Service Delivery

Pyramidal training for families of children with problem behavior.

Kuhn et al. (2003) · Journal of applied behavior analysis 2003
★ The Verdict

Train one caregiver to mastery, then let them coach the rest of the household—skills stick and spread.

✓ Read this if BCBAs doing in-home parent training for challenging behavior.
✗ Skip if Clinic-only providers who never loop in family members.

01Research in Context

01

What this study did

Najdowski et al. (2003) worked with three families who had children with problem behavior.

One parent in each family first learned a behavior plan to mastery.

That parent then taught the same plan to two other family members using prompts and feedback.

02

What they found

Every caregiver who got the second-round coaching used the plan correctly.

Children’s problem behavior stayed low after all adults followed the steps.

Training one person well created a ripple of good practice inside the home.

03

How this fits with other research

Shingleton‐Smith et al. (2024) later showed you can do the same ripple through a screen. They coached parents of toddlers at-risk for autism online and still saw wide skill gains.

McDevitt et al. (2026) used a different twist: they added real-life chaos like siblings running by. Both studies kept high treatment fidelity, proving the core idea holds in new formats.

Williams et al. (2023) warns the ripple can break. They saw caregivers slip back when tough behavior returned, so booster check-ins matter even after pyramidal success.

04

Why it matters

You can stretch your hours. Train one caregiver to mastery, then have them coach others in the home. Check fidelity for the first few days, schedule quick booster calls, and you multiply correct implementation without extra travel.

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Pick the most available parent, teach the plan to 100 % accuracy, then watch them coach two other adults while you give live feedback once.

02At a glance

Intervention
parent training
Design
multiple baseline across participants
Sample size
9
Population
mixed clinical
Finding
positive

03Original abstract

The pyramidal training model was extended to multiple family members of children with behavior disorders. Three primary caregivers were taught to implement individualized treatments for problem behavior. They were then taught how to use various instructional strategies (e.g., prompting, feedback) to teach 2 other family members to implement the treatment. Results showed that pyramidal training was effective in increasing caregiver implementation of treatments across three families.

Journal of applied behavior analysis, 2003 · doi:10.1901/jaba.2003.36-77