Training Family to Treat Non-Compliance - Literature review Example

Training Family to Treat Non-Compliance al Affiliation) The family plays an important and integral role in treating non-compliance of an individual with autism. There are many types of trainings that are used to treat non-compliance. Non-compliant behavior According to Errorless Academic Compliance Training for Children with Autism Spectrum Disorders ,non-compliant behavior results from the subject (autistic child) failing to complete an instruction issued by a person in authority such as parents or teachers. In many households that have an autistic child, on-compliance is exhibited by the child and it is very challenging if the household members do not have the necessary skills to aid them in modifying and eliminating problematic behaviors exhibited(Errorless Academic Compliance Training for Children with Autism Spectrum Disorders,2011). Behavioral effects of non-compliance Moes et.,al suggests that individuals with autism are faced with social deficiencies that result to their inability to predict what is going to happen and an impediment in understanding their environment and events occurring in their surroundings. This causes the individuals to experience anxiety and fear on a daily basis, which is expressed through obsessive behavior and problematic behaviors (Moes, 2000). Since autism is not a visible ailment, the majority of the public dismiss people suffering from autism as suffering from odd behavior. Some attribute an autistic child’s problematic behavior to naughtiness and the parent’s inability to manage their child’s behavior. This leads to parents avoiding taking their children in public places to avoid the social stigma associated with the problematic behavior of the child. These results in the autistic child being anxious and his other siblings feeling isolated and lonely due to them being house bound. This has the effect of stunting the emotional and social development of the children-the autistic and non-autistic. Paxton et.,al notes that children with autism are usually not successful in academics and other social situations, which leads to loss in self-confidence and low self-esteem issues meaning they are vulnerable to bullying and abuse. A majority of them suffer from elevated levels of depression and anxiety and a variety of mental health ailments. The resultant effect is that a majority of children suffering from autism lack emotional and social support and they become marginalized and isolated by the society (Paxton, 2007) . Types of family trainings for non-compliance Self-directed behavioral family intervention It is a very effective tool used in treating and preventing a variety of behavioral and emotional difficulties in children. The project aims to review the strategies adopted under self-directed interventions in order to assist parents in coping and dealing with some of the children’s difficult behaviors. An analysis is made on the efficiency of said interventions and the problems that result from the adoption of the self-directed program. A good example is the Self –directed triple P program which has been reviewed by previous studies to be an effective family intervention tool that fits into the model of a large family intervention that is multi-level. The efficiency and effectiveness of such interventions have a high degree of correlation with the service delivery of parental programs. Parenting interventions major aim is to enable a parent to understand and manage a child’s behavior while also improving the quality of their relationship with the child. Others have stated that the sole purpose of family interventions is to maximize a child’s development. Parents are taught to use firm discipline consistently and moderately in order to curtail bad behavior from their children. Behavioral family interventions try to influence a child’s behavior through modification of some sectors of the environment of the family. This is achieved by maintaining and enforcing a child’s difficult behaviors. Canali suggests that behavioral intervention is responsible for the modification of behavior in both the parents and children and the treatment gains are generally maintained. The positive effects are not restricted to modification of behavior but include reduction in stress and anxiety levels for parents. Parents have reported high levels of satisfaction due to the behaviors family interventions and generally view the programs as socially acceptable (Canali, 2008). However, there are problems associated with self-directed family intervention such as the lack of support from parents due to their perceived lack of interest in some instances. This is especially true for parents with problematic children or children believed to have behavioral and emotional problems like those with autism. A survey conducted in Australia revealed that of the children identified with emotional and behavioral disorders, only 2% had received any form of treatment from a mental health medical practitioner and only 10% of parents had received any form of education to cope and manage the children. Martinez Jr, argues that, there are a number of cultural and psychological implications that are associated with seeking medical help regarding children’s difficult emotional and physical behavior. The stigma attached to the situation sometimes inhibits parents from seeking help. Other factors such as work schedules, travel time, transport costs and difficulties in arranging child care prevents from attending sessions geared towards equipping parents with the necessary skills for managing such behavior (Martinez Jr,2001). Group Intensive Family Training (GIFT) In the absence of quality and effective treatment, children with autism develop problematic behavior manifested as aggression, disruptive actions, and self-injury. For treatment to be effective early diagnosis is key and a continual of treatment is provided at home necessitating the need for family members to be equipped in dealing with autistic children. Reports suggest the need for early behavioral intervention by the family in order be sufficiently adequate in tackling the issue of problem behavior. Others suggest that parents should be trained as therapists so that they can be able to understand their children’s behavior and be able to modify problematic behavior when it arises. There is need for parents to use behavioral