The Effects of a Parent Coach on Parents' Acquisition and Implementation of Parenting Skills

Article excerpt

Abstract

This project addressed the need for research in teaching positive parenting skills to parents of children who are noncompliant. Participants in this study were four parents and their noncompliant children. A parent coach assisted each parent in acquiring and implementing the positive parenting skills, which included delivering appropriate "please do" instructions, pre-teaching target skills, delivering "effective praise," implementing "corrective teaching," using self-monitoring strategies, and reinforcing the child's behavior. The parents delivered the instructions to their children in their homes daily. This study measured (a) the parents' learning of the parenting skills and self-management procedures, (b) the parents' implementation and maintenance of the parenting skills and self-management procedures, and (c) the effects of the parents' use of these skills on their children's compliant behavior. A multiple-probe design across parents was used to evaluate the implementation of the parent training and use of the skills. The parents successfully learned and used the skills-based teaching techniques, the reward system, and the self-monitoring strategies. child compliance with parental instruction improved. In addition, the parents' and children's opinions were evaluated to verify the importance of the skills and teaching procedures as a measure of social validity.

Researchers have reported antisocial behavior as the most prevalent of all childhood behavior problems, affecting 3% to 9% of school-aged children in the United States (Bourn, 1993; Hester & Kaiser, 1998; Loeber & Schmaling, 1985; Sprague & Walker, 2000; Walker, Colvin, & Ramsey, 1995). Children who enter school with limited social skills commonly struggle with peer and teacher relationships, and over time the failure to adjust in these areas is correlated with delinquent and criminal behavior as they approach their teenage and adult years (Hester & Kaiser, 1998; Southam-Gerow & Kendall, 1997; Walker et al., 1995). Sprague and Walker (2000) referred to antisocial behavior as a general response class that includes behavior such as noncompliance, aggression, and bullying. It has been suggested that noncompliance is the "keystone" behavior that gradually leads to antisocial acts (Loeber & Schmaling, 1985). Factors that contribute to antisocial behavior in children include divorce, poverty, abuse, socioeconomic i ssues, and child-rearing practices (Hester & Kaiser, 1998; Walker, 1997). However, the predominant variables are parenting practices and coercive family interactions (Patterson, DeBaryshe, & Ramsey, 1989; Patterson, Reid, & Dishion, 1992; Walker et al., 1995). Specifically, coercive parenting practices account for 30% to 40% of the variance in children's levels of antisocial behavior (Patterson et al., 1989; Tolan & McKay, 1996; Walker et al., 1995).

A child who is labeled "antisocial" obviously lacks what society defines as prosocial behavior or social skills. According to the social skills literature, professionals, not parents, typically teach prosocial behaviors to aberrant children (Budd, 1983; Walker et al., 1995). Schools in the United States frequently include programs that attempt to develop social skills in children (Verduyn, Lord, & Forrest, 1990; Zaragoya, Vaughn, & McIntosh, 1991); however, because parent and home conditions are critical to the development of acceptable social behavior, parents must be partners with personnel from schools and other agencies who share a common goal of intervening with antisocial behavior problems (Walker et al., 1995). Almost 20 years ago, Budd (1983) asserted that noticeably absent from the social skills literature was the consideration of parents in the role of teaching social skills to their children, such research is still lacking. Considering that the origins of behavior problems are associated with condi tions in the home and community, it seems logical that the parents become involved in altering their children's behavior. When parents are involved in the teaching of social skills, the overall effectiveness of a program is enhanced because of the increased number of settings and change agents involved in strengthening the child's behavior; as a result, the overall impact on the child's prosocial behavior is likely to be heightened (Walker et al., 1995).

What, then, are the most effective strategies and procedures to involve parents and promote a meaningful change? Williams, Williams, and McLaughlin (1991) indicated that "the effectiveness of outcomes depends greatly on the cooperativeness and ability of the parents" (p. 402). Others have suggested that when designing and selecting methods for training parents, one must be attentive to the parents' needs and select procedures that are acceptable to parents as well as professionals (Tolan & McKay, 1996). The methods used here produced significant changes and were feasible for the consumer to implement (Mitchem &Young, 2001).

Since the 1960s, a major thrust on parent behavioral training has centered on contingency management (Dembo, Sweitzer, & Lauritzen, 1985; Graziano & Diament, 1992; Kazdin, 1997; Wiese & Kramer, 1988; Williams et al., 1991). The findings regarding outcomes of parental behavioral training have been inconsistent. Researchers should consider this issue and ask if there are ways to improve behavioral training so that it will produce more potent and durable outcomes.

One suggestion that has received limited research attention is to blend training on behavioral consequences with social skills training (Budd, 1983; Marchant, 1996). The merging of contingency management and social skills training has the potential of eliminating antisocial behavior problems (Budd, 1983; Skiba, 1999). Skiba (1999) proposed that one should systematically teach socially appropriate behavior to children so that they know precisely what is expected rather than relying on the typical reactive approach to implement consequences. Other researchers have reported that the use of examples, explanations, prompts, and verbal rationales have successfully cultivated social behavior in children and youth (Graziano & Diament, 1992; Richman, Harrison, & Summers, 1995; Willner et al., 1977), supporting Budd's (1983) and Skiba's (1999) recommendations.

The parent training literature indicates that the majority of trainers who teach parents behavioral strategies are licensed professionals such as therapists, psychologists, and social workers and that the training typically occurs in a clinic or school (Dembo et al., 1985, Graziano & Diament, 1992; Richman et al., 1995; Rotto & Kratochwill, 1994). Shifting from the use of licensed professionals and clinic-based interventions to the use of parent coaches (e.g., nonprofessionals, parents) and home-based interventions potentially offers several advantages to parent training (Sanders & James, 1983; Strain, Steele, Ellis, & Timm, 1982; Timm, 1993; Timm & Rule, 1981). First, such training is more accessible to parents, especially those who are confined to their homes or resist assistance, such as mothers who work, parents without personal transportation, or those who are fearful of clinic settings. Second, it is expensive to provide services in a home via licensed professionals because of the higher salary and trav el expenses. Third, in-home training by parent coaches eliminates the need of programming for generalization from clinic to home. If a licensed professional teaches skills to a child and/or a parent in the clinic and then expects him or her to transfer the skills to the home, additional effort and time will be required to ensure that the skills transfer successfully. This time and effort requires funding from the agency employing the professional.

