An analysis of parent-implemented behavior support plans: The effects of in-home consultation on treatment integrity and reductions in challenging behavior

Abstract

Young children with autism spectrum disorders often exhibit challenging behaviors across a variety of settings. These behaviors frequently interfere with children's development, with full participation in inclusive educational and community-based activities, and with a family's overall quality of life. Recent research has supported function-based approaches to understanding and managing challenging behavior, and the importance of family involvement in planning and implementing behavior support plans is frequently cited as a critical component for meaningful outcomes. Unfortunately, few studies have actually examined parents' implementation of multi-component behavior support plans within natural contexts such as family routines. Furthermore, the use of multiple outcome measures to evaluate the overall effectiveness of a behavior support plan is limited. The purpose of this study was to address limitations in this literature. Specifically, this study evaluated (a) the level of treatment integrity of parent-implemented behavior support plans within established family routines, (b) the effects of individualized consultation within the natural environment on treatment integrity, and (c) the relationships between treatment integrity, reductions in children's challenging behavior, and other outcome measures. A single-subject, multiple baseline across participants design was used. Results indicated that levels of treatment integrity increased following in-home consultation and that increased levels of treatment integrity resulted in meaningful reductions in children's challenging behavior as measured by direct observation data and parent report outcome measures.