Scoping Review: Caregiver Training to Reduce Challenging Behaviors Displayed by Children on the Autism Spectrum
Caregiver training can work for challenging behaviors in autism, yet most published protocols are long and technical—so slice them into bite-size steps and check parent buy-in early.
01Research in Context
What this study did
O'Neill et al. (2025) mapped every single-case study that taught parents how to handle challenging behaviors in autistic children. They pulled papers from 2000 to 2023 and sorted them by training style, behavior type, and how parents learned the steps.
The team did not pool numbers. They simply counted trends: how many studies used video models, how many targeted aggression, how many checked if parents really did the steps.
What they found
Most studies taught parents through hands-on coaching at home or in clinics. Hitting, kicking, and screaming were the top three behaviors parents asked to fix.
The review shows the toolbox is full—PECS, visual schedules, differential reinforcement, extinction—but many protocols need 20-plus steps. Parents often needed several weeks of practice before they felt confident.
How this fits with other research
Kemmerer et al. (2023) looked at the same ocean of papers one year earlier. Their map warned that most studies skip social-validity details. O'Neill et al. (2025) zoom in on just the challenging-behavior corner and confirm the gap still exists.
Vargas Londono et al. (2023) pooled 13 experiments with culturally diverse families and found small yet steady drops in problem behavior after parent training. The new scoping review includes those same experiments, showing the small effects sit inside a wider pattern of complex, multi-step protocols.
Ferreira et al. (2022) ran a single study where mothers learned PECS and later reported less stress. O'Neill's map places that trial among dozens like it, revealing a trend: communication-based parent training may chip away at both behavior and caregiver burden.
Why it matters
If you write parent-training goals, start by listing the exact teaching steps you will model. The review shows simpler protocols are rare, so you may need to break lengthy procedures into weekly mini-goals. Add brief social-validity check-ins at baseline, mid-point, and post to close the gap Kemmerer flagged. When caregivers speak another language, weave in the translation tactics Fabiola found effective; expect smaller but still worthwhile gains.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Take your current parent-training plan and cut it into three shorter skill steps; add a 2-question social-validity survey before the first coaching session.
02At a glance
03Original abstract
Effective intervention for children on the autism spectrum who engage in challenging behavior is critical. To ensure meaningful behavior change, caregiver training to support intervention implementation in the natural environment is often required. It is fortunate that both behavioral interventions and caregiver training are considered evidence-based for the reduction of challenging behavior. However, behavioral interventions may be comprised of an idiosyncratic combination of behavior-change strategies that require caregivers to accurately implement several strategies simultaneously or sequentially. The complexity of these interventions may affect parents’ ability to implement interventions accurately and consistently in the natural environment, which may in turn affect child outcomes. However, no review has synthesized the evidence from single-case design studies that evaluate the effects of caregiver training on a variety of caregiver-mediated interventions for autistic children who engage in challenging behavior. Given the complexity of caregiver training and caregiver-mediated interventions, and their increasing popularity, a greater understanding of the related evidence is warranted. We identified trends in participant demographics, caregiver training approaches implemented, child challenging behavior addressed, and behavioral intervention approaches employed. We propose recommendations for interpreting and applying results in practice, and avenues for future research directions.
Behavior Analysis in Practice, 2025 · doi:10.1007/s40617-024-00960-y