|Title:||Development and Testing of the Family Behavior Support App|
|Principal Investigator:||Barton, Erin||Awardee:||Vanderbilt University|
|Program:||Early Intervention and Early Learning [Program Details]|
|Award Period:||3 years (9/1/2016-8/31/2019)||Award Amount:||$1,499,866|
|Type:||Development and Innovation||Award Number:||R324A160086|
Co-Principal Investigator: Hedda Meadan (University of Illinois) and Angel Fettig (University of Massachusetts Boston)
Purpose: The purpose of this project is to develop and pilot test the Family Behavior Support App (FBSApp), an intervention aimed at supporting parents in implementing interventions with their young children with disabilities and challenging behaviors in home settings. Persistent challenging behavior observed at a young age is associated with poor social and academic outcomes, and the rates of challenging behavior are higher for children with developmental disabilities. Challenging behavior places stressful demands on families. Mobile technology provides an opportunity to increase the accessibility and efficiency of support for parents of these children. In this project, the investigators will create a mobile application to support parents in implementing functional assessment (FA)-based interventions, which work by determining the purpose (function) that a particular behavior serves for a child and using this information to develop a plan for reducing and preventing the behavior.
Project Activities: In the first year of this project, the intervention will be developed and refined through expert review, cognitive interviews, and focus groups. Field tests with parents will be conducted in the second year using single-case design studies. In the final year of the project, a randomized controlled trial will be conducted to evaluate the promise of the intervention for parents of children with disabilities and challenging behavior, including the promise of a supplementary feature for use by the early childhood professionals who support these families.
Products: The products of this project will include a fully developed intervention, FSBApp, for parents of children with disabilities and challenging behavior, as well as peer-reviewed publications and presentations.
Setting: The research will take place in the homes of families in Tennessee, Illinois, and Massachusetts.
Sample: Young children (ages 2–5 years) with identified disabilities and challenging behavior and their parents will participate in this study. In addition, the early childhood professionals who work with families of children with challenging behavior will participate. Approximately 4–5 professionals and 4–5 families will participate in the cognitive interviews, with an additional 10–12 parents and 10–12 professionals in the focus groups. Four families will participate in the field test. Finally, the pilot study will be conducted with 66 families, 33 in the intervention group and 33 in the control group. For approximately half of the families in the intervention group, their child's early childhood professionals will also participate to test the supplemental professional login component.
Intervention: The FSBApp will be a free software application for mobile devices (phones and tablets) that will help parents track and monitor the behavior of their young children with disabilities and challenging behavior using functional assessment. The major components of the intervention include an interactive video user guide; personalization through entry of family and child information, including specific challenging behaviors and their contexts; comprehensive functional behavior assessment through identification of the antecedents and consequences of the behavior; hypothesis generation to help determine the function the behavior serves; creation of a behavior support plan for parents to address challenging behavior and teach new skills; support for parent implementation of the plan; and a recording system for ongoing progress monitoring. The app will also feature two optional supplementary components—a login for professional interventionists who are working with the families and links to resources for the families to access.
Research Design and Methods: During the first 2 years of the project, the research team will conduct an iterative process of developing and refining the intervention. In the first year, they will develop the technology and content for the intervention, followed by a series of expert reviews, feasibility and usability testing using cognitive interviews with parents and professionals, and focus groups with parents and professionals. In the second year, field tests will be conducted with parents using multiple-probe single-case design. In the third year, a pilot study will be conducted to evaluate the intervention's promise for efficacy using a randomized controlled trial design in which parents in both the intervention and control groups will have access to webinars but only the intervention group will have access to the FSBApp.
Control Condition: For the pilot study, families in the control group will have access to webinars that cover FA-based interventions, but will not have access to the FSBApp.
Key Measures: Child outcome measures in this study include direct observation of challenging behavior and social-emotional skills, the Child Behavior Checklist, and Ages and Stages Questionnaire: Social Emotional. Back-end user data from the FSBApp will also be collected. These user data and coded video clips of family routines will be used to assess fidelity of implementation. Parent and professional provider outcomes will also be measured through surveys of satisfaction, semi-structured interviews, and the Parent Stress Index–Short Form.
Data Analytic Strategy: Qualitative analyses of the focus group data and cognitive interviews will be summarized and used with the expert reviews to guide the formative development process. The single-case design data from the field test will be examined with visual analysis and estimated effect sizes. To compare groups in the pilot study, the investigators will use a repeated measures analysis of variance model.