervention with Preschool Children with Autism Spectrum Disorder: A Review of Literature
Young children with Autism Spectrum Disorder (ASD) often exhibit a delay in language and communication skills, social skills, independent functioning skills, and academic skills. Without a doubt, services and interventions are essential to meet the growing needs of families (Symon, 2005) as positive relationships between families and their child with ASD can also be effected. In effort to improve the skills and relationships of families with children with ASD, Hansen, Blakely, Dolata, Raulston, and Machalicek (2014) advocated for the need of effective intervention to prevent obstruction in meaningful participation in the education setting.
Effective interventions that address the goals of the individuals as stated in their Individualized Educational Plan (IEP) can improve the child’s ability to master and generalize the goals. Therefore, it is essential to involve parents in providing intervention in the home as it promotes generalization of learning skills in various settings other than school, and with various people other than the teacher. Furthermore, it increases the opportunities to master the skills. In a study conducted by Symon (2005), families were placed in the roles of professionals and were taught specific skills and strategies to improve their own child’s social communication skills. The home-based learning structure promotes naturalistic interactions, which is also an important component of early intervention approaches (Meadan, Ostrosky, Zaghlawan, & Yu, 2009).
The purpose of this literature review is to evaluate and analyze previous studies to support the effectiveness of home-based learning as parents learn effective strategies to implement at home to their young child with ASD. Additionally, the review of relevant literature shall also promote and increase parent interaction, responsibility, and accountability in their child’s growth and learning, while also establishing and sustaining effective family-school partnerships. Rogers et al. (2014) agreed with other researchers that there is robust evidence that parents are capable of providing effective interventions to their child with a disability which will effect desirable changes.
Inclusion of Parents Implementing Interventions
Parents can help their children improve learning skills by being present during the learning and development of their young child. Parents are often the first teachers and with the help of professionals, they can also become a professional in teaching their child the skills they most need. Parent Implemented Intervention (PII) is an effective evidence-based practice (EBP) used to improve child social communication skills, decrease problem behavior, and to increase child play skills (Amsbary & AFIRM (2017). PII benefits families of children with disabilities as it emphasizes positive parent and child interactions and focuses on improving the child’s skills, increasing communication, and decreasing behavior problems. Although PII is an EBP, it involves implementing various other EBPs such as modeling, reinforcement, prompting, PECS, social narratives, discrete trial training, visual supports, and many more depending on the target behavior. It involves collaboration between teachers and parents or caregivers in the process of modeling, coaching, teaching, training, and planning with parents to implement EBPs in their everyday routines at home such as, but not limited to, dressing, mealtimes, bathing, and transitioning to an outing. Rogers et al. (2014) conducted a research study on Infant Start, a PII for Symptomatic Infants which focuses on early treatment for infants with symptoms of ASD. It suggests that enrolling symptomatic infants in parent-implemented intervention before 12-months gives greater results as PII serves a great benefit for young children with autism.
Similar to PII, Parent-Child Interaction Therapy (PCIT) consists of parents learning to teach their young child skills through two phases of relationship building phase with positive parenting strategies and a discipline phase to provide effective discipline strategies to enhance parent-child relationships. This therapy involves an increased level of collaboration between therapist and parents as it involves unique live coaching with guided support, reinforcement, and feedback to help the parent master the skills (Masse, McNeil, Wagner, & Quetsch, 2016; Fowles et al., 2018). Although it was originally intended for typically developing children, with the increase of disruptive behaviors in children with ASD, PCIT has been used to treat disruptive behaviors and noncompliance behaviors in young children (Agazzi, Tan, Ogg, Armstrong, & Kirby 2017).
In a study conducted by Fowles et al. (2018), the researchers compared and analyzed the efficacy between home-based PCIT and clinic-based PCIT. Their findings were inclusive in that there was a 65% completion rate amongst the home-based participants, as no strategy is effective without consistency. Although in their study, both home-based and clinic-based PCIT showed increases in the skills of the implementer, and reduction of the child’s behavior problems, it suggests that home-based learning is just as important as clinic or school-based learning. Moreover, parent involvement is essential and effective in the development of children with special needs. It is crucial that schools teach parents the key tenets of parental advocacy and school-to-home collaboration.
The Impact of Inclusion of Parents Implementing Intervention
Studies have indicated that parents of children with autism often experience higher rates of stress due to their child’s disability and their lack of skills to cope in their daily life (Hayes & Watson, 2013; Nguyen, 2013). The challenges most families face include lack of communication and interaction with their child which leads to frustration and stress due to ineffective parenting strategies and the caregiving environment (Schares & Shaner, 2009; Agazzi et al., 2017). Nonetheless, after the implementation of PCIT and its two phases of treatment, parents reported an increase in prosocial behaviors and in obedience, and a decrease in undesirable behaviors; parents also reports an improvement in their own stress, anxiety, and depression.
