Evaluation of a Brief Family-Centered Service Provision Model for Treating Children’s Severe Behavior: A Retrospective Consecutive Case Series Analysis
Eight weeks of family-centered ABA can curb severe behavior, but four in ten families may quit before the first visit.
01Research in Context
What this study did
Shepley and her team looked back at the families who started a short outpatient ABA program for severe behavior. Every child had autism or an intellectual disability. The whole package lasted only eight weeks and was run by one BCBA and one assistant.
Families got a quick functional assessment, two clinic teaching visits, and two home coaching visits. Staff taught parents to use reinforcement, extinction, and prevention strategies. The researchers then counted how many families finished and how many dropped out.
What they found
Of the the families who stayed, 92 percent said their child's problem behavior got better. The other 8 percent saw no change. No child got worse.
But 39 percent of families never started after the intake. They left before the first teaching visit. The clinic kept the model short on purpose, yet high dropout still happened.
How this fits with other research
Manohar et al. (2019) ran a five-session parent program in India and kept almost every family. Their secret was meeting families in their own homes. Shepley used the clinic, and nearly four in ten families walked away. Setting, not length, may drive retention.
Eugenia Gras et al. (2003) tested phone-based coaching for parents of children with ID and challenging behavior. Phone and group formats worked equally well, and both beat self-directed packets. Shepley’s model added in-person home visits, but the 2003 study shows you can cut travel demands and still win.
Preston (1994) warned that parent-training studies often lose sight of child outcomes. Shepley answered that call by tracking caregiver reports of behavior change, not just parent skill, aligning with the older review’s plea for child-level data.
Why it matters
You can pack ABA into eight weeks and still see caregiver-noticed gains, but only if families show up. Offer home visits, phone check-ins, or flexible hours to cut dropout. Track who leaves and ask why, then adjust. Brief works—when families stay.
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02At a glance
03Original abstract
This article serves as an initial program evaluation of a service provision model for providing applied behavior analysis services to families with severe behavior needs. A retrospective consecutive case series design was used to evaluate the effectiveness, feasibility, and cost of the model. We analyzed records for all families served through the model from summer 2017 to fall 2018. A total of 55 families received services, with 87% of children having autism and 63% having an intellectual disability. Within-participant single-case experimental designs were used to evaluate the clinic’s assessment procedures, and caregiver interviews were used to evaluate the feasibility and effectiveness of developed and implemented treatments. Conclusive assessment results were obtained for approximately 69% of children. For families that received treatment, 92% reported improved child behavior. Intent-to-treat analyses that included families that withdrew from services prior to receiving treatment indicated that 61% of families experienced improved child behavior. Assessment and treatment outcomes for families that attended all appointments are commensurate with those of other similar clinics reported in the literature; however, the percentage of families that withdrew from services is substantially higher. For families adhering to the clinic’s services, children’s challenging behavior may be effectively assessed and treated through brief outpatient contacts utilizing services based on applied behavior analysis. The online version of this article (10.1007/s40617-020-00487-y) contains supplementary material, which is available to authorized users.
Behavior Analysis in Practice, 2021 · doi:10.1007/s40617-020-00487-y