intervention techniques. The Division of Development- Behavioral Pediatrics established the Hands-On Parent Education Center (HOPE) and a group intensive family training program was formed to provide an effective and efficient training program for parents. It was a 12-week program where six parent-child combinations attended a facility simulated like a preschool for a period of 5 days per week for 3 hours each week. The total training time was 180 hours. The aim of the project is to help parents slowly move the behavioral intervention of their children from the clinic to their home by training parents to be the primary therapist of their children. Family – school collaboration Eyberg et.,al argues that collaboration between families and a school is only achieved if there exists constant interactions between the family and the school, which is essential since children are members of both groups (Eyberg, 1982). Family members are related in so many ways that a person’s experience affects the other members of the unit and the family plays an important role in the development of a child’s progress in school. In order for a child to develop well, there is need for the school to understand a family to facilitate collaborative relationships. Initially, most families in America consisted of the traditional nuclear family-one father, one mother, and the child (ren) however, in the last couple of years the family make up has greatly changed. Reports from the U.S Bureau of Census assert that in the last 25 years, single father families have increased from 1.3 million to 3.2 million while single mother families have increased from 5.8 million to 13.6 million. This is mainly attributed to increased percentages of reported divorce cases coupled with adoption and spousal deaths. The new family dynamics today such gay and lesbian headed families need to be understood since they have unique challenges consisting of social stigma and discrimination. Traditional perceptions of what constitutes a family need to be revised in order to accommodate and acknowledge the distinct pressures faced by the families, which interact with teachers. Blair et.,al note that building collaborative partnerships is a multi-dimensional process involving - recognizing the areas of change, mobilizing people, developing a long term strategy to effect change, seeking support from partners, choosing a group structure, establishing trust among the partners and developing opportunities for learning for the partners(Blair,2010). Kuhn et.,al note that, there are cases where the collaboration between parents and children has aided in helping children with difficulties. School staff in rural Kentucky established that a preschool child was developmentally stunted and the parents did not know of the services provided by the community. However, the parents were willing to work with the school, human service providers, and health officers in order to enroll the child in a preschool program. A team was formed by the agency to support the parents and work with the child at home. The father was referred to a training program job and due to the success of the joint initiative, a formal arrangement was established for the purpose of tackling issues of a similar nature in the future (Kuhn, 2003) . Another case is reported in Salinas, California where families with seriously ill children established a support group for the families and children. The support group had partners like the American Cancer Society, which is an outreach program, and Healthy Start an initiative sponsored by the state with many links. The families convene on a weekly basis to learn and support each other regarding their children’s difficulties. The collaboration has been so successful such that some of the parents have begun offering leadership to other Healthy Start projects. Austin is of the opinion that through the collaboration between the school and family, individuals with different knowledge bases are brought together and different people can meet partners with distinct skills and knowledge that can be of benefit to others (Austin, 2005). Since developing collaboration is a learning process, it is important to distinguish between professional development, community involvement, and parent education from the other work. Sibling training to treat non-compliance Positive Behavior Support (PBS). Anan et al states that, children with autism disorders are one of the most challenging issues combatted by teachers and parents due to their problem behaviors. It is the most effective and current tool in treating and managing challenging behavior of autistic children. The practice has been proven to be reliable in dealing with individuals having a variety of difficult behaviors and disabilities (Anan, 2007). It is an approach that has been modified from traditional behavioral management techniques. The approach is a set of strategies that are based on strategy for the purpose of reducing problem behaviors through establishing effective environments and teaching the children appropriate communication and social behavior. PBS aims to decrease problem behaviors through the creation of an effective environment where the children are taught new skills instead of focusing on the difficult behaviors exhibited. An integral part of PBS is functional behavior assessment or simply (FBA).FBA aids in determining the events that cause and promote the child’s behavior and are considered the best techniques in establishing and designing behavioral interventions. It is imperative that environmental situations be identified to enable prediction of the occurrence and lack of it of the child’s problem behavior. The other goal pertains to obtaining and expanding the information to be used in improving the effectiveness of the intervention strategies to be adopted. In some instances, the autistic sibling may exhibit aggressive behavior in order to seek attention from their siblings or parents. Smith et al., argues that most children with autism have social skills deficiencies and may as a result experience difficulty in communicating properly their needs or influence their surroundings. Through the problematic behavior, the autistic child is in fact trying to communicate his/her needs. By understanding the goal of the child’s behavior, one is able to start teaching an alternative replacement behavior and new skills for interacting (Smith, 