The main purpose of this study was to investigate the effectiveness and acceptability of using parent coaches to teach parents positive, proactive skills and the appropriate use of positive reinforcement in their homes. The second purpose was to examine the effects of the parents' use of the skills they had learned on children's noncompliant behavior.

Methods

Participants

Two participant groups were included in this study--children and parents. The selection criteria identified children with behavioral needs and as a result their parents were invited to participate. The following paragraphs are organized according to child participants, selection criteria, and parent participants.

Children. Four boys, ages 6, 6, 7, and 9, who were enrolled in the public school system, participated in this study. Two of the boys qualified for special education services in the state of Utah, one classified as behaviorally disordered and the other as learning disabled. None of the boys had received previous formal instruction on the use of the compliance skill.

Initially, the child participants for this study were suggested by the faculty of an inner-city elementary school. The demographics (given in averages) of the families whose children attend this school include 56% ethnic enrollment, 80% low-income families (qualifying for free or reduced cost lunch), with mobility rates of 62%, and SAT basic battery test scores in the 40th percentile.

Selection Process. From a pool of 183 first- and second-grade students who attended the targeted elementary school, children participating were referred based on a multi-gating process. The first gate was for the first-and second- grade teachers to identify the three children in the class who exhibited the most externalizing behavior problems using gate one of the Systematic Screening for Behavior Disorders instrument (SSBD, Walker & Severson, 1992). [The SSBD has acceptable reliability and validity. It adequately serves the screening purpose for which it was constructed (Kelley, 1998; Walker et al., 1990; Zlomke & Spies, 1998).] Gate two consisted of the teachers completing checklists for students identified in stage one. These checklists assess both adaptive and maladaptive (social) behavior. The third gate involved the school principal and psychologist examining the list of students who exceeded normative criteria on the checklists and recommended families they felt would both benefit from and be willing t o participate in the study. From these recommended families two were chosen and consented to participate.

An additional family, with 7- and 9-year-old boys, was referred by the school social worker. This family also met the criteria and agreed to participate. Because these two boys have the same parents, they are not considered to be independent participants in the implementation phase of the multiple-probe design. Each phase of the study began simultaneously for these two brothers.

The fourth selection gate was based on the overall average of the child's compliant behavior displayed during baseline. We adapted Forehand's (1977) recommendation that less than 60% compliance to adult instructions be considered problematic and the child defined as noncompliant. His research suggests that compliance in "normal" children range from 60%-80%. Each child included in this study had a mean of less than 60% compliant behavior. The final gate was for the parents to give written permission for their child to participate and a personal commitment that they would participate.

Parents. Of the four parents involved, three were female between 25 and 39 years of age and the fourth was a male in his 30s. None of their parents had been taught to use "effective praise," "corrective teaching," "direct teaching," and self-monitoring strategies, or how to give "please do" instructions. The make-up of the families included one single-parent household and two 2-parent households; three of the four participants were biological parents. The parents' education level ranged from high school to college level with associate degrees, and their incomes varied from $5,000 to approximately $40,000. The number of children in the families ranged from 2 to 5. Since 3 of the 4 parents were female, the pronoun she is used throughout this paper to refer to parent participants. Child and parent participants are representative of the community's population. Pseudonyms for the participants are used to maintain confidentiality. The dyads were made up of the following parent-child combinations: Dyad 1, Seth and h is mother, Diane; Dyad 2, Keith and his parents Connie and Karl; Dyad 3 was composed of Connie and Karl, and their other son, Joshua; and Dyad 4, Daniel and his step-mother, Mary.

Setting

All baseline and intervention sessions were conducted in the homes of the parent-child dyads, as the home is generally the most natural environment for implementing parent interventions and for observing parent-child interactions (Wierson & Forehand, 1994; Williams et al., 1991). The majority of parent-child interactions occurred in the vicinity of living rooms, family rooms, and children's bedrooms.

Procedures

The effects of parent coaches on the learning of parenting skills and the effects of the parents' use of newly learned skills on their child's compliance with instructions are connected and, therefore, were simultaneously examined. However, for the purpose of clarity, descriptions of the study's dependent and independent variables are presented as (a) the parent component and (b) the child compliance component. The participants, setting, and experimental conditions are identical and, therefore, are not repeated.

Dependent Variables and Measures for Parent Component

This component was designed so that a parent coach taught the parenting skills to each parent in her home. Data were collected on six dependent measures: please do" instructions, "direct teaching," "effective praise," corrective teaching," tokens and reinforcers, and parent self-monitoring. All of these variables are discussed in the ensuing paragraphs. The six target behaviors served two functions: first, in examining the results of parent training they served as dependent measures (parent component); second, as the parents used their newly learned skills with their child, these behaviors became part of the independent variable (child compliance component). Data collected on these parent behaviors verified the correct implementation of the procedures.

The parents learned to use the "direct teaching sequence" to teach the compliance skill. The function of the "direct teaching sequence," a formal teaching strategy, was to describe the steps of the compliance skill, give a rationale for significance of the skill, model how to use the skill, solicit a response from the child, and provide feedback for the use of the skill. Each step of this strategy was used during the child-education condition to teach the child the steps of the compliance skill, and each child was provided adequate opportunities to practice the steps before being required to use them daily. After the parents had introduced the compliance skill to their children via the direct teaching sequence, they began conducting sessions of approximately 30 minutes in length. During these sessions the parents gave instructions to the child (8 or more per session), the child responded to the parent's instruction, and the parent followed the child's behavior with the appropriate consequence (i.e., correctiv e teaching or praise). Sometimes the parent coach was present during these sessions and other times she was not. Thus, the parent used the skills on days when the parent coach did and did not visit the home.

