Adherence to treatment in a behavioral intervention curriculum for parents of children with autism spectrum disorder.

The team asked 24 parents to rate how well they used six ABA skills at home. Each parent had just finished a 12-week training course and passed all mastery tests.

Parents scored themselves on a 1-to-5 scale for things like giving clear instructions and using praise. They also answered questions about how confident they felt using the strategies.

In five of the six skill areas, parents said they followed the steps below mastery level. Only confidence in the method predicted higher scores; mastery test scores did not.

In plain words, passing the class did not mean parents actually used the skills. Feeling sure the plan would help their child was the key driver.

Han et al. (2025) pooled 25 studies and found ABA can boost language when hours are high. Their review includes parent-training papers, yet none tracked parent confidence as an outcome.

Castañe et al. (1993) and Falakfarsa et al. (2022) show that most ABA studies still skip integrity checks. The 2011 survey explains one reason why: mastery alone is not enough; confidence must be measured and supported.

Burrell et al. (2023) later showed that extra support helped 47 % of families stick with a feeding plan. Together, the papers suggest you should screen for parent confidence early and add coaching when it is low.

You can add a quick confidence rating to your intake forms. If scores are low, build in extra rehearsal, video feedback, or peer parent mentors before sending families home. This small step may turn trained parents into active users.