Helping autistic children reach their full potential requires a team approach. Parent training, also often referred to as parent training, reduces parent stress, improves outcomes and increases the efficiency of intervention. Most insurance companies require parent training and participation to authorize services. While we all agree parent training provides the best outcomes for children, many professionals don’t receive explicit training in how to conduct parent training effectively.
Parent training requires a combination of relationship development and an exchange of knowledge. Professionals walk a fine line between establishing themselves as the expert while building enough trust to encourage follow-through. Parents must believe you care about their child and your recommendations will make a difference. Merge Behavioral Skills Training (BST) with active listening skills and see the difference in your parent training sessions.
Fast fact: According to the CDC, ABA services can cost between $17,000-$100,000 annually. A study by Solomon, Necheles, Ferch, and Bruckman (2007) evaluated a parent training model that cost $2,500 annually. A focus on parent-led intervention may result in a more cost-efficient means of service delivery.
1. Set Clear Expectations From the Beginning
During your very first conversation with parents, make sure they understand the important role they play in services. For many parents, you represent their first experience with a service provider. Others might have experience with “drop off” style services such as physical or occupational therapy. ABA parent training is unique and many parents may not understand their part.
Clearly describe expectations for the frequency and duration of parent training sessions. Discuss any requirements for documentation. Are parents responsible for collecting and submitting data or other documentation regularly? Identify any tasks you will expect the parents to complete on their own. Will you assign “homework” after each parent training session?
These types of concrete expectations reduce misunderstandings. Parents care about their children but they may have many conflicting priorities that make it appear as they don’t want to be involved in treatment. When parents understand the expectations from the beginning, they can commit to following through or they can negotiate different expectations that better align with their other obligations (i.e. 30 minute sessions twice per month rather than one 60 minute session each month).
2. Use an ABA Parent Training Curriculum to Create a Predictable Structure
Parents, especially parents of children with autism, have busy, chaotic lives. They juggle many different schedules, appointments and other obligations. Fitting in another task can feel daunting. Parent training often leads to homework assignments where professionals task parents with implementing some aspect of treatment at home. Create a predictable system for parents so that this becomes just part of their routine.
A prepared parent training curriculum can make this easy. Check out our ACHIEVE Parent Training Curriculum, or other commercially available programs such as the RUBI Parent Training Manual. These products provide a wide body of resources to simplify parent training and can be easily adapted to the individual needs of each family.
Make standing parent training appointments that occur at the same time on the same day of the week. Avoid needing to contact parents between appointments to schedule the next training session. Parents should know that they meet with you on the first and third Tuesday from 3-4 every month.
Use a standard structure and format for training during each session that includes:
- Reviewing the parents’ use of intervention at home
- Modeling new interventions or interventions that need further training
- Providing opportunities for parents to use interventions and receive feedback
- Assigning homework for them to practice before the next parent training session
Using a homework calendar that provides tasks for them to complete each week can help parents stay on track and practice important skills at home between appointments. These calendars keep expectations concrete and actually reduce the sense of overwhelm. Parents often feel they are expected to run hours of programming or implement complex interventions. Using a homework calendar like the one below helps parents understand what your expectations really are. As parents become proficient with implementing ABA strategies, gradually increase the difficulty of the tasks you include on the homework calendar. Download the templates below to get started.
This calendar provides specific assignments on specific days. Parents can choose to complete tasks on different days, but this calendar provides more structure and guidance for parents who need it. At the bottom is space to provide brief information about programs or goals for the month.
This calendar offers more flexibility but might be too open-ended for some parents. Assignments for the month are listed at the top of the calendar and parents initial in the calendar when they complete an assignment.
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With this complete curriculum you get:
- 26 lessons with assignments and quizzes that cover important skill acquisition and behavior reduction topics in easy-to-understand language.
- 2 lessons to help you learn what keeps parents from implementing what they’ve learned – and how to fix it!
- Stories and examples in each lesson to build trust and credibility with parents and caregivers.
- Language to show parents how it’s possible to incorporate the strategies into what they are already doing to reduce their feeling of overwhelm.
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3. Use Active Listening During ABA Parent Training
As a professional in the field of ABA, you are a problem-solver, a fixer. You assess skill deficits and identify the function of behavioral excess. Naturally, when parents discuss a problem they experience at home, your first inclination is to offer a solution. Active listening offers a way for you to connect with parents that will improve follow-through when you do offer your advice.
Active listening refers to a combination of skills that demonstrate understanding and acceptance that leads to the listener feeling heard. These techniques build trust. When a parent trusts you, he’s more likely to follow your advice and thus see the results you anticipate.
Although there is some variability depending on your source, there are essentially 3 main components (Weger, Castle Bell, Minei, & Robinson; 2014):
- Using nonverbal communication to demonstrate an interest in what the learner is saying
- Paraphrasing what the speaker said
- Asking questions to encourage the speaker to elaborate
Active listening involves statements such as:
- “I understand how that might make you feel…”
- “Tell me more about…”
- “What I hear you saying is…”
When using active listening, you avoid disagreeing with the other person’s statement, even when you really don’t agree with what they say. For example, the parent might express concern about using ABA with their child because of what they have seen on social media. You might be tempted to encourage the parent to dismiss their concerns and state that they should avoid social media. Your relationship with the parent will be stronger and they will trust you more if you ask them to explain more about their concerns without trying to resolve those concerns. Our post Understanding the Debate About ABA goes into more detail about why parents might express this concern.