For the purpose of this study, "effective praise" was defined as a statement that is contingent, specific, and immediate, which will most likely have a positive effect on a specific behavior (Young, West, Marchant, Morgan, & Mitchem, 1997). "Please do" instructions were defined as direct, reasonable, and clearly stated directions (Houlihan, Sloane, Jones, & Patten, 1992). Excluded from this definition were the following types of instructions: (a) chain instructions, a series of instructions strung together; (b) vague instructions, which do not specify observable behaviors to be performed by the child; (c) question instructions, which imply that the child has the option of choosing whether or not to do as asked; (d) "let's" instructions, which imply that the parent intends to help with the task when in fact she does not; (e) instructions followed or prefaced by excessive verbalizations; (f) "don't" instructions; and (g) "stop it" instructions (Fore hand & McMahon, 1981; Houlihan et al., 1992; Richman et al., 1 995). Th instructions needed to be simple so that they could be completed in a short amount of time, such as putting shoes away, picking up toys, setting the table, taking out the garbage, and so forth. Long, drawn-out instructions were not considered in this category, such as cleaning up a bedroom with many items on the floor.

The "corrective teaching sequence" was used by the parents during child education condition and treatment phases: coaching, fade I, and fad II. As expected, errors occurred periodically when the child was first learning the steps and using the skill. Parents were taught to recognize errors as opportunities to reteach the skill and to use each step of the "corrective teaching sequence" to correct the behavior. This sequence let the child know what behavior was inappropriate and why it was inappropriate and it enabled the parent to teach an alternative behavior to the child. "Corrective teaching" was also used when the child forgot to use one or more steps of the compliance skill.

If, during the sessions, the child used all four steps of compliance correctly, the parent placed a marble in a plastic jar, and the marbles were exchanged for reinforcers selected from a reinforcement menu at the end of the session. Reinforcement menus were generated together by the parent and child.

The parents learned the parenting skills as described and defined in the preceding sections, and they self-monitored their use of the skills via the following process. Prior to giving the child the first instruction, the parent retrieved a parent card from a plastic envelope located on the refrigerator. First she wrote the date and the child's name on the card, gave the instruction, and ensured that the child completed the instruction. While initiating the interaction with the child by giving the instruction, the parent wrote a key word which corresponded with that instruction (e.g., "shoes" for putting shoes away), and then she evaluated each of her behaviors. The parent wrote an "X" for the skills used correctly, completely, and independently and left the box empty for skills used incorrectly, incompletely, and/or with assistance. The parent behaviors were much more global on this form than on the data collection form used by the observers. After the session was completed, the parent gave the card to the pa rent coach.

Independent Variable and Measures for Parent Component

The independent variable for the parent component included the parent coach formally teaching the skills to the parents, offering support and Feedback as they implemented them each day, and providing parents with reinforcers.

The parent coaches were two female students enrolled in a special education program at Brigham Young University--one a graduate student (no prior background or experience in special education) and the other an undergraduate, 33 and 23 years old, respectively, who were in the beginning stages of their special education studies. The researchers trained the parent coaches to use the skills via modeling, verbal rehearsal, role plays, video examples, and written materials. Mastery of each skill ([greater than or equal to]90%) across two training sessions was expected of both parent coaches prior to teaching the parents. The skills that the parent coaches learned included the six skills taught to parents plus the data collection procedures.

After the parent coaches mastered the skills, they assumed responsibility for teaching the parents the skills during the parent education condition and for assisting the parents in teaching their children the compliance skill during the child education phase. Once a parent mastered the parenting skills, the sessions were conducted with that parent and her child. Sessions, with parent coaches present, were scheduled three times a week at the earliest stage of the study (coaching phase), then faded as the study advanced. During the sessions, the parent coaches observed and collected data on the parent-child interactions, guided and supported each parent's implementation of the parenting skills via observation, assisted with the parent's self-monitoring procedures, and provided verbal feedback. The parent coach also offered support through telephone contacts and informal visits.

Reinforcement was used to encourage the parents to implement the skills correctly and to use the parent card daily when coaches were not present. Initially, the parents received a reinforcer once a week, and the frequency was gradually reduced. The reinforcers included dinner gift certificates, cosmetic items, movie passes, books, passes for family outings (swimming, zoo, pizza, ice cream).

Dependent Variables and Measures for Child Compliance Component

As noted previously, this component involved the parents teaching, correcting, and reinforcing child compliance. The dependent variable in this study was child compliance to parent instructions. This variable was measured via event recording (i.e., both instructions given and child responses) and reported by way of a percentage for each child behavior completed correctly during each parent-child interaction.

Compliance. Compliance was defined as the child starting to do the assigned task within 5 seconds of the time the instruction was given and completing it prior to the parent giving the next instruction. The specific components of compliance are described in Figure 1.

Independent Variables and Measures for Child Compliance Component

As this was an indirect training study, the independent variables for this component are identical to the dependent variables of the parent component, i.e.; what parents were taught in parent component was the intervention for the children during the child compliance component. The independent variables for this study included use of the following parent skills: teaching the child the compliance skill using the "direct teaching sequence," giving effective "please do" instructions, delivering "effective praise" and corrective teaching, using self-management strategies, and reinforcing the child's compliant behavior.

Data Collection Procedures

Observers and observer training. Two types of observers were employed for this study: parent coaches and independent observers (for the purpose of interobserver agreement, discussed below). To limit the number of extra people in the homes and to control for observer obtrusiveness, the parent coaches served as the primary observers. Two independent observers, female undergraduate students with minimal knowledge of the study, collected interobserver agreement data to control for any bias resulting in the parent coaches being the primary observers. All observers were trained to use the data collection procedures by videotaped and staged live scenarios.

