Category: Autism Spectrum and Developmental Disorders
Children with developmental and intellectual disabilities (ID) are at a high risk of developing disruptive behavior disorders that cause physical, emotional and cognitive harm to the self and others. While behavioral interventions are one of the most strongly supported forms of treatment, they are highly time and resource intensive for providers and caregivers (Campbell, 2013). Further, they require consistent, often effortful, implementation by caregivers who are already under increased stress due to the severity and complexity of their child’s disabilities (Herring et al., 2006). The literature has recently begun to explore caregiver barriers to treatment implementation, but a validated assessment does not yet exist to assist in treatment planning for these populations. Kazdin, Holland, Crowley, and Breton (1997) developed a measure of barriers to treatment participation for families of children in treatment for externalizing behaviors; however, this measure was given following treatment, and, thus, was not able to assist in treatment planning and may have been subject to retrospective biases. Thus, the goal of the current study is to validate a pre-treatment barriers assessment (BA) for families of children with comorbid disruptive behavior disorders and developmental disabilities or IDs. The BA was adapted from Kazdin et al.’s measure to be a prospective measure given at intake that is more specific to children with disruptive behavior disorders and developmental disabilities. The measure consists of 18, 5-point Likert scale questions and 13 yes/no questions about familial resources, stress, and buy-in. The first aim of the study is to analyze the underlying structure of the measure by conducting an exploratory cluster analysis of 123 BAs that were collected at intake for families seeking treatment for behavior problems at a large autism center. The second aim is to analyze the measure’s ability to predict treatment success and/or reason for discharge. Outcome data are available for 60 participants and will be regressed on the emergent factors. The sample population is racially diverse (37.6% African American, 16.8% Hispanic), and the majority are low socioeconomic status (70% of children are on Medicaid), representing an often under-served and under-represented population in research. Diagnoses of children undergoing treatment are also diverse: approximately 60% have a diagnosis of an Autism Spectrum Disorder, but children with IDs and medically complex genetic disorders were also treated (e.g., Fragile X, Angelman's syndrome). The relative contribution of measured factors will be discussed and the corresponding impact on participation in treatment and treatment planning will be described.