Results from a clinical trial published in the Journal of Applied Behavior Analysis support the feasibility and efficacy of a virtual program for teaching applied-behavior analysis (ABA) principles to parents of children with autism spectrum disorder (ASD).
While study data support the use of ABA for improving social and language capabilities in children with ASD, many children are unable to access treatment due to “geographic, economic, and time barriers.” The present study sought to examine the feasibility of training parents to implement ABA themselves, rather than requiring clinic or facility visits.
The study randomized parents of a child with an ASD to either treatment (virtual training) or control (waitlist). Parents in the waitlist condition were offered access to the virtual program after the completion of the study. Administered via a virtual private network, the training program comprised 9 multimedia modules, each lasting 35-60 minutes. The modules addressed principles of behavior analysis, skill acquisition procedures, and behavior reduction procedures.
Parental implementation of ABA skills were assessed in virtual work and play-based training environments at 2 timepoints: baseline (pretest) and after completion of training (posttest). A trained clinician used dependent measures from the Behavioral Implementation of Skills for Work Activities (BISWA) and the Behavioral Implementation of Skills for Play Activities (BISPA) to assess parent implementation in a simulated virtual environment. Parents in the treatment condition were also asked to describe their experiences with virtual ABA.
A total of 25 parents completed the study, among whom 21 (84%) were women. Parental age ranged from 26 to 46 years. Overall, 13 families were assigned to the treatment group and 12 were assigned to the waitlist (control) group.
At baseline, the mean percentage of ABA opportunities implemented correctly on the BISWA was low in both the treatment (35% ± 17%) and control (35% ± 15%) groups. The percentage of opportunities implemented correctly was significantly greater at posttest for the treatment group (99% ± 2%), though not for the control group (35% ± 19%).
On the BISPA, similar trends were observed. Pretest implementation was low in the treatment (14% ± 10%) and control (9% ± 10%) groups. At posttest, the percentage of opportunities implemented correctly was significantly greater in the treatment group (92% ± 12%), but unchanged in the control group (13% ± 9%).
Parents in the treatment condition displayed improvement in the percentage of skills mastered on the BISWA (15 ± 9 to 93 ± 12) and BISPA (0% to 80% ± 29%) over the study course. The same was not observed of parents in the control condition. The mean satisfaction rating with the virtual training program was 6.6 out of a possible 7 (range, 6.3-6.5). All training program enrollees indicated that they would recommend the program to others. These data support the feasibility of a virtual ABA training program for parents. Compared to the control group, parents in the treatment condition displayed a better implementation of skills during virtual roleplay sessions.
Study limitations include the small sample size and the fact that parent skills were measured in a roleplay scenario, rather than directly with their child. However, research suggests that post-training performance with a confederate is strongly correlated with performance with a child. “Results add to the growing literature on the efficacy and acceptability of virtually delivered training in ABA,” the investigators wrote.
Fisher WW, Luczynski KC, Blowers AP, et al. A randomized clinical trial of a virtual-training program for teaching applied-behavior-analysis skills to parents of children with autism spectrum disorder. J Appl Behav Anal. 2020;53(4):1856-1875.