During the study, the parent coaches and independent observers conducted observations one to three times per week in each of the homes during the sessions for approximately 30 minutes per session. The number of observations varied as the frequency of home visits by the parent coaches were faded. Data were collected by the parent coaches during the parent-child interactions. The parents collected data 5 days per week, using the parent cards during these sessions with and without coaches.

The parent coaches, independent observers, and parents, and the research assistant used a pencil/paper data collection method for each of the parent-child interactions: instruction, child response, and feedback. Data were collected for each component (step) of the parent and child behaviors. For example, data were collected on each step of child compliance--looks, says "okay," starts task, and finishes task--rather than collapsing all four steps into one global step. This approach was used for the other dependent variables. When the parent gave an instruction, the parent coach/observer wrote a key word that represented the instruction (e.g., "coat" for the instruction "hang up your coat") in the box labeled "parent gives instruction." The other behaviors (i.e., compliance, effective praise, corrective teaching) were coded "+" when the child or parent completed each step correctly, completely, and independently. Behaviors were coded "-" when the child or parent missed one or more steps, required assistance, a nd/or exhibited inaccuracy on one or more steps.

Interobserver agreement. Data from a parent coach and an independent observer were compared instruction by instruction (chronologically, for each instruction as opposed to a typical comparison by time intervals). Agreement was defined as the observers recording the same code for a specific instruction, and disagreement was defined as the observers recording different codes, or one observer missing an instruction that the other had recorded. Interobserver agreement data were collected for approximately one-third of the observation sessions across baseline, coaching, and all systematic fading phases of the study and agreement was calculated using the following formula: number of agreements divided by the number of agreements plus disagreements x 100. If agreement dropped below 80% at any time (which happened once), the researcher conducted a review session with the observer(s). Agreement was also calculated between parent coaches and parents, using these same procedures.

During the baseline phase, interobserver agreement ranged from 78% to 96%, with an 'overall average of 89%. For the treatment phases, the interobserver agreement data consisted of the following ranges and means: coaching phase--range 85% to 100% with a mean of 98%; fade I phase-range 88% to 99% with a mean of 95%; and fade II phase--range 96% to 100% with a mean of 99%. Interobserver agreement for the entire study varied from 78% to 100% with an overall average of 96%.

Experimental Design and Conditions

A multiple-probe design across the four parent-child dyads was used to evaluate the effect of the independent variables on the dependent variables. This study consisted of baseline, coaching, and fade I and II phases as well as the parent and child education conditions.

Baseline. During this condition, the researcher asked each parent to give instructions to determine to what extent the parents used the teaching and reinforcement skills and to what extent the children were compliant prior to the intervention. In addition, no skills were introduced to the parents or children, nor were rewards given.

Parent education condition. The parent coaches taught the parents to use the skills described above via verbal rehearsal, modeling, and written materials, the same procedures that were used with the parent coaches. The parents were required to master each skill (>90% accuracy) and to demonstrate proficient use (>90%) of each skill across two training sessions prior to advancing to the child education condition. In a previous study (Marchant, 1996) the parent training was completed in two sessions; therefore it was anticipated that the length of the parent training would be the same for this study. As a result baseline data were not collected during training for this study. However, the number of sessions necessary for the four parents to acquire the skills varied from three to nine.

The parent from Dyad 1 acquired the skills at 100% accuracy over the course of four sessions, whereas the couple that formed both Dyads 2 and 3 required nine sessions to master the skills at approximately 95% accuracy, and the parent from Dyad 4 mastered the skills at 100% accuracy in three sessions. Because the couple in Dyads 2 and 3 both, had learning disabilities they required additional techniques, such as cue cards, mnemonic strategies, and extensive role-plays. The parent education sessions were conducted exclusively with the parents at their convenience in locations free from distractions. After the parents completed the initial training sessions, the child education condition commenced.

Child education condition. After a parent mastered the parenting skills, she taught her child the steps of compliance using the "direct teaching sequence." During the child education condition, the child was required to reach 100% mastery in both saying and demonstrating the steps of compliance skill before the coaching phase began. Specifically, the parent described the desired behavior, gave rationales for its use, modeled the behavior, elicited a verbal response from the child, and provided praise or corrective feedback to the child. These one-on-one sessions between parent and child gave the child ample opportunities to practice the steps of the skills prior to daily implementation. Parents also explained the reinforcement system to the child. During the coaching phase the parent gave eight instructions; therefore, the child needed to earn eight marbles to purchase the reinforcer. As the study progressed the number of parent instructions increased from 8 to 15; therefore, the number of marbles needed to p urchase a reinforcer increased. A parent coach was present as each parent taught her child to provide necessary support and to record both the parent's use of skills and the child's responses.

Coaching phase. During the coaching phase, the parents implemented the parenting skills during the 30-minute sessions. The parent set a kitchen timer for 30 minutes, retrieved the parent card, wrote the date and child's name on the card, and gave the first instruction to the child. Afterward the parent provided feedback to the child (i.e., "effective praise or corrective teaching"), giving an earned marble and self-monitoring by completing the parent card. This sequence continued through 8 to 10 instructions. Concurrently, the parent coach gave praise or correction to the parent. Sessions with the parent coach present were conducted 3 days per week; the parent coach also made one telephone call each week to offer additional support and to check on the other daily sessions.

In addition to support and feedback, the parent coaches provided reinforcement to the parents. Specifically, a parent received a reinforcer once a week contingent on: self-monitoring at least 4 days per week, using the parenting skills >80% as recorded by the parent coach for each daily session, and reaching >80% data agreement rate with the parent coach. The parent-child dyad advanced from the coaching phase to the Fade I phase when they used the skills at >80% accuracy across two or more consecutive sessions.

