Behavioral Skills Training Research Articles

Virtual Behavioral Skills Training for Parents: Generalization of Parent Behavior and Child Learning

Virtual Behavioral Skills Training for Parents: Generalization of Parent Behavior and Child Learning

Using an Instructional Package to Support Adults with Autism in Communicating with a Medical Provider.

Adults with autism spectrum disorder (ASD) often experience co-occurring physical and mental health challenges throughout their lives. At the same time, they frequently face many barriers to accessing proper care. Strategies to improve communication and understanding can help to mitigate some of these barriers. This study examined the effects of an instructional package, including a video module accompanied by guided notes, the Autism Healthcare Accommodations Tool (AHAT), and behavior skills training (BST) to teach adults with autism to communicate their unique needs and request accommodations to a medical provider. Three participants independently completed a self-guided video module that modeled how to complete the guided notes and AHAT to identify appropriate accommodations and prepare for a doctor's appointment. Once finished, participants were taught to verbalize their needs and accommodations through BST. Results showed that participants' communication skills increased after introducing the instructional package, generalized to a novel provider and maintained once the instructional package was removed. This intervention proved to be an effective and socially valid method to improve communication for adults with autism in medical settings. Implications and suggestions for future research are discussed.

Training Staff to Implement Free-Operant Preference Assessment: Effects of Remote Behavioral Skills Training

Behavior Skills Training (BST) was used remotely to teach four special education teachers who lived in China to conduct free-operant preference assessments. A multiple baseline across participant design demonstrated a functional relationship between remote BST and the percentage of assessment steps completed correctly. Additionally, two of the four participants demonstrated generalization. Limitations and future research directions are discussed.

A comparison of staff training procedures to teach flexible prompt fading

AbstractQuality behavior intervention requires critical thinking skills, in‐the‐moment analysis, flexibility, and clinical judgment. Yet, there has been limited research on developing these complex skills. Flexible prompt fading (FPF) is a prompting procedure that requires the interventionist to continually analyze learner responding and make in‐the‐moment decisions to maximize learning during the teaching session, ultimately using clinical judgment while using prompting as a teaching strategy. FPF has consistently been demonstrated to be effective and in some cases more efficient than other prompting procedures. However, there has been no research demonstrating effective training procedures for the skills necessary to implement FPF. In order to more widely disseminate procedures that require these analytic skills, effective training procedures must be identified. The current study evaluated the effects of behavioral skills training (BST) and a progressive approach to staff training to teach staff to implement FPF with autistic individuals/individuals with ASD and the effects of each training method on development of clinical judgment skills. The results demonstrated that both training procedures were effective in teaching implementation of FPF.

Development and Effectiveness of Dialectical Behavioral Therapy-Based Emotion Regulation Skills Training for Adolescents

Development and Effectiveness of Dialectical Behavioral Therapy-Based Emotion Regulation Skills Training for Adolescents

School-based consultation and coaching for promoting teachers’ generalized outcomes: A meta-analysis

School-based consultation or coaching may be used to promote teachers' use of various classroom management practices and interventions. An important aspect of school-based consultation and coaching is ensuring teachers generalize their use of evidence-based practices that were trained through consultation. However, the extent to which teachers generalize practices trained through consultation or coaching is somewhat unclear. As such, the purpose of this meta-analysis was twofold: (a) synthesize the existing school-based consultation literature to determine the extent to which teachers generalize practices they learned through consultation and coaching and (b) make a call to action for researchers to collect generalization data in consultation and coaching research. Seventeen studies were identified for review, in which results indicated school-based consultation and coaching to be effective for promoting teachers' generalization of EBPs (LRRi = 0.82) as well as target outcomes (LRRi = 1.15). Specific implementation supports (i.e., in situ training and behavioral skills training) significantly contributed to teachers' generalization, with specific practices (i.e., behavior specific praise) being more generalizable. Furthermore, moderation analyses were conducted to delineate aspects of consultation and coaching that are more likely to promote teachers' generalized outcomes. Limitations, future directions, and implications for research and practice are described.

Training school psychologists to conduct culturally informed Functional Behavior Assessment interviews.

