As a BCBA, you know that parent engagement is crucial for successful ABA therapy outcomes. However, in a recent study of 176 BCBAs who regularly provide family guidance as a part of their position, only 23% of respondents indicated that they received formal instruction on working with families as a part of their graduate studies.1 What’s more, finding tools to keep parents, families, and caregivers engaged outside of clinical sessions is not always easy.
Parents also face imposing barriers to full engagement. When their child is first diagnosed, they’re navigating a whole new world from trying to understand complex behavioral concepts from ABA and related fields to feeling the pressure of their child’s future on their shoulders.
In simple terms, it can be a very overwhelming time.
To support families, approach parent engagement in simple, manageable, and practical ways that work for you and your clients.
Challenges in Parent Engagement
As a BCBA, your training and board certification in Behavior Analysis equip you with a wealth of behavior theory and intervention strategies. These essential concepts provide the raw material to help children and families with behavioral challenges.
But you might find significant gaps between theory and practice. Many programs don’t teach how to engage parents and caregivers. Few clinical guides exist. Engagement often falls into the “learn as you go” category. Even seasoned BCBAs can find this aspect of the job difficult. After all, each child and family is different.
Many clinicians are trained to work with kids and not necessarily trained to be putting on the hat of a social worker and thinking about how to work with a family in a different way.
Jamie Pagliaro, Executive Vice President & Chief Learning Officer, Rethink Share this
Common challenges include:
- Time constraints (for both BCBAs and parents)
- Communication gaps
- Difficulty translating clinical concepts into everyday language
- Maintaining consistency between therapy sessions and home life
These real-world challenges often lead to reduced parent engagement, understanding, and confidence, which can result in slower progress for the child.
Rethinking Parent Engagement Tools
There are dozens of different approaches that emphasize parent engagement, including:
- Pivotal Response Treatment (PRT)
- Early Start Denver Model (ESDM)
- TEACCH (Treatment and Education of Autistic and Related Communication Handicapped Children)
- PEERS (Program for the Education and Enrichment of Relational Skills)
- RUBI (Research Unit on Behavioral Interventions)
Each approach has advantages tied to evidence-based, trusted research and clinical care. They’re comprehensive and robust. However, the rigor can sometimes be intimidating and hard to digest for parents. Printed materials and resources can be helpful when trying to teach important concepts, but they can also overwhelm some families. Support should be tailored to meet families where they are with the tools they need to be successful.
The Power of Technology
Effective use of technology can change the game. For example, RUBI has already been developed as a modular approach. It consists of specific digestible lessons designed to be flexible. As such, it can be easily adapted to today’s online and mobile environment.
Technology serves as a starting point. But ultimately, we want to give clinicians the flexibility to modify things. When working with families who've been in treatment for a couple years, clinicians want the flex configuration — and a traditional configuration when it’s a new family.
Stewart Pisecco, Ph.D. Share this
Breaking training into bite-sized pieces that focus on immediate priorities helps parents engage. They can work with interactive elements designed to increase understanding and retention using a smartphone or tablet, which complements scheduled, billable parent training hours.
And when parents feel comfortable and less overwhelmed, they’re more likely to participate actively in their child’s therapy. They gain a better understanding of what to prioritize and how to start. They also become more likely to stay engaged when they see how the training directly relates to their child’s needs.
When a parent has a goal that feels like it’s five steps away from where their kid is right now, sometimes the conversations are just about reestablishing the baseline instead of starting up high.... how is your kid currently doing in meeting that goal on a day-to-day basis?
Karen Bearss, Ph.D., Associate Professor, Department of Psychiatry and Behavioral Sciences, University of Washington Share this
Meeting Payor Expectations and Improving Outcomes
ABA practices must also consider payors as well as parents. Payors increasingly focus on parent engagement as a measure of program effectiveness. They look for a comprehensive approach to evaluate the impact of parent engagement.
You never have to get a justification from a health plan for parent training. It’s easy to get those hours. The things that we get measured on when we work with health plans is, are we seeing an increase in 97156 [sessions the provider spends face–to–face with the guardians or caregivers]?”
Stewart Pisecco, Ph.D. Share this
A data-driven approach validates the importance of parent involvement and provides powerful insights that can guide future strategies and demonstrate your program’s effectiveness to families and payors.
Parent engagement metrics also give you tangible evidence of involvement. Feedback from families helps you understand their experiences and identify areas for improvement. You can use it to refine your approach and show parents their input is valued. Your relationship with caregivers leads to better outcomes for children—skills learned in therapy are likelier to stick.
You need a structure that provides you the ability to connect with a parent who may have very different values and interests than you. Just the ability to communicate creates a connection.
Alan Fullbright, M.ED, BCBA, LBA, Director of Clinical Care and Quality Assurance, Attend Behavior Share this
From Barriers to Outcomes
Helping families integrate ABA principles into daily life is critical to children’s success—extending engagement beyond therapy sessions helps ensure that positive behaviors generalize to the home environment. By adopting these simple strategies and incorporating digital tools into your practice’s toolkit, parent engagement can become more effective and less stressful for everyone involved—a key to long-term success.
How to Cultivate Effective Parent Engagement
- Build a collaborative caregiver-clinician relationship. Identify goals together and establish clear communication channels for how each family prefers to stay in touch – email, text, phone calls, or a mix.
- Set realistic expectations. Be upfront with parents about what engagement involves and its benefits.
- Create a structured yet flexible plan. Outline critical areas to cover, but be ready to adjust based on family needs.
- Touch base with parents regularly to track progress at home and address concerns promptly.
- Leverage technology. Use digital tools to share resources, track progress, and maintain ongoing communication.
- Remember, the goal is to make parent engagement feel supportive, not burdensome. Tailor your approach to each family’s unique situation while providing compassionate and individualized support.
For More Insights
Watch as Dr. Pisecco, Dr. Bearss and Dr. Fullbright share how to close the parent training gap in the full replay of our virtual Fireside Chat: Rethink BH & Attend Behavior.
References
1 Amanda Fullbright, Sharyn Kerr, Stewart Pisecco, Karen Bearss, Alan Fullbright. Presented in “Strategies for Overcoming Barriers to Effective Family Guidance” (panel discussion, Council of Autism Service Providers conference). 4/24/23.