This week we close our discussion regarding tips and tricks for parent training. You can find Part 1 here and Part 2 here.
This week, in our final addition, we’ll look at more practical information for getting parent training off on the right foot. The overarching principle from today’s article is this:
If you‘re looking to help parents by changing their behavior, start by changing what they attend to at home.
We’re here to help parents—not tell them what to do. Nor should we enter this relationship with the lofty expectation that they’ll simply change their behavior because “we’re behavior analysts.” Instead, we have to be the professionals. As such, we have to help them get there.
So here are a few ideas for doing so!
Look to get a quick win—start with basic parenting behavior. When starting ABA therapy, it's important to remember that parents, especially at the beginning, are eager to see quick results. So often, improvements can be made to the immediate home environment by simply having the parents adopt a basic parenting behavior that they might not be implementing consistently. These basic behaviors are usually related to general daily structure or the quality of the parent-child relationship in the home.
For example, attention is such a frequent component related to problem behavior. A quick win might be to suggest that parents spend 10-15 minutes each evening snuggling, reading, and giving direct 1:1 attention with their child. This can vastly improve the learner’s behavior as it offers predictable access to caregiver attention. Another example of a quick approach is to have parents tell their child "I love you" 10 times each evening. This can have an immediate and positive impact on the child's quality of life and the family's environment. Although it can be difficult to provide precise advice that solves specific problems, implementing these types of suggestions can go a long way in building a strong relationship with the family and achieving positive outcomes sooner.
Look for a parent “aha” moment—start with data collection. To get parents on board with ABA therapy, it can be helpful to encourage them to have their own "aha moments" by taking data on the behavior of their kiddo at home. Rather than pointing out where they may be falling short or what they need to change, simply having them track certain behaviors and come to their own conclusions can be effective.
If a child is spending a lot of time on an iPad, for example, instead of immediately telling the parents to limit that time or trying to explain the effects of blue light on neural pathways, try a different approach. Suggest that they track how much time the child spends on the device and report back to you on it. By having the parent’s objectively taking data on the learner’s environment, you’re also shaping the way they attend to that environment. This can help them identify areas for improvement on their own. When these conclusions align with your clinical recommendations, you have buy in. To finish the example above, if the parent notices that the learner is on the iPad for 3-4 hours every evening, its a possibility that they will come to the conclusion that limiting iPad time might be a direction that they need to take at home.
Parent training means parent behavior. A great way to help parent training be successful is to have parents label their own behavior and emotions. Instead of just looking at the child's behavior and trying to change it, it's important to recognize that the caregiver (i.e., the parent) might play a crucial role in whether or not that behavior happens in the first place. By starting with the parent and asking them to track their own behavior and emotions, it can be helpful in understanding the relationship between their behavior and the child's behavior.
For instance, before introducing the concept of ABC data (Antecedent, Behavior, Consequence), it may be helpful to ask parents to record their emotional response to their child's problem behavior right after it happens. How do they feel when a problem behavior occurs? Do they notice an increase in anxiety? Frustration? It’s important to go about this non-judgmentally. Again, we’re looking to help parents notice the variables that might impact their behavior or their child’s behaviors early on—not to eliminate them completely.
Tough intervention? Give it an expiration date. If you're struggling to get parents on board with a tougher intervention at home, consider having them agree to a timeline. First, it’s important to note that your interventions should be realistic and manageable for the parents to implement, not too complicated or impractical. However, sometimes you introduce a plan that the parents may be able to carry out but you're unsure if they'll commit to it. Make it easy and start by suggesting they implement the plan for a specific time frame.
For example, maybe you ask that they withhold the iPad at home unless their kiddo successfully voids on the toilet. Instead of leaving it at that, ask them to carry this out over the next 15 days only. If parents are nervous about withholding such a high value item, this gives them light at the end of the tunnel if things go poorly. It also gives the intervention enough time to work…and if it works, you’ll likely get permanent buy-in on toileting…and probably other interventions in the future. Negative reinforcement is a powerful thing—for parents, too.