The impact of parental involvement in the implementation of strategies to help their preschool child with autism also includes collaboration. As goals are identified for the IEP, professionals and parents are able to work together to address the needs of the child in the home setting and use the best strategy to achieve the goal. However, in collaboration, parents must be willing to learn the new strategy, and must also be willing to document and share data during the follow-up.
In summary, there is a substantial amount of research and evidence that recommends parental involvement in the education of children with autism. Roy (2016) purported that including parents in interventions is a valuable component of intervention programs. In addition, other research supports that parents have shown the capability of implementing behavioral, social, and communication programs for their children with special needs (Symon, 2005).
With parents providing strategies to their child, they may also gain more knowledge of ASD, reduce stress levels, and increase their collaboration with the schools. These can likely instill hope and support for families, while increasing the skills of young children with ASD (Nguyen, 2013). It is recommended that schools seek to help and involve parents in the implementation of meaningful strategies and EBPs to help them teach their young child with autism. Moreover, it is suggested that parents show motivation in being active participants in their child’s learning experiences as it benefits the child and family as a whole and increases parent-teacher collaboration.
References
Agazzi, H., Tan, S. Y., Ogg, J., Armstrong, K., & Kirby, R. S. (2017). Does parent-child interaction therapy reduce maternal stress, anxiety, and depression among mothers of children with autism spectrum disorder? Child & Family Behavior Therapy, 39(4), 283–303. https://doi-org.ezproxy.fiu.edu/10.1080/07317107.2017.1375622
Amsbary, J., & AFIRM Team. (2017). Parent implemented interventions. Chapel Hill, NC: National Professional Development Center on Autism Spectrum Disorder, FPG Child Development Center, University of North Carolina. Retrieved from http://afirm.fpg.unc.edu/parent-implemented-interventions
Fowles, T. R., Masse, J. J., McGoron, L., Beveridge, R. M., Williamson, A. A., Smith, M. A., & Parrish, B. P. (2018). Home-based vs. clinic-based Parent–Child interaction therapy: Comparative effectiveness in the context of dissemination and implementation. Journal of Child and Family Studies, 27(4), 1115-1129. doi:http://dx.doi.org.ezproxy.fiu.edu/10.1007/s10826-017-0958-3
Hansen, S. G., Blakely, A. W., Dolata, J. K., Raulston, T., & Machalicek, W. (2014). Children with autism in the inclusive preschool classroom: A systematic review of single-subject design interventions on social communication skills. Review Journal of Autism and Developmental Disorders, 1(3), 192-206. doi:http://dx.doi.org.ezproxy.fiu.edu/10.1007/s40489-014-0020-y
Hayes, S. A., & Watson, S. L. (2013). The impact of parenting stress: A meta-analysis of studies comparing the experience of parenting stress in parents of children with and without autism spectrum disorder. Journal of Autism and Developmental Disorders, 43(3), 629-42. doi:http://dx.doi.org.ezproxy.fiu.edu/10.1007/s10803-012-1604-y
Masse, J., McNeil, C., Wagner, S., & Quetsch, L. (2016). Examining the efficacy of parent-child interaction therapy with children on the autism spectrum. Journal of Child & Family Studies, 25(8), 2508–2525. doi-org.ezproxy.fiu.edu/10.1007/s10826-016-0424-7
Meadan, H., Ostrosky, M. M., Zaghlawan, H. Y., & Yu, S. (2009). Promoting the social and communicative behavior of young children with autism spectrum disorders. Topics in Early Childhood Special Education, 29(2), 90-104. doi:http://dx.doi.org.ezproxy.fiu.edu/10.1177/0271121409337950
Nguyen, Q. T. (2013). An evaluation of a parent training program (Order No. 3564231). Available from Education Database. (1400804795). Retrieved from ezproxy.fiu.edu/login
Rogers, S. J., Vismara, L., Wagner, A. L., Mccormick, C., Young, G., & Ozonoff, S. (2014). Autism treatment in the first year of life: A pilot study of infant start, a parent-implemented intervention for symptomatic infants. Journal of Autism and Developmental Disorders, 44(12), 2981-95. doi:http://dx.doi.org.ezproxy.fiu.edu/10.1007/s10803-014-2202-y
Roy, C. P. (2016). Increasing family engagement in an elementary school (Order No. 10242587). Available from Education Database. (1854891188). Retrieved from http://ezproxy.fiu.edu/login?url=https://search-proquest-com.ezproxy.fiu.edu/docview/1854891188?accountid=10901
Symon, J. B. (2005). Expanding interventions for children with autism: Parents as trainers. Journal of Positive Behavior Interventions, 7(3), 159-173. Retrieved from http://ezproxy.fiu.edu/login?url=https://search-proquest-com.ezproxy.fiu.edu/docview/218785472?accountid=10901
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