An Evaluation of Behavioral Skills Training for Teaching Caregivers how to Support Social Skill Development in their Child with Autism Spectrum Disorder. M. Hassan, A. Simpson, K. Danaher, J. Haesen, T. Makela, & K. Thomson
Background
One of the hardest parts of teaching social skills to children with ASD is how difficult it is to get the skills they learned to generalize to the natural social environment. Involving caregivers in the process and having them practice during everyday situations can help with this challenge. However, most caregivers do not have prior training on how to best help their child develop social skills. Behavioral skills training (BST) is an evidence-based approach used to teach a variety of skills and includes providing instructions, modeling, rehearsal or role-play, and feedback. Prior research suggests that BST alone is not enough for some learners. These learners also need to practice the skills in the natural environment, known as “in situ” training. This study examined whether an in situ training component was necessary when teaching caregivers how to support their child’s social skill development. Interestingly, the caregivers were also learning how to use BST for social skill instruction. This means that the study was evaluating the effectiveness of BST when training caregivers to use BST.
Who was involved?
Caregivers who had children with ASD between the ages 6-8 years old participated in this study and were already seeking treatment from a community agency (i.e., had signed their child up for a social skills group). The caregiver training and social skills group happened in the same timeframe across a period of 8 weeks. There were two studies described within this article.
In Study 1, before intervention started, the researchers observed four caregivers with their child during a play situation during the social skills group for about five minutes. This is called baseline, which just means that information is taken about how someone behaves before any interventions or special changes are made. Then, there was a 50-60 minute individual BST training session conducted followed by individualized assessment. Later, there was a group-based BST session followed by an assessment and then a one-month follow-up.
In Study 2, researchers observed four different caregivers with their child during a play situation for baseline, followed by a 50-60 minute individual BST training session and assessment. Then, instead of a group session, the caregivers received in situ training. Two-month follow-up assessments were done in this study.
What was the outcome?
In Study 1, all four caregivers used BST during training role plays with 100% accuracy, but these skills did not transfer to their interactions with their child during the social skills group. In Study 2, the four other caregivers showed similar poor carryover until they received the in situ training. With improvements in caregiver use of BST, there were also improvements in child social skills.
What are the strengths and limitations of the study?
Strengths: This study focused on teaching social skills in the child’s natural environment rather than focusing on pre-determined skills. It also utilized caregivers who are present more often in the child’s life to support them when opportunities arise rather than therapists in just treatment settings.
Limitations: The participants were caregivers already seeking help for their child’s social skills so can’t be thought to represent all caregivers of children with ASD. The researchers also did not account for the differences in social skills taught across children (i.e., some skills much harder than others), which may have contributed to differences in caregiver accuracy.
What are the implications?
This research shows that caregivers learning how to use BST to train their child benefitted from BST in both practice situations and the natural environment to improve their accuracy. Teaching caregivers in a natural setting can help maintain skills and generalize them to novel settings over time. An additional plus from this research is that the intervention was relatively low cost in terms of time and staff to train caregivers, so the intervention approach might be easy for other community settings to use.