Fade I phase. As with the coaching phase, the parents were expected to apply the parenting skills each day under the same procedures, but with a minimum of 10 instructions. During this phase, the parent coach visited in the home twice per week. As this phase progressed, the parents' need for continual feedback and support decreased. The parents continued to receive a reinforcer contingent on using the parent skills >80%, self --monitoring 4 days week, and attaining> 80% agreement with the parent coach. During this phase, each parent's reinforcement schedule was thinned, and the child's reinforcement schedule changed from a minimum of four exchanges per week to three exchanges per week. In order to continue from fade I phase to fade II phase, the following criteria needed to be met: the parent/child demonstrated use of the skills at >80% accuracy across two or more consecutive sessions, and the parent self-monitored at least 4 days per week.

Fade II phase. As with the fade I phase, parents were urged to continue with the sessions at least five days per week with a series of 11 to 15 instructions. In this phase the parent coach visited the home once a week and telephoned the parent once. The parents and children required less coaching and their fluency in using the skills increased. Again the schedule of reinforcement was thinned for the parents and children based on their individual needs.

Parents' Self-Monitoring Data

The parents were instructed to use the parenting skills at times when the observers and parent coach were not present and to collect data on a yellow card, separate from the pink card that was used when the parent coach or observers were present. At these times, the parents monitored and collected data on the number of instructions given and completed, not specific steps of the compliance skill. They also marked whether they did or did not complete corrective teaching correctly. The data from the yellow cards provided supplementary information regarding mother and child interactions under less controlled conditions. This provided an additional 75 days of data. (See Figure 3 in Result's section.)

Treatment Fidelity

Because this study was an indirect training study, treatment fidelity checklists were developed and implemented to insure procedural integrity across the training and treatment conditions. Each checklist consisted of a number of questions that corresponded to the skills taught during a specific training session. The person who recorded data on these checklists wrote "Y" for correct and complete responses; "N" for incorrect, prompted, and/or incomplete responses; and N/A if the skill was not taught or assessed during a particular session.

In an effort to monitor the accuracy of the acquisition and use of the teaching and reinforcement procedures, the research assistant and parent coaches used these checklists during training and treatment conditions. The research assistant demonstrated 100% accuracy in acquiring and using the procedures, as did the parent coaches. Ultimately, all parents learned their parenting skills at ( 95% across two consecutive training sessions and then used these skills with ( 98% accuracy while teaching their children the compliance skill. All children learned the compliance skill at 100% accuracy. Data were also collected to assess the parent coaches' implementation of intervention across one third of the sessions of all treatment conditions. These data indicated that the parent coaches used the skills at an average of 94% accuracy with a range of 79% to 100%.

Social Validity

To assess the practical value of this program social validity procedures were developed by the researcher and administered by the research assistant, reliability observers, and parent coaches (Geller, 1991; Wolf, 1978). The parents were given a questionnaire which asked them to rate the practicality and feasibility of the procedures using a 5-point Likert-type scale and to provide written responses to some open-ended questions during the study's final stages (Mitchem & Young, 2001). The research assistant and reliability observers also conducted videotaped interviews with both the children and their parents.

Results

As shown in Figure 2, the implementation of the independent variable (the parenting skills package) by the parents appeared to have a powerful impact on their children's compliance. The results presented in Figure 2 are organized by conditions by parent-child dyad, and the details for each participant are explained below.

Baseline

During the baseline condition, no skills were introduced to the parents or children, nor was reinforcement delivered. The four boys demonstrated a range of compliant behavior from 8% to 62%. Individual mean scores were Seth, 16%; Keith, 53%; Joshua, 46%; and Daniel, 42%, all below the cut off score of 60% (Forehand, 1977). The parents demonstrated limited use of the parenting skills during baseline; the range was 4% to 14%. Their individual means were Diane, 8%; Connie and Karl with Keith, 11%, Connie and Karl with Joshua, 10%, and Mary, 8%.

Coaching

During coaching in the first treatment condition, the parents implemented the parenting skills while giving their children a series of instructions. Their correct use of parenting skills ranged from 83% to 100% with the following means: Diane, 94%; Connie and Karl with Keith, 99%; Connie and Karl with Joshua, 96%; and Mary, 97%. As the parents correctly used the parenting skills, their children's compliance immediately improved. During the coaching phase the children's compliant behavior ranged from 81% to 100% with the following averages: Seth, 91%; Keith, 91%; Joshua, 95%; and Daniel, 93%--improvements of 75%, 38%, 49%, and 51%, respectively.

Fade I

During the fade I phase, the parents continued to apply the parenting skills each day under similar procedures to those of the coaching phase, but with the fading and thinning processes in place. Parents' behavior ranged from 79% to 100% with the following means: Diane, 93%; Connie and Karl with Keith, 100%; Connie and Karl with Joshua, 96%; and Mary, 97%. The children individual means were 81% for Seth; 100% for Keith; 99% for Joshua; and 88% for Daniel.

Fade II

During the fade II phase, the parents continued with the daily parent-child interactions at least 5 days per week for a series of approximately 15 instructions per day. Additional fading procedures were implemented. The parents' use of the skills remained high, with the following means: Diane, 91%; Connie and Karl with Keith, 98%; Connie and Karl with Joshua, 96%; and Mary, 99%. The means for children's compliant behavior were 80% for Seth, 98% for Keith, 99% for Joshua, and 98% for Daniel.

Self-Monitoring Results

Figure 3 presents the parents' self-monitoring data for both the times when the parent coaches were present and when they were not in the home. Figure 3 also presents the percentage of agreement between the parent and parent coach data for sessions when they were both present. The results of the parents' self-monitoring data and the interobserver agreement between the parents and parent coaches were positive; they are discussed in the ensuing paragraphs.

Parent of Dyad 1. The data that Diane recorded indicated that she used the skills an average of 99% both when the parent coach was and was not present in the home. Her interobserver agreement with the parent coach averaged 94% during all treatment conditions.

Parents of Dyads 2 and 3. When conducting the parent-child interactions with their son Keith, Connie and Karl reported that they implemented the skills an average of 98% across all treatment conditions. Their agreement with the parent coach was 98%. When interacting with Joshua, they also recorded a 98% average for the use of the skills when the parent coach was in the home and 100% when she was absent. Their agreement with the parent coach averaged 95% for all three conditions.