Exclusionary discipline is a racialized mechanism through which schools systematically remove racially and ethnically minoritized youth from the learning environment. Although the development of Functional Behavior Assessments (FBAs) and linked behavior support plans have been identified as an alternative practice, school psychologists often do not ask questions about the cultural and contextual factors that may influence students' behavior during FBA interviews. Therefore, training is warranted. Unfortunately, staff often have limited time and resources to devote to professional development; therefore, it is critical to ensure that training procedures that require more time offer better outcomes than those that require fewer resources. The present study compared the effectiveness of high intensity training (e.g., behavioral skills training) versus a low intensity training procedure (e.g., self-training) procedures on school psychologists' ability to facilitate simulated FBA interviews grounded in cultural humility with caregivers before and after exposure to one of two training conditions. Findings from regression analyses indicated that self-training adequately prepared school psychologists to adhere to the questions on the protocol, however, behavioral skills training improved the quality of interview delivery. Implications for future research and training are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Educational Programs Supporting Higher Education Individuals with Autism Spectrum Disorder: A Systematic Literature Review

Young individuals with autism spectrum disorder (ASD) seem to attend higher education more frequently. Yet, the academic performance of students with ASD and the graduation rate appear to be poorer than those of typical development students. Moreover, college students with ASD face several challenges in their everyday and social lives. Students with ASD seem not to receive the appropriate social and educational support in higher education. This article reports the results of a systematic literature review of research programs and services designed to meet the needs of students with ASD enrolled in higher education. Several interventions are available and appear to be effective in supporting students with ASD in higher education (e.g., social planning intervention, focus groups, coaching paired with behavioral skills training, video feedback, visual framework, peer mentoring, and virtual reality). In addition, this article shows that colleges and universities face the challenge of preparing for these students and the need to provide psychological support for them. Moreover, studies of experiences and opinions of college students with ASD from their perspectives are included.

Dyadic Training of Communication Partners for Autistic Students: A Feasibility Study

Access to communication is a primary challenge affecting the education of Autistic students who use augmentative and alternative communication devices. This is compounded by potential communication partners (e.g., teachers and classroom paraeducators) who have insufficient training and skills to meaningfully engage these students in communication. To address these deficits in skills and training, this feasibility study used a multiple probe across participants design to test the effects of using behavioral skills training on dyads of teachers and paraeducators in increasing teacher-delivered opportunities to respond and student communication responses. The results show that after training, teachers’ opportunities to respond and use student-specific strategies increased. Following the teachers’ implementation of the strategies, students’ prompted and unprompted communication increased. These results provide evidence that supports the use of behavioral skills training to support communication partner skill development and student communication needs. These methods showed positive social validity with participants and demonstrate a professional development method that is more feasible for use by school staff than individual training. The results of this study provide initial evidence of the effectiveness of these methods with dyads of participants as well as with licensed teachers, extending the extant research, which often focuses on the individual training of paraeducators.

A Vaping Cessation Text Message Program for Adolescent E-Cigarette Users

E-cigarettes are the most commonly used tobacco product among adolescents. Despite known harms of nicotine exposure among teens, there are no empirically tested vaping cessation interventions. To compare the effectiveness of a text message program for nicotine vaping cessation among adolescents with assessment-only control. A parallel, 2-group, double-blind, individually randomized clinical trial with follow-ups at 1 and 7 months after randomization was conducted from October 1, 2021, to October 18, 2023. Participants were recruited via social media ads; the intervention was delivered via text message; and assessments were completed online or by telephone. Eligible individuals were US residents aged 13 to 17 years who reported past 30-day e-cigarette use, were interested in quitting within 30 days, and owned a mobile phone with an active text message plan. To optimize study retention, all participants received monthly assessments via text message about e-cigarette use. Assessment-only controls (n = 744) received only study retention text messages. Intervention participants (n = 759) also received an automated, interactive text message program for vaping cessation that delivers cognitive and behavioral coping skills training and social support. The primary outcome was self-reported 30-day point-prevalence abstinence from vaping at 7 months analyzed as intention-to-treat, with missingness coded as vaping. Among n = 1503 adolescents randomized, average age was 16.4 (SD, 0.8) years. The sample was 50.6% female, 42.1% male, and 7.4% nonbinary/other; 10.2% Black/African American, 62.6% White, 18.5% multiracial, and 8.7% another race; 16.2% Hispanic; 42.5% sexual minority; and 76.2% vaped within 30 minutes of waking. The 7-month follow-up rate was 70.8%. Point-prevalence abstinence rates were 37.8% (95% CI, 34.4%-41.3%) among intervention participants and 28.0% (95% CI, 24.9%-31.3%) among control participants (relative risk, 1.35 [95% CI, 1.17-1.57]; P < .001). No baseline variables moderated the treatment-outcome relationship. There was no evidence that adolescents who quit vaping transitioned to combustible tobacco products. A tailored, interactive text message intervention increased self-reported vaping cessation rates among adolescents recruited via social media channels. ClinicalTrials.gov Identifier: NCT04919590.

Using behavioral skills training to establish extended conversational exchanges.