Don’t stop talking. Frequent communication is crucial for building strong relationships with parents and achieving better results as a BCBA. While it may seem obvious, it is essential to maintain consistent communication with parents to foster trust and collaboration. Even if you can't be present for every pickup and drop-off, make an effort to connect with parents at least once or twice a week. Utilize text messages* and emails to keep in touch and find creative ways to stay connected.
One helpful strategy is to dedicate an hour each week to email other professionals and parents. By setting this routine, parents will come to expect communication from you and be more likely to engage in dialogue about the interventions you're implementing. Additionally, encourage your staff to remind parents about the intervention plan and collect data to ensure its implementation. Prompting your RBT to ask questions at drop-off and pick-up can also help keep parents engaged and accountable.
Keep interventions simple and basic—especially in the beginning. To improve the chances of success, it's important to focus on one simple thing at a time when working with parents. Introducing complicated or multiple interventions at once can be overwhelming and lead to failure. Parents have many competing demands, so it's crucial to prioritize the most important goal for their child and give them simple, singular instructions and interventions to carry out each evening and weekend over a specific timeline.
This approach will increase the likelihood that parents will follow through with the intervention plan. Avoid introducing technical concepts like ABC data or the four functions of behavior and instead introduce one thing at a time in the simplest way possible. By keeping interventions simple and manageable, parents will be more likely to engage and see the desired results.
Talk like a regular person. When introducing something that you'd like parents to work on, don't over-complicate your explanation. Be succinct, clear, and refrain from jargon. There's a lot of training that goes into talking about jargon and the way BCBAs overuse it sometimes…However, this is something that can't be stressed enough. It's often unnecessary for parents to learn our language when 99.9% of the population doesn't use it. Unfortunately, if we're spending a great deal of time using that jargon and/or insisting that they understand it, we're asking them to take an extra step out of a busy day, using up time they likely don't have, which ensures that they might not follow through or grasp the concepts that we're trying to teach. Instead, keep your instructions simple. Given the recent examples I've used in this article so far, I'll provide examples of how you might phrase these instructions in the simplest terms.
What I’m going to ask you to do, is to sit down and read a story, snuggle, and give Braden 100% of your attention for 10-15 minutes every night at bed time. Can you do that for the next two weeks?
Can you make sure to give Sarah 10 hugs every day for the next 10 days? I’m just interested in seeing what her reaction will be.
Can you do me a favor? Can you just keep track of the amount of time Cohen spends on his iPad on weeknights. Just a guestimation here. I don’t need you to do anything else. I’m just curious about it.
I’m always interested in the way people feel after a problem behavior occurs. Do you think you could record the date and time Jared has a tantrum? Also, do you think you could write in how it impacted you and/or others? Did it upset anyone? Did it upset you? (Note: Make sure you’ve gained trust with caregivers for programs like these.)
So, we’re going to try something. Do you think you can ONLY give Kellen access to his iPad if he goes potty? Do you think you can do that for, like, 15 days?
Note that most of these “asks” are simple. There isn’t a great deal of behavior analytic lingo. There isn’t an explanation. Should the parent ask for one, obviously you would provide it. However, keeping things simple and clear can go a long way.
Use technology to help you! Finally, I believe one of the best-kept secrets for keeping parents engaged and on board is utilizing certain technologies like specific online forms. As I mentioned earlier, frequent communication and data collection are crucial in turning parents' attention towards what we need them to focus on. One approach that I find effective is using Google Forms or similar tools* (MS Teams has something similar), where parents can fill out a form every morning.
This form usually comes to them as a link in their email. Each morning, they return to that link and fill out the form. Initially, you can have the RBTs remind them to fill out the form at drop off each day. The items on the form serve as an ecological assessment and attempt to capture general setting events (sleep schedule, eating behavior, etc.) from the time that they weren’t in therapy. Additionally it directs their attention—every day. You can customize the form to include items that are specific to the interventions you hope to see in the home. For example, you might ask them how much time the learner engaged with the iPad at home in relation to the number of times they voided independently on the toilet. This is a great approach for helping parents attend to certain variables they might not normally notice. And…you’ll get great data.
What tips and tricks do YOU have? Let me know!
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*Note that there are usually certain HIPAA requirements regarding the use of text messages, google forms, etc. Check with your supervisor before implementing these approaches.