Parent of Dyad 4. Mary recorded 99% use of the skills when the parent coach was and was not present in the home for both the coaching and fade I conditions. Her agreement with the parent coach's data averaged 96%.

In regard to the self-monitoring skills, all parent participants collected data consistently across all treatment conditions when the parent coach was and was not present in the home. They reported use of the skills at 97% accuracy or better under all situations and maintained interobserver agreement levels of 93% and higher when their data were compared to the parent coach's data.

Social Validity Results

The parents gave written and oral feedback about their feelings towards the program. The parents claimed that the most valuable part of the parenting program was that it required them to spend time with their children, which, in their opinion, promoted stronger relationships and more harmonious living conditions in their homes. They also stated that the teaching, prompts, and feedback from the parent coaches were helpful as they developed their parenting skills. When asked which component(s) of the program assisted them in maintaining their skills as the parent coaches' visits decreased, they indicated their motivation was that the skills worked for them when dealing with their children. Most of the parents reported that they had shared information about the parenting program with others, particularly relatives, because they felt that the methods were effective and that the methods enhanced communication within their family unit. All of the parents noted that they recommend this program to other parents becau se it builds stronger family relationships and fosters more structure within a home environment.

The children's opinions about the program, expressed during post study interviews, were similar to those of their parents. Overall the boys said that they found the program to be fun, particularly because they were able to earn reinforcers. They indicated that they desired to continue to "play the marble game" to receive additional reinforcers. Additional results are presented in Table 1

Discussion

Various researchers have raised the concern of how to produce a well-designed intervention program for parents whose children are noncompliant and/or have other antisocial tendencies, a program that is responsive to both the child's and the parent's individual needs (Dembo et al, 1985; Graziano & Diament, 1992; Tolan & McKay, 1996; Williams et al., 1991). In an attempt to find additional methods to manage compliant behavior this study examined a program designed to be parent/family friendly, practical, and feasible (Mitchem & Young, 2001), as well as effective.

There is substantial evidence that the treatment package had a strong influence on the participants' behavior. It is important to note that parent behavior correlated with improvement in their children's data. The extreme change in both parent and child behavior from baseline to the intervention phases is evidence of a positive effect; further evidence of the impact was the maintenance in all behaviors across fading conditions. The replication of the effect across all participants suggests the probability of a functional relationship between the independent and the dependent variables.

A key component of the independent variable of this study was the use of a home-based parent coach, a concept that has received limited attention in the parent training literature. Some studies have explored involving a parent buddy, such as a friend or a relative, to participate in the training to support the parents (Rotto-Kratochwill, 1994; Webster-Stratton, 1998). Strain, Timm, and their colleagues (Strain et al., 1982; Timm, 1993; Timm & Rule, 1981) used parents to assist professionals with parent training. Considering the findings of these previous studies, we decided to involve nonprofessionals (e.g., students) as parent coaches to provide home-based training to the parents. Our findings indicated that the parent coaches assisted the parents in effectively acquiring and implementing parenting skills. Without conducting a component analysis, it is virtually impossible to isolate the parent coaches' influence as the treatment variable primarily responsible for changing parent behavior; however, there is evidence that they contributed greatly to the meaningful results. For example, one mother made numerous statements during the study that she appreciated the parent coach's willingness to listen, give positive feedback, and spend time with her. Her comments support Wahler's (1980) recommendation to shift toward friendly relationships when conducting parenting programs.

The parent coach concept might include inviting parents who have successfully completed a parenting program to serve as coaches for other parents, such as was done by Strain and Timm in their research (Strain et al., 1982; Timm, 1993; Timm & Rule, 1981). Ultimately such a program could lead to a permanent support system for parents so that when faced with questions or concerns about parenting issues they would have an advocate to whom they could turn for reassurance. Using parent volunteers as parent coaches would increase cost-effectiveness issues of parenting programs. These are avenues that merit further investigation but were beyond the scope of this initial study.

An important aspect of the methodology used to improve the children's compliant behavior was that the parents directly taught their children steps of the social skill: "How to follow instructions." All children in this study mastered the four steps of this social skill at 100% accuracy. During the daily sessions, when the parents gave the children instructions, the children also demonstrated consistent use of the four steps of the social skill.

As with most children, the children in this study sometimes forgot to use the skill or refused to engage in appropriate behavior. Rather than encouraging the use of negative consequences or punishers, such as timeout or response cost, the parent coaches taught the parents how to use "corrective teaching" as a strategy for dealing with inappropriate behavior. "Corrective teaching" was designed as a way for the parents to take advantage of teaching moments, such as when the child was noncompliant, and reteach the appropriate behavior via this sequence. While punishers can eliminate inappropriate behavior, they do not necessarily teach and/ or strengthen appropriate behavior (Young, Black, Marchant, Mitchem, & West, 2000). Furthermore, punishment may create an aversive environment where it becomes much more difficult to build strong relationships of trust and support (Young, 1993; Young et al., 2000). The data from this study suggest that the parents' use of corrective teaching helped the children replace inappr opriate behavior with appropriate behavior. Thus, the results demonstrate that parents can effectively improve child behavior by blending social skills training and behavioral strategies. These results all indicate that researchers should continue to explore ways to merge social skills and behavioral strategies to build socially acceptable behavior in children, as recommended by Budd (1983) and Skiba (1999).

This study examined the implementation of the compliance skill solely within the home environment. Researchers have recommended that the prevention and intervention strategies for antisocial behavior must occur in three settings: (a) at home by parents, (b) at school by classroom teachers, and (c) on the playground by peers (Dishion, Patterson, Stoolmiller, & Skinner, 1991; Walker et al., 1995). Parents reported that their children used the skills in other contexts, such as the library and school, at times apart from the formal observations, and with other adults such as teachers, relatives, and parent coaches. These examples demonstrate that it is possible for the compliance and other social skills to generalize, although examining both how and to what extent such generalization can occur within other contexts deserves further investigation. Another interesting phenomenon related to generalization is that some of the boys' siblings spontaneously acquired the steps to the skills. This phenomenon should also b e investigated.

