Review of Evidence-Based Approaches to Caregiver Training

  • Alison CoxEmail author
  • Sarah Davis
Intellectual Disabilities (M Feldman and R Condillac, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Intellectual Disability


Purpose of Review

Training caregivers on tasks related to quality of life for the individuals they support is important across service sectors. Moreover, trainees often rank quality training as highly acceptable. This review summarizes the current status of the caregiver training literature, while providing recommendations for future research initiatives.

Recent Findings

Telecommunication and pyramidal training models represent advancements in caregiver trainings, and burgeoning evidence suggests that these approaches may effectively develop caregiver skill mastery. However, improved caregiver performance may not reliably coincide with client improvement.


Behavioral skills training is an evidence-based approach to establish mastery across a range of skills within the context of caregivers supporting individuals with intellectual and developmental disabilities (IDD). Research examining skill generalization and maintenance, and the relationship between caregiver skill mastery and client outcomes remains relatively understudied. Early evidence examining advancements in caregiver training is promising and may offset costs associated with standard training approaches.


Caregiver training Behavioral skills training Intellectual and developmental disability 


Compliance with Ethics Guidelines

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    American Psychological Association Presidential Task Force on Evidence-Based Practice. Evidence-based practice in psychology. Am Psychologist. 2006;61(1):271–85. Scholar
  2. 2.
    Behavior Analyst Certification Board. Professional and ethical compliance code for behavior analysts 2019. Accessed 29 July 2019.
  3. 3.
    Gardner JM. Teaching behavior modification to nonprofessionals. J Appl Behav Anal. 1972;5(4):517–21.CrossRefGoogle Scholar
  4. 4.
    Rose DJ, Church RJ. Learning to teach: the acquisition and maintenance of teaching skills. J Behav Educ. 1998;8(1):5–35.CrossRefGoogle Scholar
  5. 5.
    • Davis S, Thomson K, Connolly M. A component analysis of behavioral skills training with volunteers teaching motor skills to individuals with developmental disabilities. Behav Interv. In press. Recent research by the second author directly comparing didactic and BST approaches. Google Scholar
  6. 6.
    Parsons MB, Reid DH. Reading groups: a practical means of enhancing professional knowledge among human service practitioners. Behav Anal Pract. 2011;4:53–60. Scholar
  7. 7.
    Parsons MB, Rollyson JH, Reid DH. Evidence-based staff training: a guide for practitioners. Behav Anal Pract. 2012;5(2):2–11. Scholar
  8. 8.
    • Parsons MB, Reid DH. Training residential supervisors to provide feedback for maintaining staff teaching skills with people who have severe disabilities. J Appl Behav Anal. 1995;28:317–22. research thoroughly describing and applying BST approach in the context of supporting individuals with IDD.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Miltenberger RG. Behavior modification: principles and procedures. Grove: Thomson/Wadsworth; 2008.Google Scholar
  10. 10.
    Dickson MJ, Vargo KK. Training kindergarten student’s lockdown drill procedures using behavioral skills training. J Appl Behav Anal. 2017;50:407–13. Scholar
  11. 11.
    Hankla ME, Kohn CS, Normand MP. Teaching college students to pour accurately using behavioral skills training: evaluation of the effects of peer modeling. Behav Interv. 2018;33:136–49. Scholar
  12. 12.
    Davenport CA, Alber-Morgan SR, Konrad M. Effects of behavioral skills training on teacher implementation of a reading racetrack intervention. Educ Treat Child. 2019;42(3):385–408. Scholar
  13. 13.
    Hogan A, Knez N, Kahng S. Evaluating the use of behavioral skills training to improve school staffs’ implementation of behavior intervention plans. J Behav Educ. 2015;24:242–54. Scholar
  14. 14.
    Belisle J, Rowsey KE, Dixon MR. The use of in situ behavioral skills training to improve staff implementation of the PEAK relational training system. J Organ Behav Manag. 2016;36:71–9. Scholar
  15. 15.
    Lambert JM, Bloom SE, Kunnavatana S, Collins SD, Clay CJ. Training residential staff to conduct trial-based functional analyses. J Appl Behav Anal. 2013;46:296–301. Scholar
  16. 16.
    Alaimo C, Seiverling L, Sarubbi J, Sturmey P. The effects of a behavioral skills training and general-case training package on caregiver implementation of a food selectivity intervention. Behav Interv. 2018;33(1):26–41. Scholar
  17. 17.
    Hassan M, Simpson A, Danaher K, Haesen K, Makela T, Thomson K. An evaluation of behavioral skills training for teaching caregivers how to support social skills development in their child with autism spectrum disorder. J Autism Dev Disord. 2018;48(6):1957–70. Scholar
