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This article describes the effects of an intervention in which parents were taught to use facilitative strategies when interacting with their children with profound disabilities. The intervention consisted of reinforcing appropriate parent behavior as it was being observed by them on prerecorded videotapes, A multiple probe design across three subjects was used to assess the relationship between the intervention and participant behavior. Dependent measures included parent use of facilitative strategies, defined as the use of choice, elaboration, social games, and imitation. Child-dependent measures were defined as social and isolate behavior. The results indicated a functional relationship between the training parents received and their increased use of facilitative strategies within training and nontraining situations in two of the dyads. In two of the three subject dyads, parents' use of facilitative strategies appeared related to child's frequency of social behavior. Two of the parents reported positive differences in the quality of their interactions after the intervention. Early childhood special education professionals examined a set of the videotaped observations and rated posttraining tapes higher than baseline tapes on interaction quality for two of the three dyads.

Early childhood educators regard child-initiated, child-directed, teacher-supported play as the primary context in which young children learn, whereas special educators have relied more heavily on teacher-directed activities that are focused on specific skill development. The purpose of this manuscript is to suggest that a play-based environment is the most natural instructional context for young children with severe disabilities. The application of a play-based curriculum requires neither an abandonment of effective instructional special education practice nor a violation of early childhood education best practice. Adopting such an approach, however, does represent a conceptual step away from existing practice. Further, allowing play activities to form the foundation on which effective instruction and classroom organization are built requires the utilization of best practice in the fields of early childhood education and early childhood special education in conjunction with effective practices for educating students with severe disabilities.

Children with complex disabilities such as autism spectrum disorders and Landau Kleffner syndrome often lack means to participate in everyday family routines. Serious problem behaviors may result from their challenges in responding to and initiating communicative interactions. These behaviors can change routine family activities such that the child and other family members (parents, siblings) are dissatisfied with these routines. The purpose of this study was to examine the use of functional assessment and positive behavior support carried out in equal partnership with family members to reduce a child's challenging behavior and increase his or her engagement in three family-chosen home activities. A multiple-baseline design across routines was used to determine the effectiveness of intervention in reducing challenging behavior and increasing engagement in the routines. Additionally, the study explored outcomes for positive and negative parent–child interactions within the three –targeted routines. Following parent implementation of positive behavior support, results indicated (1) reductions in challenging behavior, (2) increases in the child's engagement, (3) increases in positive parent–child interactions, (4) decreases in negative parent–child interactions, and (5) increased number of days that the child slept through the night. Social validation by parent observers provided additional support for the effect of the intervention on the child's behavior and child–parent interaction.

Although our field has made significant progress in the measurement of procedural fidelity in research studies, we argue for a more nuanced and expansive perspective on procedural fidelity. Specifically, we review the status quo of procedural fidelity measurement in intervention research along with specific suggestions for increasing both precision and focused research on the levels of procedural fidelity that are needed to maximize outcomes for individual participants. Second, we offer an expanded example of procedural fidelity by examining the data on the influence of typical peers, particularly on how the data influence a broad range of skills for individuals with severe disabilities. Finally, we examine the need for multiple layers of procedural fidelity assessment if we are to fully understand the vast array of contextual variables that can influence both procedural fidelity and child outcomes, particularly in a progression of research from initial efficacy assessment through scale-up and replication. We utilize the program-wide implementation of the Pyramid Model for illustrative purposes.

Behavioral support with families is a multifaceted endeavor that should be studied from the various perspectives that affect its feasibility, efficacy, and potential to produce outcomes that are durable and meaningful to people's lives. This study describes a qualitative analysis of one family's experience during a 10-month process of assessment and intervention for the behavioral challenges of a boy with multiple and severe disabilities. Data collection included an audiojournal recorded by the boy's mother and a series of semistructured interviews with both parents and the boy's older brother. The data were synthesized to chronicle the impressions of the family relating to the phases of the positive behavioral support process. The data yielded two pervasive themes that describe the impact of the problem behavior on the family and the effects of the behavioral support process on the child and his family. Together, with a companion article that presents the procedures and quantitative analyses (Vaughn et al., 1997), the methods and findings from this study offer a broader view of behavioral support than has been evident in the literature thus far. The findings are presented as a heuristic for researchers to engage in participatory investigations that can illuminate important features of support processes with the intention of increasing responsiveness to consumers (e.g., families) and enhancing the benefits of community-based support efforts.

In this study and a companion article (Fox et al., 1997), we present an investigation that uses multiple research perspectives to study community-based, family-centered behavioral support. This study describes the intervention strategies and quantitative analyses that were used to address the challenging behaviors of a boy with severe disabilities. A collaborative team that included the boy's mother designed and implemented functional assessments and hypothesis-based interventions in three settings: a drive-through bank, a large grocery store, and a fast food restaurant. Data showed that the interventions reduced problem behaviors in all three settings and that concomitant increases were observed in desirable mother-child interactions. Specific tantrums associated with transitions through doorways were decreased substantially. Social validation data supported the efficacy and feasibility of the support strategies. This quantitative analysis provides further testimony for the use of positive behavioral support in complex, public environments.

What key issues and challenges affect the lives of people with severe disabilities todayâ€"and what should tomorrow's professionals do to address them? Aligned with the core values and agenda of TASH, this visionary text prepares professionals to strengthen supports and services for people with disabilities across the lifespan. Readers will fully examine more than a dozen critical topics in the lives of people with severe disabilities; explore necessary reforms to policy and practice; and set clear goals and priorities for improving early intervention, education, health care, behavior suppor