Why Parent Involvement is Crucial to Autism Therapy

Hopebridge Offers Caregiver Training as Part of Innovative Autism Service Mix

Your child means the world to you. When they experience challenges that could benefit from an evaluation or therapy, as children with autism spectrum disorder (ASD) do, it can be nerve-wracking to take those first steps to seek outside help. It may feel strange to send them somewhere new for therapy and question what goes on or whether they are receiving the best possible care.

With Hopebridge, you don’t have to wonder. We show you.

Whether your child attends center-based autism therapy at one of our locations, or a clinician comes to you for in-home therapy or Telehealth sessions, we want you on our team for everything we do. Your child means the world to us, too, and we can’t give them our best without you. This is why family guidance is a key piece of our service mix.

“We’re transparent agency. It’s a huge honor that parents entrust us with their child’s safety and care. Parents should absolutely know what’s going on treatment-wise. That’s their heart on legs!” said Hopebridge Senior Clinician and Board Certified Behavior Analyst (BCBA) Anne Metzger. “We are in this together and will share the good moments, the tougher moments, the successes and the trials.”

To give a broader picture of caregiver training at Hopebridge, we turned to Anne, as well as Hopebridge BCBA Lisa Jones from our autism therapy center in South Bend, Indiana. Both have extensive, hands-on experience supporting children and parents through applied behavior analysis (ABA therapy) programs from start to transition. They are passionate advocates for family education and parental involvement as it relates to patient success in therapy.

A Caregiver’s Role is Significant to ABA Therapy and other Autism Services

We can understand that some families are initially skeptical about what to expect from their child’s therapy, but at Hopebridge, we strive for caregiver involvement. Won’t don’t just want it … we need it!

Here are five the reasons why family education and parent participation is so important:

1. It provides caregivers with more knowledge around ABA therapy.
   This training helps caregivers understand functions of behavior and why a child may be engaging in maladaptive behaviors, for instance. It helps explain the difference between reinforcement and punishment, and shows them why reinforcement is more effective. If they have a better grasp on ABA, they can better enter their child’s world, are more likely to work on skills at home, and can serve as an advocate for their child with relatives, teachers and the community.
2. Caregiver training leads to more success and generalization.
   Parent training helps children generalize skills across environments and people. At the centers, we use these sessions to teach families how to help their child generalize their skills into the home and other areas of life. It’s great if a child can do something at Hopebridge, but they don’t live here. We need to make sure it’s functional in the environments in which they participate in on a regular basis.
3. Caregiver education forms a deeper connection with the family.
   One of the seemingly simple but crucial reasons for family guidance is that it keeps parents aware of what goes on during therapy. This service also shows them first-hand that we care about what happens beyond our center walls and that the family is a part of the treatment for their child.
4. It shows the child that their family and Hopebridge clinicians are on the same team.
   By seeing their family and therapy team working together, plus following consistent practices and routines during therapy and personal time, these sessions give us the opportunity to show our kids that we are all in this together.
5. Health insurance requires caregiver involvement.
   Not only do we want to see caregivers involved in their child’s care, but insurance companies do, too. If they don’t have evidence of it, they’ll ask, because like us, they know that it is important to the health and progress of the child.

What Does Family Education and Parent Training Look Like at Hopebridge?

Just like how Hopebridge approaches other areas of autism therapy, family guidance is individualized and will look different for each child.

For children who attend therapy at Hopebridge, training sessions can either take place at the center to work with them one-on-one, or they can occur via telehealth consults, which give clinicians the opportunity to watch families interact with their child in the home setting. Families utilizing in-home therapy usually also receive parent training at home.

At a minimum, Hopebridge wants to meet with parents or guardians once a month, but it’s not uncommon to work with parents on a weekly basis. We really want to connect with parents and can be flexible according to their schedules and their child’s needs. 

Parents or guardians are welcome and invited into the clinic to watch the therapist run a session, or to participate in one themselves. To do so, the caregiver must schedule the appointment in advance so the BCBA is available to walk them through everything. Appointments are also necessary so Hopebridge can continue to follow HIPAA guidelines, since our kids often share therapy rooms.