While this might seem like common sense, it’s easy to get caught up in teaching ABA strategies and forget that parents might not be ready to learn them. When you conduct parent training you might have an agenda that you feel compelled to cover. Maybe it aligns with the parent training goals you outlined in your treatment plan. Insurance companies require data regarding progress toward identified parent goals. You want to collect this data for the upcoming review period and you might feel as though you lack sufficient time to cover these topics.
You might worry that using active listening will encourage the sort of “problem of the day” approach to parent training where parents bring up something new each time you meet. Create a written agenda for your meetings, allowing ample time for parents to discuss what’s on their minds at the beginning and then again at the end. Use a timer during parent training sessions to keep on schedule. Explain to parents that what they have to say is important and you want to make sure you leave time at the end for them to discuss their thoughts on your recommendations.
4. Help Parents Celebrate Small Victories
As a professional in the field of ABA, you understand that progress is often slow. You expect gradual changes and measure small improvements to determine success, but many parents seek the big win. They want their child to learn skills at a rapid rate and catch up to their peers.
Some parents ask questions such as “when will my child speak?” expecting your response to be within the next few months. You cringe and don’t want to burst their bubble, but on the other hand, you can’t give them false hope. Assure parents that their big goals are also your big goals.
When parents say “when will my child speak,” find out what their underlying concerns are. Do they want their child to communicate so they know what he wants? Do they want him to interact socially with others and develop friendships? Are they concerned about their child appearing “normal?” When a parent talks to you about their big goals, help them break it down into smaller, more achievable goals. Ask questions until you get to the heart of what their concern is.
Help parents create reasonable expectations during parent training by celebrating all of the small victories their child experiences. While you must discuss concerns and behavioral challenges, make sure to include as many victory celebrations as you can. Even a child who struggles to master goals has reason to celebrate if you look hard enough.
Talk about how each small skill builds on the next to lead to those important goals that parents want. For example, motor imitation teaches children to watch others and do what they do. Teaching them to attend to and imitate others may lead to improved vocal imitation which in turn may lead to improved vocal communication. Tie together the programs that might seem unrelated to parents to help them see how each building block leads to their child’s success.
Cultivating confidence is the third secrete in our ACHIEVE parent training framework. When parents believe they can make a difference, they are much more likely to follow through with what you ask them to do.
5. Lose Your Superman Cape
You worked hard to earn your credentials and have a lot of knowledge to impart to parents. You also might experience a slight case of imposter syndrome if you’re new in the field. Add to this pressure from insurance companies to collect data and more pressure from your company to maximize billable time, and you have the perfect recipe for walking into parent training and expelling vast amounts of information at them. You come across as the untouchable expert. A type of superhuman who has vast knowledge and wisdom that they could never hope to achieve.
When you shed your superhero facade, you become much more relatable to parents. They see themselves in you and believe that if you can do it, they can too. Talk about your experiences learning some of the techniques you teach them. Discuss your failures and how those failures led you to a more effective solution. Convey your journey using statements such as:
- “I once thought that…”
- “I used to think that…”
- “When I first heard about…”
Parents of children with autism experience daily challenges and often feel alone in their struggles. Share some of your challenges, from a professional standpoint, to connect with them on their journey. Help them understand that you might not walk in their shoes, but you know they are working hard. While you strive to instill confidence in the parents of our clients, it’s equally important that they see your flaws and the areas where you struggle. Help the parents see your Clark Kent behind your Superman. Parents will appreciate seeing both sides of you.
6. Allow Parents to Choose Their Own Parent Training Goals
As a professional, you likely have some idea of what your parents need to learn to help their child be successful. Often professionals identify parent training goals during the assessment process. Parents, like the rest of us, are more committed to achieving goals that they help identify. If you think the parents need to understand the ABCs of behavior, but they are focused on teaching their child to speak, you will not get a lot of ABC data from them.
Be ready to be flexible with your identified parent goals. Parents might begin treatment by saying they want to learn about one aspect or skill, but through the process of developing a relationship with them, you might notice different priorities. Be open to switching gears, but avoid the trap of the “problem of the week” where parents come to you with new problems every week. Have parents take notes and write down their goals.
Since so many strategies and techniques in ABA are interrelated, you can tie your priorities in with the parents’. For example, as in the example above, since you want the parents to understand the ABCs of behavior, you can discuss communication as part of the 3-term contingency. The image below depicts how to explain this to parents. Helping parents see communication behaviorally begins the conversation about the ABCs while focusing on the parents’ priorities.
When you work with parents to determine what their priorities are, help them look at the big picture. If you had a magic wand and could change just one thing at home, what would make the biggest difference in their everyday lives? Use the Choose a Behavior Worksheet to help families narrow their choices down to behaviors that will make a significant impact.