1999). According to Morawska et.,al ,the process of performing an FBA is described as a method of establishing goals, purposes, and functions of the student’s behavior or as an attempt to develop an understanding of what causes a student to behave in a particular manner about his environment. Others suggest that it is an effort to establish clear and predictable interactions between occurrences in the person’s surroundings and those of problematic behavior (Morawska, 2006). An FBA is conducted in a number of ways but has two general tools for assessing and aiding in the collection of data relating to events and variables that are associated with the occurrence or lack thereof it in the autistic child’s problematic behavior. One of the assessment tools involves the use of interviews and rating scales to get information from the people who know him best; his family, teachers and other students. The other method involves observing the autistic child performing his duties in his natural surroundings. The observer may use the ABC format, which entails him describing the subject’s behavior and the consequences resulting from the behavior. Results from the FBA test are examined by a professional team who develop hypothesis regarding causes of problematic behavior and then intervention strategies are developed with focus being placed on teaching appropriate behavior and reducing the unwanted behavior. Recent reports from research suggest that PBS can be used in removing and preventing problematic behaviors suffering from autism. A review of published studies established that there was a reduction in challenging behavior by 53% in cases where PBS was adopted as the strategy of modifying behavior. PBS has been prescribed by the Individuals with Disabilities Education Act (IDEA) as the most preferable strategy of intervention in dealing and eliminating behavior in students with disability. Effects on the individual with autism Clements argues, that by using the developmental approach however, autistic children have the following benefits:- a. They are able to become members of a community in a classroom setting. b. They have access to emotional and social support from the teachers and students. c. They are able to be understood better and their strengths and needs are met. d. They gain opportunities to engage with their peers on a social perspective through expressing themselves, watching, and listening to others (Clements, 2005). Future research According to the Centers for Disease Control and Prevention, every 1 in 88 children are autistic. .This figure represents a 23 % increase in autism rates between 2006 to 2008 and an increase by 78% from 2002.Researchers have attributed the increased proportions of children having autism to broader definitions of autism and earlier identification than before. It is also of interest to note that there is an increase in the attention paid on autism-spectrum disorders. The increased attention has led to funds being raised by advocacy groups, federal agencies and other interest stakeholders worth millions of dollars in order to establish the causes and best treatment plans. Conclusion There is still no sufficient evidence to establish the best way to treat non -compliance behavior in children but positive reports are that there is need for early diagnosis and treatment before the age of 6 years as it has been established as the most appropriate age where treatment is most effective. Duda et.,al suggests that it is possible to reverse or decrease the symptoms of autism in infants. Brain research on children at different developmental stages is likely to aid in the treatment of autism in the future (Duda, 2008). References Martinez Jr, C. R., & Forgatch, M. S. (2001). Preventing problems with boys noncompliance: effects of a parent training intervention for divorcing mothers. Journal of consulting and Clinical Psychology, 69(3), 416. Eyberg, S. M., & Robinson, E. A. (1982). Parent‐child interaction training: Effects on family functioning. Journal of Clinical Child & Adolescent Psychology, 11(2), 130-137. Kuhn, S. A., Lerman, D. C., & Vorndran, C. M. (2003). Pyramidal training for families of children with problem behavior. Journal of Applied Behavior Analysis, 36(1), 77-88. Anan, R. M., Warner, L. J., McGillivary, J. E., Chong, I. M., & Hines, S. J. (2008). Group Intensive Family Training (GIFT) for preschoolers with autism spectrum disorders. Behavioral Interventions, 23(3), 165-180. Morawska, A., & Sanders, M. R. (2006). Self-Directed Behavioural Family Intervention. International Journal of Behavioral Consultation and Therapy, 2(3), 332-340. Moes, D. R., & Frea, W. D. (2000). Using family context to inform intervention planning for the treatment of a child with autism. Journal of Positive Behavior Interventions, 2(1), 40-46. Duda, M. A., Clarke, S., Fox, L., & Dunlap, G. (2008). Implementation of positive behavior support with a sibling set in a home environment. Journal of Early Intervention, 30(3), 213-236. Blair, K. S. C., Lee, I. S., Cho, S. J., & Dunlap, G. (2010). Positive behavior support through family-school collaboration for young children with autism. Topics in Early Childhood Special Education. Smith, M. R., & Lerman, D. C. (1999). A preliminary comparison of guided compliance and high-probability instructional sequences as treatment for noncompliance in children with developmental disabilities. Research in developmental disabilities, 20(3), 183-195. Austin, J. L., & Agar, G. (2005). Helping Young Children Follow Their Teachers Directions: The Utility of High Probability Command Sequences in Pre-K and Kindergarten Classrooms. Education and Treatment of Children, 28(3), 222-236. Errorless Academic Compliance Training for Children with Autism Spectrum Disorders: Effects on Compliance and Social Communicative Responses. (2011). Nelson, H. (2006). The effects of intervention involving a robot on compliance of four children with autism to requests produced by their mothers. Canali, C. (2008). Assessing the evidence-base of intervention for vulnerable children and their families. Padova: Fondazione Emanuela Zancan onlus. Clements, J. (2005). People with autism behaving badly helping people with ASD move on from behavioral and emotional challenges. London: Jessica Kingsley. Paxton, K., & Estay, I. (2007). Counselling people on the autism spectrum a practical manual. London: Jessica Kingsley Read More