Using behavioral skills training to establish extended conversational exchanges.

Teaching compassionate-based behaviors across communication partners to students of applied behavior analysis: a preliminary investigation of comparative effectiveness

Applied behavior analysis (ABA) focuses on providing socially significant treatments and practices. Recent advancements in ethically-minded research have encouraged practitioners to think beyond the technical skills required for implementing behavior-analytic practices and consider how these practices are delivered. Compassionate care in ABA has recently been conceptually defined and subsequently researched to explore ways to explicitly and systematically teach compassionate-care-based skills within the scope of ABA. Researchers have noted barriers specific to the time required to teach compassionate-care-based skills using behavior skills training (BST) especially when working to train groups in compassionate care skills. Further, these studies have focused primarily on using compassionate care towards interactions with caregivers as communication partners. This study operationalized the compassionate care-based skill of receiving feedback within a behavioral analytic lens and taught it to eight master's students enrolled in an ABA course. An experimental case study approach was used to evaluate the relative benefit of modified behavioral skills training (BST) versions, including conditions with and without rehearsal opportunities and individualized performance feedback. Results indicated that all participants demonstrated significant skill increases across multiple communication partners (i.e., client, caregiver, colleague) compared to baseline sessions, with conditions including opportunities for rehearsal and performance feedback resulting in higher skill acquisition for seven of the eight participants. Conditions that required the participants to generalize to novel scenarios and novel communication partners resulted in lower competencies; however, all participant skills across all communication partners remained higher than baseline measures. Limitations included practicing skills within role-play scenarios only, the application of compassionate care-based skills in a variety of cultures, and limits related to using an experimental case study as a methodological approach. Implications for future research and practitioner-based applications are discussed.

Using behavioral skills training to teach goal setting for health behaviors

AbstractGoal setting is a component of many behavior‐change interventions, with the Specific, Measurable, Attainable, Relevant, Time‐Bound (SMART) goal‐setting method being a commonly used strategy. The current study used a multiple‐baseline across participants design to evaluate the efficacy of behavioral skills training (BST) to teach individuals to set health‐related SMART goals in response to multiple hypothetical health scenarios. Participant attempts at goal setting were scored according to a task analysis encompassing each major element of SMART goals. Goal‐setting performance noticeably improved following an average of 1.25 h of BST, and participants rated the intervention and outcomes favorably.

Using Peer-Led Behavioral Skills Training to Teach Trainees Active and Empathic Listening Skills in a Virtual Environment

Using Peer-Led Behavioral Skills Training to Teach Trainees Active and Empathic Listening Skills in a Virtual Environment

Mental health providers are inexperienced but interested in telehealth-based virtual reality therapy: survey study.

Virtual reality (VR) is an emerging technology that can enhance experiences and outcomes in mental healthcare. However, mental health therapists have been slow to adopt VR into practice. Implementation of telehealth-based VR therapy (tele-VR) could catalyze adoption and innovation in mental healthcare. To explore therapists' perspectives on tele-VR, we conducted a cross-sectional survey of practicing mental health providers in the United States in June-July 2023. We analyzed 176 completed surveys from therapists, of whom 51.14% had no prior experience with VR, only 6.25% had used VR clinically, and 56.82% had neutral impressions of VR for therapy. Despite therapists' general inexperience with VR, therapists indicated a wide variety of tele-VR simulations (e.g., social situations, flying, heights) and features (e.g., personalized spaces, homework, interactivity) would be moderately to extremely useful for their practices. Therapists also requested additional VR simulations and features for their telehealth clients such as behavioral skills training, exposure therapy, gender identity therapy, and psychological assessments in VR. Therapists rated Health Insurance Portability and Accountability Act compliance, the ability to try VR before buying, affordability for therapists, accessibility for clients, and insurance coverage as the five most influential implementation factors for tele-VR. Overall, therapists were generally inexperienced and neutral about VR for telehealth therapy, but were interested in tele-VR for specific applications. These findings provide actionable directions for future research and collaborative development of therapeutic VR content and features.

Pepea Pamoja:† Applying the Ecological Validity Framework to co-develop a wellbeing and behavioural training program for caregivers of young children with autism in low-resource settings of Kenya and the United States.

