Using the Prevent-Teach-Reinforce Model to Reduce Problem Behaviors in Children With Autism Spectrum Disorders

Study Overview
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Brief Summary
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Children with autism spectrum disorders often engage in problem behaviors such as self-injury, destruction, aggression, and stereotypy. Prior research has clearly shown that these problem behaviors may interfere with learning, daily functioning, and social participation. As such, engaging in problem behaviors has a negative impact on the health and quality of life of children with autism spectrum disorders and their families. One promising solution to reduce problem behaviors in this population is the Prevent-Teach-Reinforce (PTR) model, which relies on the evidence-based practices of positive behavior support. Although the use of PTR has been gaining considerably support in schools, the model has never been evaluated as part of a rigorous large-scale study using parents as interventionists. Thus, the purpose of the project is to conduct an assessment of the effectiveness of a home-based version of the PTR model in reducing problem behaviors in children with autism spectrum disorders and in improving families' quality of life. Our hypotheses are that implementing the PTR will (a) produce larger reductions in problem behaviors than participating in an individual parent training session, (b) increase engagement in prosocial behaviors, (c) decrease parental stress, and (c) improve the quality of life of the family. The results of the study will allow an examination of whether PTR is an effective and acceptable model to reduce problem behaviors at home in this population. Given that problem behaviors incur high societal costs when they persist into adolescence and adulthood, the study may potentially lead to large cost reductions in the treatment of difficulties associated with autism spectrum disorders. By reducing engagement in problem behaviors, the implementation of the model may also promote and facilitate the social participation as well as improve the quality of life and health of children with autism spectrum disorders and their families.

Official Title
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Using the Prevent-Teach-Reinforce Model to Reduce Problem Behaviors in Children With Autism Spectrum Disorders

Conditions
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Child Development Disorders, Pervasive

Intervention / Treatment
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* Behavioral: Prevent-Teach-Reinforce Model
* Other: Individual Parent Training Session


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Clinical diagnosis of autism spectrum disorder Must exhibit problem behavior Exclusion Criteria: Already receiving services to reduce problem behaviors at home

Ages Eligible for Study
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Maximum Age: 12 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Behavioral approach<br>The Prevent-Teach-Reinforce Model will be implemented with families in their home settings. | Behavioral: Prevent-Teach-Reinforce Model<br>* Implementation of the model once to twice per week over a period of 8 weeks<br>|
| Active Comparator: Educational approach<br>Each child's parent will participate in one 2- to 3-hour individual parent training session on the assessment and treatment of problem behavior in children with autism spectrum disorders. | Other: Individual Parent Training Session<br>* One 2- to 3-hour individual parent training session on the assessment and treatment of problem behavior<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from baseline in parental report of problem behavior at 8 weeks | Problem behavior scale of the Problem Behavior Inventory | Prior to the start of the intervention and 8 weeks later | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from baseline in quality of life at 8 weeks | Beach Center Family Quality of Life Scale | Prior to the start of the intervention and 8 weeks later | 
| Change from baseline in parental report of stress at 20 weeks | Parenting Stress Index Short Form | Prior to the start of the intervention and 20 weeks later | 
| Change from baseline in parental report of stress at 8 weeks | Parenting Stress Index Short Form | Prior to the start of the intervention and 8 weeks later | 
| Change from baseline in quality of life at 20 weeks | Beach Center Family Quality of Life Scale | Prior to the start of the intervention and 20 weeks later | 
| Social validity of the intervention | Treatment Acceptability Rating Form - Revised | After 8 weeks of intervention | 
| Change from baseline in parental report of problem behavior at 20 weeks | Problem behavior scale of the Problem Behavior Inventory | Prior to the start of the intervention and 20 weeks later | 
| Change from baseline in parental report of positive social behavior at 20 weeks | Positive social behavior scale of the Nisonger Child Behavior Rating Form | Prior to the start of the intervention and 20 weeks later | 
| Change from baseline in parental report of positive social behavior at 8 weeks | Positive social behavior scale of the Nisonger Child Behavior Rating Form | Prior to the start of the intervention and 8 weeks later | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Autism spectrum disorder, Problem behavior