Transforming Coercive Processes in Family Routines: Family Functioning Outcomes for Families of Children with Developmental Disabilities
Single case design research on family centered positive behavior support (PBS) over the past 20 years has provided evidence of the approaches acceptability, effectiveness and durability when implemented with families of children with developmental disabilities and problem behavior. Although quality of life is a key tenet of PBS, only a few studies of PBS with families have measured quality of life outcomes. The purpose of this study is to present family functioning results from the second half of a longitudinal study that investigated the consequential validity of an ecological approach to family centered PBS. The approach aimed to transform coercive into constructive family processes in family routines during a process of comprehensive assessment, multicomponent plan design and implementation support in collaboration with families. Ten families of children with developmental disabilities participated. Settings were 32 family routines, with two to four routines per family. Family functioning measures were family quality of life, parental stress, parental locus of control and social support. A repeated measures, quasi-experimental group design across mothers and fathers evaluated the statistical significance of changes in family functioning when comparing baseline to intervention and follow-up phases. Results evidenced significant improvements for mothers in family quality of life and parental stress during intervention and follow-up, and in parental locus of control during follow-up. Results evidenced significant improvements for fathers in parental stress during intervention and follow-up, but no significant improvements in family quality of life or parental locus of control. Results are discussed in terms of contributions to the literature, implications for practice, limitations, and future research.
KeywordsPositive behavior support Family centered service delivery Autism Developmental disabilities Family quality of life Coercive processes
We thank the 10 families for their participation in the longitudinal study, and for their contributions to our knowledge about improving child behavior and child and family quality of life. We thank Robert Horner and Michael Stoolmiller for their contributions as formal consultants to project. We thank Roger Bakeman, Larry Irvin, Gerald Patterson and Paul Yovanoff for their contributions to the research methodology. We thank Lauren Binnendyk, Lauren Elkinson, Brenda Fossett, and Laura Green for their contributions as family interventionists. We thank Sophia Khan for her contributions as project coordinator. We also thank the many research assistants for their contributions as well.
JML: designed and executed the study, provided training and supervision to family interventionists and research assistants, and wrote the first manuscript draft. LDM: provided clinical supervision of interventionists working with families enrolled in the study, psychological counseling support to three parents enrolled in the study, and editorial input on the manuscript draft. CC: implemented the intervention with two families, provided supervision and training to research assistants, and provided editorial input on the manuscript draft. SL: led the implementation of the research project at the consortium site, implemented the intervention with two families, provided supervision and training to research assistants, and provided feedback on the manuscript draft. BDZ: assisted in monitoring the quality of the data throughout the study and guided the analysis and write-up of the statistical analysis procedures employed in the study; that is, planned comparisons using non-parametric statistics.
The research project was supported by grant 5R01HD041671 from the National Institute of Child Health and Human Development (NICHD) of the National Institutes of Health (NIH) to the University of British Columbia. The project was additionally supported by a consortium agreement with Rutgers Robert Wood Johnson Medical School (RWJMS).
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
All procedures performed in the study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The Behavioral Research Ethics Board at the University of British Columbia, and the Institutional Review Board at the University of Medicine and Dentistry of New Jersey specifically approved this study.
Informed consent was obtained from all individual participants included in the study.
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