Collateral Effects of Behavioral Treatment for Problem Behavior on Caregiver Stress.
Caregiver stress improves most after behavior therapy when the child’s problem behavior is attention-maintained, less so for automatic or mand functions.
01Research in Context
What this study did
Ferguson et al. (2021) tracked caregiver stress before and after behavioral treatment for kids with autism, ID, or developmental delay.
Doctors first ran a functional analysis to find why each child acted out. Then they looked at how stress changed for each reason.
What they found
Stress dropped the most when problem behavior was fed by attention.
Stress barely budged when the behavior ran on automatic reinforcement or served as a mand.
How this fits with other research
Einfeld et al. (1996) already showed PRT parent training brightens family dinnertime and lowers stress. The new study adds: the payoff is biggest when the function is attention.
Harrop et al. (2016) found rising child RRBs push caregiver stress up. F et al. flip the lens—after treatment, stress only falls if the function is attention, not automatic.
Hsiao et al. (2017) showed strong family-teacher ties indirectly cut stress. F et al. say even with good ties, automatic or mand functions blunt the relief.
Why it matters
You can now forecast which families will feel better. If the FA points to attention, sell the treatment hard—parents will notice life easing. If the behavior is automatic or mand-based, add caregiver coping skills or respite so stress does not stall.
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02At a glance
03Original abstract
When individuals with autism and intellectual and developmental disabilities exhibit severe problem behavior, assessment and treatment are often warranted. Parents of such individuals are at high risk for developing parenting stress. In this study, 194 parents completed the Parenting Stress Index-Short Form at their child's time of admission to and discharge from inpatient or outpatient treatment for severe problem behavior. Parent stress was examined in relation to rate and function of child problem behavior as determined via functional analysis. Repeated measures analyses of variance were conducted, and differential effects were observed when child participants exhibited an attention, automatic, or mands function for problem behavior. These findings highlight the importance of considering function of problem behavior in relation to parenting stress.
Journal of autism and developmental disorders, 2021 · doi:10.1111/j.1469-7610.2010.02266.x