Training Paraprofessionals to Teach Children with ASD William Calderhead & Jordan Kulaga Sam Houston State University wjc011@shsu.edu

Acknowledgments This work was supported by a grant from the Texas Higher Education Coordinating Board’s Autism Grant Program. The opinions expressed are those of the authors and do not represent the views of the Texas Higher Education Coordinating Board.

Research Questions Can we train teachers/paraprofessionals to implement ABA techniques at a high level of competence using role-play and performance feedback? If each successful RBT course completer receives supervision for 2 hours/week during the 10 months following completion of the course, will the completer’s skills improve? Can RBT course completers maintain and generalize skills during the 10 months following completion of the course? Will stakeholders report that face-to-face RBT training has social validity?

Advance Organizer Introduction Method Results Discussion Q & A Limitations Implications for Practice Q & A

Problem Context Lectures do not ensure high level of skill proficiency in ABA techniques (Alexander, Ayres, & Smith, 2015). Lack of knowledge and expertise in working with children w/ ASD can cause irreparable harm by inadvertently reinforcing inappropriate behaviors and delaying academic progress (Rispoli, Neely, Lang, & Ganz, 2011). Need more practice and role-play opportunities than available in traditional face-to-face courses

Registered Behavior Technician (RBT) Credential Authorized by Behavior Analysis Certification Board in 2012 Target: behavior technicians, paraprofessionals implementing behavior plans directly w/ clients RBT Requirements > 18 years & high school completion or equivalent Complete 40-hour RBT training Pass RBT Competency Assessment Criminal background check < 180 days before submitting application RBT Exam: 90-min multiple choice (75 scored items) Maintaining credential: Receive supervision for 5% of hours spent delivering ABA services

Method Participants Setting 12 public school paraprofessionals and 1 special ed teacher 10 paraprofessionals completed course 1special ed teacher completed course Setting Large lecture hall on satellite campus of midsize university in Houston metro area

Completers’ Characteristics 10 females; 1 male Mean age = 33.4 years Of the 8 completers who replied to the question about post-high school training, 6 indicated that they had some. Mean number of years working in special education programs = 3.7

Role Play Measures Behavioral Implementation of Skills for Work Activities (BISWA; Fisher et al., 2014) 36 discrete trials on receptive-identification skills in which participant needed to make appropriate response to confederate behaviors In 4 trials: correct response & no problem behavior In 16 trials: no response, incorrect response, stereotypy, or other problem behavior (aggression, disruption, echolalia, & negative vocalizations) W/in those16 trials, there were further challenges after confederate made an error: prompted correct response, prompted incorrect response, no response, or other problem behavior

Role Play Measures Behavioral Implementation of Skills for Play Activities (BISPA; Fisher et al., 2014) 20 trials in “play-based, naturalistic training context” (p. 1047) In 10 trials: confederate engaged in bid for joint attention, initiated conversation, engaged in functional play, described an emotion displayed by paraprofessional, or initiated play In 10 trials: confederate engaged in problem behavior (aggression, disruption, echolalia, negative vocalizations, & stereotypy)

Procedure 48-hour course met 4 days/week, July 6 – Aug 1 Each 3-hour class included a 10-min break 14 quizzes across course Experimenter was instructor; undergrad SPED major served as teaching assistant Course content: 6 areas of competence on the RBT Task List: measurement, assessment, skill acquisition, behavior reduction, documentation and recording, and professional conduct and scope of practice

Behavior Skills Training (BST) Instruction: Describe skills & provide rationale for use Modeling: Show how to perform skill Rehearsal: Give participant opportunities to perform skill Feedback: Praise correct responding & provide corrective feedback for incorrect responses (Miles & Wilder, 2009; Miltenberger et al., 2004)

Results Participants on average increased their BISPA scores by 4 points on a 30-point scale from pre- to posttest. Increases were highly variable. 2 participants scored the same on pre- and posttest 8 participants increased from pre- to posttest 1 participant decreased from pre- to posttest Increases did not appear to correlate with age or number of years in SPED program 2 participants reached mastery (> 90%) on use of extinction (#8) and delivery of reinforcement (#9)

Social Validity Questionnaire Results Adapted from University of Nebraska Medical Center Virtual Care Program Social Validity Questionnaire (Fisher et al., 2014) 6 questions required ratings on 1 – 7 scale, from Strongly Disagree to Strongly Agree w/ 4 = Neutral 9 of 11 course completers answered the questionnaire

1. Each class covered the core content of a given topic 1. Each class covered the core content of a given topic. I was satisfied with the amount and type of information covered in the classes. Mean = 6.1 2. We conducted several role-plays throughout the training and each role-play covered a different topic. I was satisfied with the role-plays as a component of training (e.g., opportunity to practice the skills and receive real-time feedback). Mean = 5.3 3. I was satisfied with the quality and organization of these classes. Mean = 6.1 4. During role-plays and throughout the training program, you had the opportunity to ask your instructor questions about the content of the curriculum or rationale for certain skills during the role-plays. I was satisfied with my instructor’s ability to answer my questions. Mean = 6.2

6. Overall, I was satisfied with this program. Mean = 6.1 5. I am satisfied with the interactions that I had with my instructor (e.g., time to respond to questions, course updates). Mean = 6.1 6. Overall, I was satisfied with this program. Mean = 6.1 7. Would you recommend this type of instruction to other individuals who are not able to receive on-site instruction? All 9 respondents replied “yes.”

Overall Findings RBT course appeared to increase paraprofessionals’ skills in naturalistic play situations Skill increases appeared not to correlate with number of years working in special education programs Completers rated course as socially valid

Limitations: Internal Validity Subject nomination Only 2 out of 32 districts contacted agreed to participate Special education administrators contacted potential participants Participants might be members of extreme groups Subject selection 4 of 11 completers volunteered before experimenter arranged for $1,000 stipends 7 completers volunteered after experimenter arranged for $1,000 stipends

Implications for Practice Face-to-face RBT courses should include opportunities to practice and role play skills Use BST Do not allow evaluation of video clips during RBT Competency Assessment Provide stipends to RBTs in training or make course completion a job requirement

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