Using the Prevent-Teach-Reinforce Model to Reduce Problem Behaviors in Children With Autism Spectrum Disorders

Children with autism spectrum disorders often engage in problem behaviors such as self-injury, destruction, aggression, and stereotypy. Prior research has clearly shown that these problem behaviors may interfere with learning, daily functioning, and social participation. As such, engaging in problem behaviors has a negative impact on the health and quality of life of children with autism spectrum disorders and their families. One promising solution to reduce problem behaviors in this population is the Prevent-Teach-Reinforce (PTR) model, which relies on the evidence-based practices of positive behavior support. Although the use of PTR has been gaining considerably support in schools, the model has never been evaluated as part of a rigorous large-scale study using parents as interventionists. Thus, the purpose of the project is to conduct an assessment of the effectiveness of a home-based version of the PTR model in reducing problem behaviors in children with autism spectrum disorders and in improving families' quality of life. Our hypotheses are that implementing the PTR will (a) produce larger reductions in problem behaviors than participating in an individual parent training session, (b) increase engagement in prosocial behaviors, (c) decrease parental stress, and (c) improve the quality of life of the family. The results of the study will allow an examination of whether PTR is an effective and acceptable model to reduce problem behaviors at home in this population. Given that problem behaviors incur high societal costs when they persist into adolescence and adulthood, the study may potentially lead to large cost reductions in the treatment of difficulties associated with autism spectrum disorders. By reducing engagement in problem behaviors, the implementation of the model may also promote and facilitate the social participation as well as improve the quality of life and health of children with autism spectrum disorders and their families.

Study Overview

• Status: Completed
• Conditions: Child Development Disorders, Pervasive
• Intervention / Treatment: Behavioral: Prevent-Teach-Reinforce Model; Other: Individual Parent Training Session

• Study Type: Interventional
• Enrollment (Actual): 42
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Canada
  • Quebec
    • Lachine, Quebec, Canada
      • West Montreal Readaptation Centre
    • Montreal, Quebec, Canada
      • Gold Centre
    • Montréal, Quebec, Canada, H3L 3T1
      • CRDITED de Montréal

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: No older than 12 years (Child)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Clinical diagnosis of autism spectrum disorder
• Must exhibit problem behavior

Exclusion Criteria:

• Already receiving services to reduce problem behaviors at home

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Behavioral approach; The Prevent-Teach-Reinforce Model will be implemented with families in their home settings.	Behavioral: Prevent-Teach-Reinforce Model; Implementation of the model once to twice per week over a period of 8 weeks
Active Comparator: Educational approach; Each child's parent will participate in one 2- to 3-hour individual parent training session on the assessment and treatment of problem behavior in children with autism spectrum disorders.	Other: Individual Parent Training Session; One 2- to 3-hour individual parent training session on the assessment and treatment of problem behavior

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change from baseline in parental report of problem behavior at 8 weeks	Problem behavior scale of the Problem Behavior Inventory	Prior to the start of the intervention and 8 weeks later

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change from baseline in quality of life at 8 weeks	Beach Center Family Quality of Life Scale	Prior to the start of the intervention and 8 weeks later
Change from baseline in parental report of stress at 20 weeks	Parenting Stress Index Short Form	Prior to the start of the intervention and 20 weeks later
Change from baseline in parental report of stress at 8 weeks	Parenting Stress Index Short Form	Prior to the start of the intervention and 8 weeks later
Change from baseline in quality of life at 20 weeks	Beach Center Family Quality of Life Scale	Prior to the start of the intervention and 20 weeks later
Social validity of the intervention	Treatment Acceptability Rating Form - Revised	After 8 weeks of intervention
Change from baseline in parental report of problem behavior at 20 weeks	Problem behavior scale of the Problem Behavior Inventory	Prior to the start of the intervention and 20 weeks later
Change from baseline in parental report of positive social behavior at 20 weeks	Positive social behavior scale of the Nisonger Child Behavior Rating Form	Prior to the start of the intervention and 20 weeks later
Change from baseline in parental report of positive social behavior at 8 weeks	Positive social behavior scale of the Nisonger Child Behavior Rating Form	Prior to the start of the intervention and 8 weeks later

Collaborators and Investigators

• Sponsor: Université de Montréal
• Investigators: Principal Investigator: Marc Lanovaz, Université de Montréal

Study record dates

Study Major Dates

• Study Start: October 1, 2014
• Primary Completion (Actual): June 1, 2016
• Study Completion (Actual): September 1, 2016

Study Registration Dates

• First Submitted: May 29, 2014
• First Submitted That Met QC Criteria: May 29, 2014
• First Posted (Estimate): June 2, 2014

Study Record Updates

• Last Update Posted (Estimate): October 25, 2016
• Last Update Submitted That Met QC Criteria: October 24, 2016
• Last Verified: October 1, 2016

More Information

Terms related to this study

• Keywords: Autism spectrum disorder; Problem behavior
• Additional Relevant MeSH Terms: Behavioral Symptoms; Mental Disorders; Pathologic Processes; Neurodevelopmental Disorders; Disease; Problem Behavior; Autism Spectrum Disorder; Child Development Disorders, Pervasive; Developmental Disabilities
• Other Study ID Numbers: CERFAS-2014-15-058-P