In summary, this study demonstrated that four parents of elementary school aged boys, with the support of a parent coach, effectively acquired and implemented the parenting skills and their children's compliance to instructions given at home improved dramatically. Researchers should continue to examine these techniques with other populations and in various contexts.

References

Bourn, D. F. (1993). Over-chastisement, child non-compliance and parenting skills: A behavioural intervention by a family centre social worker. British Journal of Social Work, 23, 481-499.

Budd, K. S. (1983). Parents as mediators in the social skills training of children. In L. L'Abate & M. A. Milan (Eds.), Training and research (pp. 245-262). New York: Wiley.

Dembo, M. H., Sweitzer, M., & Lauritzen, P. (1985). An evaluation of group parent education: Behavioral, PET, and Adlerian programs. Review of Educational Research, 55, 155-200.

Dishion, T. J., Patterson, G. R., Stoolmiller, M., & Skinner, M. L. (1991). Family, school, and behavioral antecedents to early adolescent involvement with antisocial peers. Developmental Psychology, 27, 172-180.

Forehand, R. L. (1977). Child noncompliance to parent requests: Behavioral analysis and treatment. In M. Hersen, R. M. Eisler, & P. M. Miller (Eds.), Progress in behavior modification (Vol. 5, pp. 111-147). New York: Academic Press.

Forehand, R. L., & McMahon, R. J. (1981). Helping the noncompliant child. New York: Guilford.

Geller, E. S. (Ed.). (1991). Social validity: Multiple perspectives [Special issue]. Journal of Applied Behavior Analysis, 24 (2).

Graziano, A. M., & Diament, D. M. (1992). Parent behavioral training: An examination of the paradigm. Behavior Modification 16(1), 3-38.

Hester, P. P., & Kaiser, A. P. (1998). Early intervention for the prevention of conduct disorder: Research issues in early identification, implementation, and interpretation of treatment outcome. Behavioral Disorders, 24(1), 57-65.

Houlihan, D., Sloane, H. N., Jones, R. N., & Patten, C. (1992). A review of conceptualizations and treatments of child noncompliance. Education and Treatment of Children, 1, 56-77.

Kazdin, A. E. (1997). Acceptability of child treatment techniques: The influence of treatment, efficacy, and side effects. Behavior Therapy, 12, 493-506.

Kelley, M. L. (1998). Review of the Systematic Screen for Behavior Disorders. In J. C. Impara, B. S. Plake, & L. L. Murphy (Eds.), The thirteenth mental measurements yearbook (pp. 994-995). Lincoln, NE: Buros Institute.

Loeber, R., & Schmaling, K. B. (1985), Empirical evidence for overt and covert patterns of antisocial conduct problems: A meta-analysis. Journal of Abnormal Child Psychology, 13, 337-352.

Marchant, M. (1996). The effects of parental leaching on the acquisition of instruction following behavior of at-risk preschool children. Unpublished master's thesis, Utah State University, Logan.

Mitchem, K., & Young, K. R. (2001). Adapting self-management programs for classwide use: Acceptability, feasibility, and effectiveness. Remedial and Special Education, 22, 75-88.

Patterson, G. R., DeBaryshe, B. D., & Ramsey, E. (1989). A developmental perspective on antisocial behavior. American Psychologist, 44, 329-335.

Patterson, G. R., Reid, J. B., & Dishion, T. J. (1992). Antisocial boys: Vol. 4. A social interactional approach. Eugene, OR: Catalia.

Richman, G. S., Harrison, K. A., & Summers, J. A. (1995). Assessing and modifying parent responses to their children's noncompliance. Education and Treatment of Children, 28, 105-116.

Rotto, P. C., & Kratochwill, T. R. (1994). Behavioral consulting with parents using competency-based training to modify child noncompliance. School Psychology Review, 23, 669-693.

Sanders, M. R., & James, J. E. (1983). The modification of parent behavior: A review of generalization and maintenance. Behavior Modification, 7, 3-27.

Skiba, R. (1999, June). Preventing school violence: Effective alternatives to punishment and exclusion. Paper presented at the 22nd Annual Conference for At-Risk Children and Youth, Utah State University, Logan.

Southam-Gerow, M. A., & Kendall, P.C. (1997). Parent-focused and cognitive-behavior treatments of antisocial youth. In D. M. Stoff & J. Breiling (Eds.), Handbook of antisocial behavior (pp. 384-394). New York: Wiley.

Sprague, J., & Walker, H. (2000). Early identification and intervention for youth with antisocial and violent behavior. Exceptional Children, 66, 367-379.

Strain, P. S., Steele, P., Ellis, T., & Timm, M. S. (1982). Long-term effects of oppositional child treatment with mothers as therapists and therapist trainers. Journal of Applied Behavior Analysis, 15, 163-169.

Timm, M. A. (1993). The regional intervention program: Family treatment by family members. Behavioral Disorders, 19, 34-43.

Timm, M. A., & Rule, S. (1981). RIP: A cost-effective parent implemented program for young handicapped children. Early child development and care, 7, 147-163.

Tolan, P. H., & McKay, M. M. (1996). Preventing serious antisocial behavior in inner-city children: An empirically based family intervention program. Family Relations, 45, 148-155.

Verduyn, C. M., Lord, W., & Forrest, G. C. (1990). Social skills training in schools: an evaluation study. Journal of Adolescence, 13, 2-16.

Wahler, R. G. (1980). The insular mother: Her problems in parent-child treatment. Journal of Applied Behavior Analysis, 23, 207-219.

Walker, H. M. (1997). First steps to prevent antisocial behavior. Teaching Exceptional Children, 30, 16-19.

Walker, H. M., Colvin, G., & Ramsey, E. (1995). Antisocial behavior in school: Strategies and best practices. Pacific Grove, CA: Brooks/Cole.