Autism is a complex neurodevelopmental disability with global prevalence of one in 100 individuals. Poor access to interventions in both under-resourced regions of high-income countries and low- and middle-income countries has deleterious effects on the health and wellbeing of individuals with autism and their families. Our objective was to utilize a reciprocal innovation framework and participatory methods to adapt and co-develop a culturally grounded group-based wellbeing and naturalistic developmental behavioural intervention (NDBI) training program for caregivers of young children with autism to be implemented in Kenya and rural Indiana. This study was conducted within the Academic Model Providing Access to Healthcare (AMPATH) program. An evidence-informed Naturalistic Developmental Behavioral Intervention (NDBI) previously utilized in Indiana was adapted and iteratively refined using the Ecological Validity Framework (EVF) by a team of US and Kenyan disability experts. Key adaptations to the program were made across the EVF domains of language, persons, metaphors/content, concepts, goals, methods, and context. Substantial cultural adaptations were made to the NDBI following the EVF model, including the addition of traditional Kenyan cultural practices, use of narrative principles, and focus on daily routines over play. Pepea, the adapted program, involves 10 group sessions covering content in basic education on autism, positive caregiver coping strategies, and behavioural skills training to promote child communication and reduce challenging behaviour. Key adaptations for Pepea were integrated back into a US NDBI caregiver training program. This study fills a critical gap by detailing the adaptation process of a caregiver wellbeing and naturalistic developmental behavioural training program for caregivers of children with autism in low-resource settings. Our next steps are to report on mixed-methods outcomes from pilot implementation. Our long-term goal is to apply these insights to advance sustainable and scalable autism intervention services across the globe.

Teaching water flossing to children with and without autism spectrum disorder

AbstractOral hygiene is an important self‐care skill that some children may lack, especially children with autism spectrum disorder (ASD). Although some studies have evaluated procedures for teaching toothbrushing, no previous studies have demonstrated procedures for teaching flossing, which is essential for oral hygiene. This study evaluated an intervention for teaching water flossing to two children with ASD and two children without an ASD diagnosis. The intervention package included backward chaining, video modeling, and reinforcement, with some components implemented by a caregiver and some components implemented by an experimenter via telehealth. Behavioral skills training was used to train caregivers prior to implementation of the study. Results indicated that the intervention package was effective in teaching all participants to independently floss their teeth with a water flosser. Effects maintained for all participants 1‐week after completion of teaching. Questionnaires given to caregivers, participants, and dental professionals indicated high social validity.

Feasibility and acceptability of an online group dialectical behavioural therapy skills training in a Transdiagnostic group with Anxiety and Depression

Transdiagnostic approaches offers a paradigm shift in managing psychiatric disorders. Emotion regulation difficulties are a transdiagnostic prevalent across various mood and personality disorders. Dialectical Behavioural Therapy Skills Training (DBT-ST), initially designed as part of treatment for borderline personality disorder, targets emotion regulation and has shown promise in diverse psychiatric conditions. In lower middle-income countries with resource-constrained settings, online delivery of evidence-based interventions holds potential to bridge treatment gaps. This study assesses the feasibility and acceptability of online group DBT skills training for individuals with depression or anxiety disorders in India. Mental health professionals practising in India referred twenty-four eligible participants currently not engaged in psychotherapy. Of these, 18 initiated the 8-week virtual group DBT-ST program, with 12 completing it (66 % female, 18-35 years of age, 5 on concurrent medication). They provided feedback on therapy content's usefulness. Baseline, post-intervention, and one-month follow-up assessments measured changes in emotion regulation difficulties, depression, and anxiety symptoms. Treatment retained 66.7 % of participants, all participants found the intervention beneficial. Repeated measures ANOVA indicates significant reductions in self-reported difficulties in emotion regulation, depression, and anxiety symptoms post-intervention. These findings highlight the promise of transdiagnostic interventions like DBT-ST that merit further evaluations using RCTs with larger sample sizes.

Behavioral Skills Training for Active Shooter Scenarios Among Human Service Staff

ABSTRACT Mass shootings have become increasingly prevalent in schools and healthcare settings. Unfortunately, little information is available on training for active shooter scenarios in which a staff member is also responsible for a client. This deficit is concerning, given that previous research has found that 75% of individuals freeze during emergencies. Behavioral skills training has been shown to be an effective way to teach a variety of safety-related skills. This study used a concurrent multiple-baseline-across-participants design to evaluate the effects of behavioral skills training on active shooter scenario safety-related skills of three Registered Behavior Technicians®. The experimenters trained the participants on how to respond under various conditions and when they should run, hide, or fight. All three participants mastered the safety-related behaviors in the three conditions (run, hide, fight), demonstrated generalization to more realistic antecedent stimuli, and maintained the skills over time.

Using Behavior Skills Training and Virtual Simulations to Train Preservice Practitioners in Behavior Management: An Exploratory Comparison Study

Using Behavior Skills Training and Virtual Simulations to Train Preservice Practitioners in Behavior Management: An Exploratory Comparison Study