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| Applications of Behavioral Skills Training in Real World Contexts: Closing the Research-to-Practice Gap and Engaging Stakeholders |
| Monday, May 29, 2023 |
| 3:00 PM–3:50 PM |
| Convention Center Mile High Ballroom 4E/F |
| Area: AUT/DDA; Domain: Applied Research |
| Chair: Kendra Thomson (Brock University ) |
| CE Instructor: Kendra Thomson, Ph.D. |
| Abstract: Behavioral skills training (BST) has ample evidence demonstrating its efficacy under analogue conditions. However, a research-to-practice gap may still exist. Evaluating training outcomes, including generalization and maintenance, under a variety of real-world conditions with diverse trainees is warranted. Large N research designs comparing BST to other training methods may also help to disseminate evidence-based training across disciplines. This symposium will present training data collected with clinicians, caregivers, direct support staff, and other professionals from the developmental disability and mental health sectors. Training targets included a variety of important skills including rapport building, evidence-based communication systems, and on-the-job safety. First, we will discuss a comprehensive community-based, caregiver training on the Picture Exchange Communication System®. Second, we will present data from a centre-based pyramidal model for training caregivers how to support rapport building skills. Finally, we will share data from a pragmatic randomized controlled trial comparing BST to training-as-usual for teaching self-protection and team control skills to newly hired staff at a large mental health teaching hospital. We will also discuss how stakeholders were meaningfully involved throughout these evaluations. Strengths and limitations of the findings will be discussed within the context of bridging the gap from research to practice. |
| Instruction Level: Intermediate |
| Keyword(s): behavioral training, caregiver training, community engagement, rapport building |
| Target Audience: BCBAs or BCBA-Ds
Background in/familiarity with/experience in behavioral skills training |
| Learning Objectives: (1) describe how community stakeholders can be engaged in various steps in the research process;
(2) describe how a pyramidal training model can be used to teach clinicians and caregivers rapport building skills
(3) describe how behavioral skills training evaluations can be scaled to compare outcomes to other training models |
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| Community Engaged Research: Engaging Stakeholders to Address Autism Service Limitations |
| JULIE KOUDYS (Brock University), Melissa Ann Elliott (Bethesda Services), Jeffrey Esteves (York University), Krysten Spottiswood (Pyramid Educational Consultants of Canada), Amanpreet Randhawa (Brock University), Alyssa Treszl (Brock University), Quinlan Stamp (Brock University), Hannah Floyd (Brock University ) |
| Abstract: There is growing interest in engaging community members in the research process in order to establish meaningful priorities, improve research relevance, and increase the likelihood of outcomes being used in real-life settings. In this service presentation we will describe the process and outcomes of a three-year, community-engaged research project. The project was designed to address service limitations created by changes to publicly funded autism services in Ontario, Canada. The objectives of the project were to: increase access to evidence-based communication training (i.e., Picture Exchange Communication System®; PECS®; Bondy & Frost, 1994), develop and evaluate caregiver-mediated PECS training models to fit within available service structures, and enhance community capacity through staff training and experiential learning opportunities for graduate students. We also hoped to contribute to the literature related to behavior skills training and telehealth to support caregiver-mediated PECS implementation. Approaches to engagement of community partners at all phases of the project will be described. The iterative process of designing, implementing, evaluating, and refining training models to enhance outcomes and improve efficiency will be explained. Facilitator and caregiver training models will be presented, along with general caregiver and child outcomes, and performance metrics. Strategies to support successful community collaborations will be shared. |
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A Pyramidal Approach for Training Parents of Children With Autism Spectrum Disorder on Rapport Building Skills |
| SAMANTHA WALLBANK (Brock University), Alison Cox (Brock University), Nazurah Khokhar (Brock University), Kendra Thomson (Brock University ), Priscilla Burnham Riosa (Brock University) |
| Abstract: Establishing rapport has been associated with improved learning outcomes in the context of intensive behavioral treatment. However, training with clinicians or caregivers on this repertoire has yet to be adequately investigated. Substantial evidence suggests that behavioural skills training (BST) is an effective teaching approach. Using a modified multiple-baseline design across two therapist-parent dyads, we used pyramidal BST to teach two therapists rapport building skills (e.g., preferred items available, staying within arm’s reach, following child’s lead, provide choice, praise, silly play, labelling activities) and the components of BST. Next, we taught those therapists how to use BST to train two parents of children diagnosed with autism spectrum disorder on the same rapport-building skills. We also trained three additional parents to assess the same protocol. Preliminary probe results indicate that both therapist-parent dyads demonstrated mastery across all domains of rapport building, as did two of the three parents trained by the researchers. Follow-up probe results showed that outcomes were maintained one month after the final training session for all participants (therapists & parents). These pilot findings will help to inform the development of effective and efficient training methods for rapport-building skills. |
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Teaching Safety Skills to Mental Health Clinicians: A Pragmatic Randomized Control Trial Comparing Behavioural Skills Training to Training-As-Usual |
| Elizabeth Lin (Centre for Addiction and Mental Health ), Mais Malhas (Centre for Addiction and Mental Health ), Emmanuel Bratsalis (Centre for Addiction and Mental Health ), KENDRA THOMSON (Brock University ), Rhonda Boateng (Centre for Addiction and Mental Health; University of Toronto), Fabienne Hargreaves (Centre for Addiction and Mental Health), Heba Baig (Centre for Addiction and Mental Health ), Kayle Donner (Centre for Addiction and Mental Health ) |
| Abstract: Workplace violence is an increasingly significant topic, particularly as it applies to staff working in mental health settings. The Centre for Addiction and Mental Health, Canada’s largest mental health hospital, prioritizes workplace safety and consequently has mandated clinical staff safety training. Key components of this training are self-protection and 2–5 person team control skills, which serve as a last resort when other interventions are ineffective (e.g., verbal de-escalation). Training-as-usual (TAU) for the past 20 years has been based on a 3-D approach (description, demonstration, and doing), but without any performance or competency-based assessment. Recent staff reports indicate that the acquisition and retention of these skills is problematic and that there are issues with staff confidence in their ability to address workplace violence. We will present the final data set of a pragmatic randomized controlled trial evaluating the effectiveness of behavioral skills training (BST) against TAU in terms of the acquisition and 1-month post-training retention of self-protection team control skills as well as the impact on staff confidence. Results to date support the effectiveness of BST vs. TAU for improving staff performance compared to TAU although neither method led to long-term maintenance. Suggestions for future research will be discussed. |
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