Walker, H. M., & Severson, H. H. (1992). Systematic screening for behavior disorders. Longmont, CO: Sopris West.

Walker, H. M., Severson, H. H., Todis, B. J., Black-Pedego, A. E., Williams, G. J., Haring, N. G., & Barckley, M. (1990). Systematic Screening for Behavior Disorders (SSBD): Further validation, replication, and normative data. Remedial and Special Education, 11, 32-46.

Webster-Stratton, C. (1998). Parent training with low-income families: Promoting parental engagement through a collaborative approach. In J. R. Lutzker (Ed.), Handbook of child abuse research and treatment (pp. 183-210). New York: Plenum Press.

Wierson, M., & Forehand, R. (1994). Parent behavioral training for child noncompliance: Rationale, concepts, and effectiveness. Current Directions in Psychological Science, 3, 146-151.

Wiese, M. R., & Kramer, J. J. (1988). Parent training research: An analysis of the empirical literature 1975-1985. Psychology in the Schools, 25, 325-330.

Williams, B. F., Williams, R. L., & McLaughlin, T. F. (1991). Treatment of behavior disorders by parent and in the home. Journal of Developmental and Physical Disabilities, 3, 385-407.

Willner, A. G., Baukmann, C. J., Kirigin, K. A., Fixsen, D. L., Phillips, E. L., & Wolf, M. M. (1977). The training and validation of youth-preferred social behaviors of child-care personnel. Journal of Applied Behavior Analysis, 10, 219-230.

Wolf, M. M. (1978). Social validity: The case for subjective measurement, or how behavior analysis is finding its heart. Journal of Applied Behavior Analysis, 11, 203-214.

Young, K. R. (1993). The role of social skills training in the prevention and treatment of behavioral disorders. In B. Smith (Ed.), Focus 93Teaching students with learning and behavioral problems (pp. 341-367). Victoria, British Columbia: B. Smith & Associates.

Young, K. R., Black, S., Marchant, M., Mitchem, K., & West, R. P. (2000). A teaching approach to discipline: An alternative to punishment. Marriage and Families, August, 9-15.

Young, K. R., West, R. P., Marchant, M., Morgan, J. C., & Mitchem, K. (1997). Prevention Plus: A comprehensive program for the prevention of antisocial behavior. Logan: Utah State University, Center for the School of the Future.

Zaragoza, N., Vaughn, S., & McIntosh, R. (1991). Social skills interventions and children with behavior problems: A review. Behavioral Disorders, 16, 260-275.

Zlomke, L. C., & Spies, R. (1998). Review of the Systematic Screening for Behavior Disorders. In J. C. Impara, B. S. Plake, & L. L. Murphy (Eds.), The thirteenth mental measurements yearbook (pp. 995-996). Lincoln, NE: Buros Institute.

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Table 1

Social Validity Questionnaire Results

                                Almost  Once in
Question                        never   a while  Sometimes  Frequently

 #1 I am a more                                                 1
    positive parent
 #2 Improved child behavior                                     1
 #3 Use "please do"                                             2
    instructions at times
    apart from study
 #4 Use praise at times                                         2
    apart from study
 #5 Use corrective teaching at    1                             2
    times apart from study
 #6 Improved relationship                                       1
    with child
 #7 Skills useful with other                                    3
    children
 #8 Improved relationships                                      2
    with others
 #9 Reinforcers useful with
    child
#10 Parent card useful
#11 Observers intrusive           4
#12 Parent coaches worthwhile
#13 Reinforcers for parent
    helpful
#14 Intend to continue with
    use of skills
#15 Simple to implement                                         3
#16 Program worth parents'                                      1
    time

                                Almost     Not
Question                        Always  applicable

 #1 I am a more                   3
    positive parent
 #2 Improved child behavior       3
 #3 Use "please do"               2
    instructions at times
    apart from study
 #4 Use praise at times           2
    apart from study
 #5 Use corrective teaching at    1
    times apart from study
 #6 Improved relationship         3
    with child
 #7 Skills useful with other      1
    children
 #8 Improved relationships        2
    with others
 #9 Reinforcers useful with       4
    child
#10 Parent card useful            3         1
#11 Observers intrusive
#12 Parent coaches worthwhile     4
#13 Reinforcers for parent        4
    helpful
#14 Intend to continue with       4
    use of skills
#15 Simple to implement           3
#16 Program worth parents'        3
    time

Note. The six columns to the left of the question column the responses
the parents gave on their questionnaires. The most common response was
"Almost Always," except for question #12, which was "Almost Never."

Figure 1. Definition and examples of compliance.

(1) Look at the person: Direct eye contact was expected between the parent and child when the instruction was given and before or when the child said "OK." Positive response: Eye contact be maintained the entire time that the parent gave the instruction to the child. Positive response was recorded if the parent gave an instruction while she looked or pointed in the direction of an article or "task" and the child looked in the same direction. Negative response: The child's eyes were closed and/or looking up. down, or around, not at the parent, object, or "task." Prompting the child was counted as a negative response, also.

(2) Say "OK": The child was expected to give an affirmative reply within 5 seconds after the instruction was given. Positive examples: The child said "OK," "yes," "sure," or any other affirmative, verbal answer. The response needed to be loud enough for the observers to hear. Negative examples: The child said "no," challenged the reason with the parent for needing to do the task, gave a negative reply (e.g., called the parent a name), nodded his head, or did not respond verbally. Prompting the child was also counted as a negative response.

(3) Do the task quickly: The child needed to begin the task within 5 seconds after saying OK. Positive example: The child began or started to move toward the task within 5 seconds. Negative example: The child took more than 5 seconds to start the task or to move toward starting the task, did not begin the task, or required a prompt from the parent.

(4) Finish the task: The child needed to finish the task and the parent checked to make sure that it was completed to her satisfaction. The task needed to be completed before the next instruction was given. Negative example: The child avoided doing the task completely or did not complete some portion of the task, or the parent helped the child to finish the task when this had not been the parent's intention.

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