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The RUBI Autism Network

Parent Training for Disruptive Behaviors

For over a decade, The RUBI Autism Network has developed and tested a structured parent training (PT) manual for children with ASD and disruptive behaviors. Initial pilot studies showed that the PT manual was acceptable to families and could be reliably delivered by therapists (Bearss et al, 2013; Johnson et al., 2007; RUPP Network, 2007). Demonstration of feasibility set the stage for rigorous testing of the PT program in large scale RCTs. These studies showed that PT confers additional benefit when combined with medication (Aman et al., 2009; Scahill et al., 2012) and that PT is superior to parent education for reducing disruptive behavior in young children with ASD (Bearss et al., 2015). We are now ready and excited to disseminate the PT manual to community providers who treat children with ASD and disruptive behaviors.

The manual is based on principles of Applied Behavior Analysis (ABA) and is designed for therapists to use with parents of children with autism spectrum disorder and co-occurring challenging behaviors, such as tantrums, noncompliance, difficulties with transitions, and aggression. A trained therapist utilizes the manual to guide the parent in applying techniques and tools to help manage the child’s challenging behaviors.

The treatment includes 11 Core sessions, 7 Supplemental sessions, a home visit, and follow-up telephone booster sessions. Each of the sessions contains a therapist script, activity sheets, a parent handout, and treatment fidelity checklists. Additionally, accompanying each core session are video vignettes that the therapist uses to demonstrate concepts taught in the session. The videos include actors (a mother, father, three children) in 30-60 second vignettes demonstrating common parenting mistakes as well as implementation (to varying degrees of success) of the strategies being taught. The treatment manual is designed to be delivered individually to parents in weekly outpatient visits. Parents are given homework assignments between sessions that focus on applying techniques to specific behaviors.

Click here to learn more about the program components

Click here to see an outline of the Parent Training program

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The Therapist Manual

The Parent Workbook

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SESSIONS

SKILLS/ACTIVITIES

Behavioral Principles
  • Introduce overall treatment goals.
  • Introduce concepts of functions of behavior, antecedents and consequences of behavior

Prevention Strategies
  • Discuss antecedents to behavior problems and develop preventive strategies 

Daily Schedules
  • Develop a daily schedule and identify points of intervention (including use of visual schedules) to decrease behavior problems

Reinforcement 1
  • Introduce concept of reinforcers – to promote compliance, strengthen desired behaviors and teach new behaviors

Reinforcement 2
  • Introduce “catching your child being good.”
  • Teach play and social skills through child-led play

Planned Ignoring
  • Explore systematic use of extinction (via planned ignoring) to reduce behavioral problems

Compliance Training
  • Introduce effective parental requests and the use of guided compliance to enhance compliance and manage noncompliant behaviors

Functional Communication Training
  • Through systematic reinforcement, teach alternative communicative skills to replace problematic behaviors

Teaching Skills 1
  • Using task analysis and chaining, provide tools to replace problem behaviors with appropriate behaviors and how to promote new adaptive, coping and leisure skills

Teaching Skills 2
  • Teach various prompting procedures to use while teaching skills

Generalization & Maintenance
  • Generate strategies to consolidate positive behavior changes and generalize newly learned skills

Supplemental Sessions (as needed)
  • Provide instructions on supplemental topics or review materials

Home Visit
  • Observe the child in the natural environment
  • Learn about the layout of the child’s home
  • Plan implementation of strategies

Telephone Booster Calls
  • Review implementation of intervention strategies
  • Develop interventions for any newly emerging behavior concerns

SUPPLEMENTAL SESSIONS

CONTENTS

Token Economy Systems

This session provides parents with information on the proper use of token economies, star charts and point systems to promote positive behaviors in the home and community

Imitation Skills

This session teaches parents fundamental skills for helping their child learn to imitate others

Time Out

This session provides information on the proper use of time out, how to problem-solve if issues arise, and how to develop and implement a time out plan at home

Sleep Problems

This session provides information on how to address bedtime and sleep problems often observed in children with ASDs, such as difficulties with bedtime routines, delayed sleep onset, night awakening, sleep association problems, and the child entering the parents’ bed

Feeding Problems

This session helps the parent address a range of feeding problems that are commonly seen in children with ASD, such as food selectivity, mealtime behavior problems, and overeating

Toilet Training

This session helps the parent address a range of possible toileting issues such as diaper rituals, refusal to use the toilet, and nighttime toileting problems

Crisis Management

This session provides an opportunity to problem-solve the management of dangerous child behaviors, family crises and pressing educational issues

 

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