7. Be a Reinforcer
Find out what motivates the parents you work with. Some parents want opportunities to vent their frustrations, others want a pat on the back for their hard work, still others are motivated by accomplishing goals that make life easier at home. Take the time to build a solid relationship with the parents you serve and discover their reinforcers. Pair yourself with reinforcement so that you become a reinforcer over time.
Some parents shine when you greet them with fabulous stories of their wonderful child, despite how difficult their child may be. Others prefer an opportunity to share their most recent struggles. Give each parent their reinforcer each time you encounter them (not just during parent training) to make sure that you have sufficient opportunities to pair your self.
8. Avoid the Use of Jargon During Parent Training
The field of Applied Behavior Analysis utilizes significant amounts of jargon. Outsiders to the field find this confusing, pretentious and off-putting. Use common, everyday language without watering down the information. You must filter out the jargon or risk appearing snobby. Parents want to learn and understand, yet when you use complex terminology unnecessarily, they feel intimidated or looked down upon. Avoid speaking down to parents. Just use everyday language to describe the concepts you want them to learn.
Bring parents into the fold by speaking their language. When you actually don’t speak their primary language (i.e. when working with families from other countries), ask them if they want a translator. Many prefer to work with you 1:1. Speak slowly, but respect their intelligence. When providing parent training to non-English speakers, use a variety of teaching modalities to get your message understood.
9. Use Creative Examples
The more you tie in ABA concepts to situations parents relate to, the more buy-in you receive from parents. Examples connect parents’ experiences to the concepts you want to teach. Take a look at this example about reinforcement:
You’re working with a parent who is reluctant to have you use her son’s favorite video games as a reinforcer. She feels he is too obsessed by them and wants to limit the amount of time he spends playing the game. Although her concerns are valid, you are struggling to help him achieve his goals without an effective reinforcer.
One day, she asks why he still hasn’t mastered the goals you have been working toward. You explain that you don’t have an effective reinforcer for him. You use this example:
- You ask his mother why she goes to work.
- She says, “for a paycheck.”
- You respond by saying, “of course, but what if your boss started paying you in potato chips?”
- She responds by saying, “I would stop going to work.”
- You say, “Right. We are asking your son to go to work, but we are paying him with potato chips. He has decided to stop working for us.”
In the example above, your rationale for using a reinforcer becomes far more apparent to his mother because you use an example that she relates to. The more you help parents see the ABA contingencies at work in their own lives, the more they begin to understand what you try to teach.
10. Plan for Parent Training
If you have done your job of preparing the parents for the expectation that they will participate in parent training at least once a month, have established yourself as a reinforcer, and created a welcoming environment using active listening, your parents are likely to show up for parent training. But they might not know what to talk about. There’s nothing worse than getting them to attend a meeting only to hear nothing but crickets for the first 5 minutes as they tell you that everything’s fine at home. You already know that everything isn’t fine, that’s why their child is in services.
Although you want parent training to be dynamic and you must be ready to adapt to the parents’ priorities, you also should have a plan in place of what would be important to cover. Check out our ABA Parent Training for a complete list of session topics. Albone-Bushnell (2014) offers a list of knowledge and skills compiled from experts in the field.
Parent training topics should include:
- Understanding of expectation for their child’s independence, social competence and compliance
- Understanding of Natural Environment interventions
- Understanding of Applied Behavioral Analysis
- Understanding of how to prompt their child’s behavior in natural settings
- Knowing what a measurable goal is for their child
- Knowledge that rewards are functional and should be administered immediately and contingently following a child’s behavior
- Teaching imitation to their child
- Teaching Joint Attention to their child
Each family requires different skills, but nearly all families benefit from learning the basics. Take parent training step-by-step and take the time to relate to the families. The results are worth the effort.
The videos support and enhance the information in this post. Download our workbook to accompany the videos and use it to plan how you will improve your parent training.
Watch this video for tips on overcoming 3 common obstacles to providing parent training:
The video below provides even more advice on providing more effective parent training:
References and Further Reading
Albone-Bushnell, R. (2014). A List of Core Skills and Knowledge Necessary for Parents of Children Birth to Five Years Old with Autism, as Prioritized by Practitioners with a Behavioral Perspective.
Bearss, K., Burrell, T. L., Stewart, L., & Scahill, L. (2015). Parent training in autism spectrum disorder: What’s in a name?. Clinical child and family psychology review, 18(2), 170-182.
Molko, Ronit. “Author Post: What Is Covered? The Insurance Landscape for Autism Services.” Forbes, Forbes Magazine, 18 Apr. 2019, www.forbes.com/sites/forbesbooksauthors/2019/04/18/what-is-covered-the-insurance-landscape-for-autism-services/?sh=7e3c473625c2.
Solomon, R., Necheles, J., Ferch, C., & Bruckman, D. (2007). Pilot study of a parent training program for young children with autism: The PLAY Project Home Consultation program. Autism, 11(3), 205-224.
Weger Jr, H., Castle Bell, G., Minei, E. M., & Robinson, M. C. (2014). The relative effectiveness of active listening in initial interactions. International Journal of Listening, 28(1), 13-31.