  18. 18.
    Gunby KV, Rapp JT. The use of behavioral skills training and in situ feedback to protect children with autism from abduction lures. J Appl Behav Anal. 2014;47:856–60. Scholar
  19. 19.
    Hassan M, Thomson KM, Khan M, Burnham Riosa P, Weiss JA. Behavioral skills training for graduate students providing cognitive behavior therapy to children with autism spectrum disorder. Behav Anal Res Pract. 2017;17(2):155–65. Scholar
  20. 20.
    Strohmeier C, Mule C, Luiselli JK. Social validity: assessment of training methods to improve treatment integrity of special education service providers. Behav Anal Pract. 2014;7:15–20. Scholar
  21. 21.
    Cooper JO, Heron TE, Heward WL. Applied behavior analysis. Upper Saddle River: Pearson/Merrill Prentice Hall; 2007.Google Scholar
  22. 22.
    •• Brock ME, Cannella-Malone HI, Seaman RL, Andzik NR, Schaeferm JM, Pag EJ, et al. Findings across practitioner training studies in special education: a comprehensive review and meta-analysis. Except Child. 2017;84(1):7–26. review examining pertinent trends across the BST literature, including relationship between client outcomes and caregiver fidelity improvements. CrossRefGoogle Scholar
  23. 23.
    • Stokes TF, Baer DM. An implicit technology of generalization. J Appl Behav Anal. 1977;10(2):349–67 Seminal paper describing generalization strategies. CrossRefGoogle Scholar
  24. 24.
    Ducharme JM, Feldman M. Comparison of staff training strategies to promote generalized teaching skills. J Appl Behav Anal. 1992;25(1):165–79.CrossRefGoogle Scholar
  25. 25.
    Finn LL, Sturmey P. The effect of peer-to-peer training on staff interactions with adults with dual diagnoses. Res Dev Disabil. 2009;30(1):96–106. Scholar
  26. 26.
    Drifke MA, Tiger JH, Wierzba BC. Using behavioral skills training to teach parents to implement three-step prompting: a component analysis and generalization assessment. Learn Motiv. 2017;57:1–14. Scholar
  27. 27.
    Kornacki LT, Ringdahl JE, Sjostrom A, Nuernberger JE. A component analysis of a behavioral skills training package used to teach conversation skills to young adults with autism spectrum and other developmental disorders. Res Autism Spectrum Dis. 2013;7:1370–6. Scholar
  28. 28.
    Higgins WJ, Luczynski KC, Carroll RA, Fisher WW, Mudford OC. Evaluation of a telehealth training package to remotely train staff to conduct a preference assessment. J Appl Behav Anal. 2017;50:238–52. Scholar
  29. 29.
    Parsons MB, Rollyson JH, Reid DH. Teaching practitioners to conduct behavioral skills training: a pyramidal approach for training multiple human service staff. Behav Anal Pract. 2013;6(2):4–16. Scholar
  30. 30.
    Andzik N, Cannella-Malone HI. A review of pyramidal training approach for practitioners working with individuals with disabilities. Behav Modif. 2017;41(4):558–80. Scholar
  31. 31.
    • Van den Pol RA, Reid DH, Fuqua RW. Peer training of safety-related skills to institutional staff: benefits for trainers and trainees. J Appl Behav Anal. 1983;16(2):139–56. example of peer-to-peer training that included exploring how this approach may promote skill maintenance. CrossRefGoogle Scholar
  32. 32.
    Lindgren S, Wacker D, Suess A, Schieltz K, Pelzel K, Kopelman T, et al. Telehealth and autism: treating challenging behavior at lower cost. Pedi. 2016;137(2):167–75. Scholar
  33. 33.
    Wacker DP, Lee JF, Dalmau YC, Kopelman TG, Lindgren SD, Kuhle J, et al. Conducting functional analyses of problem behavior via telehealth. J Appl Behav Anal. 2013;46:31–46. Scholar
  34. 34.
    Giles A, Swain S, Quinn L, Weifenbach B. Teacher-implemented response interruption and redirection: training, evaluation, and descriptive analysis of treatment integrity. Behav Modif. 2018;42(1):148–69. Scholar
  35. 35.
    Kupzyk S, Shriver MD. A systematic framework for addressing treatment integrity in school settings. Psych in the Schools. 2016;53(9):954–70.CrossRefGoogle Scholar
  36. 36.
    Pence ST, St. Peter CC, Tetreault AS. Increasing accurate preference assessment implementation through pyramidal training. J Appl Behav Anal. 2012;45:345–59. Scholar
  37. 37.
    Bethune KS, Wood CL. Effects of coaching on teachers’ use of function-based interventions for students with severe disabilities. Teacher Educ Divi Council Excep Child. 2013;36(2):97–114. Scholar
  38. 38.
    Mouzakitis A, Codding RS, Tyron G. The effects of self-monitoring and performance feedback on the treatment integrity of behavior intervention plan implementation and generalization. J Pos Behav Interv. 2015;17(4):223–34. Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Applied Disability StudiesBrock UniversitySt. CatharinesCanada

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