If families wish, BCBAs can provide them with “homework,” such as specific tasks or skills to work on with their child at home, but it all depends on what parents have bandwidth for and how involved they’d like to be in therapy.

Personalized Content and Programming for Caregiver Training

For some families, BCBAs use the time to teach caregivers the foundational concepts, then teach them how it relates to the skills they’re working on with their child. They explain what and how they’re teaching it, as well as show them exactly how it’s implemented. 

“There are a ton of different paths we can take with parent training, all for the well-being of the child,” said Anne. “Our practitioners are equipped with curricula for parent training, but some parents aren’t quite ready for that. We may start by going over topics like, ‘What is autism?’ and ‘What is ABA?’ We meet the parents wherever they need to start.”

Family guidance can sometimes begin with the BCBA building rapport with the parents and any others in the household.

“Parents need pairing, too! We like to get to know a little about them so we can build a stronger connection. Some of this may seem trivial at first, but we work so closely with their kids that it’s important we show them care, too,” Lisa told us.

Goal-setting is one of the topics that is frequently discussed during these sessions. Caregivers know their child better than anyone else, so they can help guide the plan of care by sharing what is significant within their family. The BCBA may think certain targets are important – and they likely are – but if it’s not important to the family, there is no use making it a goal for the child.

“We ask caregivers what is most important to them for their child and try to help them achieve it. Toilet training, communication and decreasing tantrums are common goals,” said Anne. “We want to know what the parents’ priorities are, too, so we can align with them. What’s important to them is important to us.”

Some training sessions include reviewing the patient’s plan of care, functional behavior assessment results, or the results of other assessments. They can talk about the patient’s progress and goals. When Anne served as a practitioner, she liked to show parents their child’s progress by reviewing and interpreting her graphs together.

Family guidance can also be used to go through the behavior intervention plan to make sure parents are comfortable with everything, as well as have it generalized across environments. 

“We want their buy-in on this, so we typically work together on it and ask for permission on certain areas,” said Anne. “For instance, if a child is known to run and elope, how do we attempt to prevent this behavior with antecedent strategies, and how do we react if the behavior occurs? Consistency is key, so we need their understanding, acceptance and support to follow it at home, too.”

Behavior analysts can use this time to teach parents how to interact and play with their child while we’re in the center. Then, we want them to take the skills they learn in the clinic and bring them home to practice with their child.

Parent Training in Action

How do our family guidance sessions affect the real world?

One of the major focuses of parent training is often communication. Sometimes patients do not communicate vocally, and instead communicate via augmentative and alternative communication device (AAC) or Picture Exchange Communication System (PECS). In these cases, we can use parent training sessions to teach the family how to use the AAC or PECS. This type of training helps create a connection between the child and their family members and gives them a way to communicate with each other. In turn, it often leads to fewer tantrums now that the child can communicate their wants and needs.

Lisa told us about one family she worked with of which family education was life-changing. The patient engaged in maladaptive behaviors of aggression and property destruction when at home. Parents were unable to play with him or have him sit to eat a meal. His independence was limited; refusing to dress himself without help, brush his teeth or take medicine.

Through intensive ABA therapy at home and by providing family guidance, Lisa and the rest of his therapy team helped his parents build rapport with their child. This was done through modeling. The therapist would model what pairing looks like and Lisa would narrate to them. His mother started practicing, and little by little, she learned how to play with her son, all the way up to 30-minute play sessions without interruption!

This child now follows a morning routine of getting dressed, brushing his teeth and taking medicine with his parents’ direction. Medication is still slow-going, but on the right path. In addition to these foundational skills, this child also does simple chores for an allowance.

“To me, the biggest success is that the patient began to trust his mother. We taught her that if she says she is going to do something, she needs to do it,” said Lisa. “Now that the parents are consistent in following through with positive reinforcement, they learned they have a much happier and willing child when trust is earned.”

Get Involved in Your Child’s Therapy

Do you want a voice in your child’s therapy? We want to work with you to help your family achieve your goals for your child’s autism services. To find out what parent training can look like for your individual family, fill out our online form to schedule a diagnostic evaluation or ABA evaluation through one of our Hopebridge locations across the country.

*Informed consent was obtained from the participants in this article. This information should not be captured and reused without express permission from Hopebridge, LLC.