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Supporting Parents In Early Intervention
Melanie Pellecchia, PhD, BCBA, NCSP Assistant Professor of Psychology in Psychiatry Penn Center for Mental Health University of Pennsylvania, Perelman School of Medicine February 27, 2019
Supporting Parents In Early Intervention Melanie Pellecchia, PhD, - - PowerPoint PPT Presentation
Supporting Parents In Early Intervention Melanie Pellecchia, PhD, - - PowerPoint PPT Presentation
Supporting Parents In Early Intervention Melanie Pellecchia, PhD, BCBA, NCSP Assistant Professor of Psychology in Psychiatry Penn Center for Mental Health University of Pennsylvania, Perelman School of Medicine February 27, 2019 Why Focus on
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How are Parents Usually Involved?
Developmental Approaches Behavioral Approaches
Treatment Initiation Goal Selection Treatment Delivery
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Intervention for Young Children with ASD
Developmental Approaches Behavioral Approaches
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Developmental Approaches to Early Intervention
Key aspects:
▪ Teach within developmental sequences ▪ Foster child’s initiative and spontaneity ▪ Follow the child’s lead ▪ Connect new experiences with existing knowledge ▪ Teaching in everyday routines and natural contexts
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Behavioral Approaches to Early Intervention
Key aspects:
▪ Learning is a product of antecedents and consequences ▪ Complex skills are broken down into small parts and taught in isolation ▪ Systematic shaping of behavior ▪ Environmental arrangement needed to promote
- ptimal learning
▪ Therapist led
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Conflicting Paradigms?
Developmental Approaches Behavioral Approaches
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Naturalistic Developmental Behavioral Interventions
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Naturalistic Developmental Behavioral Interventions Developmental Approaches Behavioral Approaches
NDBI
Schreibman et al., 2015
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Naturalistic Developmental Behavioral Interventions
Developmental Consideration of developmental level Child led Natural environment
Behavioral Systematic prompting Systematic Reinforcement Environmental arrangement
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Naturalistic Developmental Behavioral Interventions
Ingredients
Environmental Arrangement Natural Reinforcement Child Initiated Teaching Following the Child‘s Lead Modeling Balanced Turns Effective Prompting
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Why Use NDBI in Early Intervention?
Contextual fit Language and Communication Gains
(Stadnick et al., 2015)
Improved Long- term Outcomes
(Estes et al., 2015)
Family Involvement Developmentally Appropriate
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Family Involvement in Early Intervention
Therapist- Mediated Intervention Parent-Mediated Intervention
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Parent-Mediated Interventions in ASD
Child- focused Intervention Targets and Strategies Parent Coaching
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Parent Coaching in Early Intervention
Parent Coaching is a Common Component to all Efficacious Parent-Mediated Interventions
Improved Child Outcomes Increased Parent Treatment Fidelity Increased Parent Engagement and Self- Efficacy Parent Coaching
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What is Parent Coaching?
Observation Reflection Action
Hanft, Rush, & Shelden, 2004
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Adult Learning Theory
Adult Learning Principles
Adults need to know why they should learn something Adults learn by doing Adults learn best when the subject is of immediate use Need to be involved in the planning for instruction Adults are problem- solvers
Knowles, 1984
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Coaching Strategy Description
Authentic Learning Experiences Learning opportunities occur as part of real-life problems or challenges Joint Planning Parent is actively involved in selecting goals and strategies for learning Demonstration Practitioner models use of a technique through role- plays and actual application In-vivo Feedback Practitioner observes parent’s use of a technique and provides immediate feedback Reflection Practitioner engages parent in self-evaluation and assessment of performance
Parent Coaching & Adult Learning Theory
Dunst & Trivette, 2009
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Parent Coaching in Community Settings
Therapist- Mediated Intervention Parent-Mediated Intervention
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Parent Coaching in Community Settings
Early intervention providers spend the majority of their time in traditional child-focused intervention.
Study 1: 70% of EI providers’ time was child-focused, rather than focused on the parent.
(Campbell & Sawyer, 2007)
Study 2: EI providers spent less than 1% of the session coaching parents.
(Peterson, Luze, Eshbaugh, Jeon, & Kantz, 2007)
Study 3: 23% of parents of children receiving EI reported receiving coaching.
(Aranbarri et al., 2017)
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Parent Coaching in Community Settings
Research to Practice Gap
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Why Does This Gap Exist?
Providers
Pedagogical Views Training
Parents
Preferences and Expectations for Treatment Competing Demands
Intervention
Intervention Complexity Treatment Goals
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Bridging The Gap
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Bridging The Gap
NDBI Parent Coaching
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Partnering with Parents
Knowledge sharing Practitioner/Parent Partnership
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Shared Decision Making
Family Goals and Preferences Environmental Context Clinical Evidence and Expertise
Shared Decision Making
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Improving Parent Self-Efficacy
Simplifying Interventions Guided Practice Frequent Feedback
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Meaningful Treatment Goals
Relevant Practice Opportunities
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Important Considerations
Parent coaching should NOT be used to answer the question: How can we maximize opportunities for treatment? Parent Coaching should NOT be a replacement/substitute for other treatment hours. Focus of Parent Coaching should be: How can we best support parents in improving family functioning? How can we empower parents to support their child’s complex needs? Parents should NOT be expected to become therapists through parent coaching. Stahmer & Pellecchia, 2015
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