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Held Dissertation.pdf (4.08 MB)

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Presented in Partial Fulfillment of the Requirements for the Degree Doctor of Philosophy in the Graduate School of The Ohio State University

Held, Megan
http://rave.ohiolink.edu/etdc/view?acc_num=osu1670001841024471

Abstract Details

2022, Doctor of Philosophy, Ohio State University, Psychology.
In recent decades, the field of autism has embraced family-centered care (FCC) as one tool for decreasing parental stress, with several studies demonstrating the positive impact of FCC on families (Dunst et al., 2007). However, parents of children with autism spectrum disorder (ASD) are less likely to report receiving FCC than parents of children with other health care needs (Brachlow et al., 2007; Gabovitch & Curtin, 2009). Applied Behavior Analysis (ABA) is a highly utilized category of treatment for ASD (Hyman et al., 2020), allowing providers of ABA the opportunity to have a particularly significant impact on families. No known studies have examined the state of FCC in ABA in the United States, and FCC is not a required component of training for Board Certified Behavior Analysts (BCBAs) (Behavior Analyst Certification Board, 2020). The aims of this study were: 1) Explore the current implementation of FCC in ABA and 2) Develop, implement, and evaluate a series of trainings for BCBAs focused on family-centered topics. In Phase One of this study, 16 parents of children aged 2-18 receiving ABA intervention for ASD and 10 BCBAs providing ABA intervention to children with ASD participated in focus groups. Transcripts were analyzed using grounded theory to identify the extent to which parents receive and BCBAs practice the four core components of FCC (respect and dignity, information sharing, participation, and collaboration). Several identified themes were common to both groups, with some themes unique to either the parent or BCBA groups. Overall, areas of strength and weakness related to the provision of FCC were shared by parents and BCBAs. Parents and BCBAs identified several barriers that prevent the provision of high-quality FCC, and BCBAs identified areas in which they would like to receive additional training. In Phase Two of this study, a series of 8 training sessions utilizing the Extension of Community Healthcare Outcomes (ECHO™) model were provided to BCBAs based on the training needs identified in Phase One, with 40 BCBAs attending at least 5 sessions. A quasi-experimental design with pre- and post- measures was conducted. BCBAs completed a questionnaire at pre- and post-test including a measure of self-efficacy and a measure of FCC provision. A measure of satisfaction was also completed at posttest. Paired samples t-tests were conducted to test for mean differences between pretest and posttest self-efficacy and FCC provision. Differences between BCBAs with a degree in behavior analysis and a degree in other areas as well as differences based on years of experience in the field of ABA were examined. Additionally, a total of 22 parents of children aged 3-18 receiving ABA intervention completed a questionnaire including demographics, a measure of perception of FCC received, and a measure of parental stress. Correlations were conducted to examine the relationship between FCC and parental stress. Results indicate that BCBAs improved significantly in self-efficacy and specific aspects of FCC from pretest to posttest. BCBAs with degrees in behavior analysis demonstrated significantly greater improvement in self-efficacy and the specific FCC component of providing general information than BCBAs with degrees in other areas. There were no significant differences between these two groups of BCBAs on pretest measures. Additionally, there was no significant relationship between years in the field of ABA and change in self-efficacy and FCC provision from pretest to posttest or self-efficacy and FCC provision at pretest. Overall, BCBAs reported high levels of satisfaction with the ECHO trainings. Additionally, results indicate that there is a significant relationship between parental stress and FCC, with parents who report receiving higher levels of FCC in the area of information sharing reporting lower levels of stress. Overall, findings suggest that there is significant room for improvement in FCC in the field of ABA, and the ECHO model is a potential avenue for effecting change among BCBAs.
Andrea Witwer (Advisor)
Vanessa Rodriguez (Committee Member)
Susan Havercamp (Committee Member)
Katherine Walton (Committee Chair)
268 p.
Psychology
autism; autism spectrum disorder; family-centered care; FCC; ABA; applied behavior analysis; parental stress; BCBA; board certified behavior analyst

Recommended Citations

Citations

  • Held, M. (2022). Presented in Partial Fulfillment of the Requirements for the Degree Doctor of Philosophy in the Graduate School of The Ohio State University [Doctoral dissertation, Ohio State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=osu1670001841024471

    APA Style (7th edition)

  • Held, Megan. Presented in Partial Fulfillment of the Requirements for the Degree Doctor of Philosophy in the Graduate School of The Ohio State University. 2022. Ohio State University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=osu1670001841024471.

    MLA Style (8th edition)

  • Held, Megan. "Presented in Partial Fulfillment of the Requirements for the Degree Doctor of Philosophy in the Graduate School of The Ohio State University." Doctoral dissertation, Ohio State University, 2022. http://rave.ohiolink.edu/etdc/view?acc_num=osu1670001841024471

    Chicago Manual of Style (17th edition)

osu1670001841024471
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This open access ETD is published by The Ohio State University and OhioLINK.