The 2020 John R Lutzker Lecture featured Dr. V. Mark Durand, Distinguished University Professor of Psychology at the University of South Florida St. Petersburg. His presentation topic was Supporting Families of Children with Autism Spectrum Disorder and Challenging Behavior. Challenging behaviors continue to top the list of concerns for families of persons with Autism Spectrum Disorder (ASD). Research shows that the presence of these problem behaviors can negatively impact the mental health of family members. Although we have made impressive gains in helping reduce these problem behaviors, obstacles remain. In this presentation, Dr. Durand covered new insights into these obstacles and how families and others can overcome them and effectively help persons with even the most severe behavioral challenges. Evidenced-based approaches to replacing behavior problems were discussed and Dr. Durand described how advances in positive psychology can help caregivers be more effective in their efforts to help those with ASD and how to help themselves lead happier and less stressful lives. Learn more: http://publichealth.gsu.edu/lutzker

1. Supporting Families of
Children with Autism
Spectrum Disorder and
Challenging Behavior
V. Mark Durand, Ph.D.
University of South Florida St. Petersburg

2. Behavioral Philosophy
• If a program doesn’t work for a child we
do not blame the child.
• We change aspects of the program.
• If family members do not implement our
plans – who is to blame?

3. Treating Challenging Behavior
• Effective behavioral assessments and
functional treatments
• Why don’t some families carry out these
plans?

4. Prevention Project
• Prospective longitudinal study

5. Developmental Progression

6. Prevention Project
• Prospective longitudinal study
• Parental Pessimism
• Self-Efficacy
• Child Efficacy

8. Pessimistic Themes
• Control
• How you think
others see you as a
parent
• Child’s ability to
control his/her
behavior
• Catastrophizing
• Stability of behavior
• Responsibility

9. Pessimistic Themes
• Control
• How you think
others see you as a
parent
• Child’s ability to
control his/her
behavior
• Catastrophizing
• Stability of behavior
• Responsibility

10. Positive Family Intervention
Project
• Can we make pessimistic families
more optimistic?
• Integrating cognitive-behavioral
intervention with positive behavioral
support
Durand, V. M., Hieneman, M., Clarke, S., Wang, M., & Rinaldi, M. (2013).
Positive family intervention for severe challenging behavior I: A multi-site
randomized clinical trial. Journal of Positive Behavior Interventions, 15(3), 133-
143.

11. Positive Family Intervention
• Standard protocol
• 8 weeks
• 1 ½ hours per individual session
• Standardized measures

12. Self-Talk Journal
Situation
What happened?
(success or difficulty)
Beliefs
What did you think and
feel?
Consequences
What happened as a
result? (actions)
When my son sat down
for dinner, he started
whining and crying.
(difficulty)
I thought “We will never
have a normal dinner”
and felt defeated, thinking
that meals will always be
a problem.
I gave him cookies so he
would stop crying.

13. Situations & Beliefs
• Identify situations that provide triggers to
negative thinking (e.g., What was exactly
happening? Where were you? What did
your child and others do?)
• Identify beliefs associated with the event
(e.g., What were you feeling and thinking
while this was going on? What did you
say to yourself?)

14. Consequences
• Identify the consequences or results of
the negative (and positive) thinking
(e.g., When you were thinking _____,
how did that affect what you did? What
were the results of your actions – both
immediate and long-term?)

15. Recognizing Consequences
• Parenting “in the moment”

16. Distraction
• Strategy to help with pessimistic beliefs
• Distracting oneself from the pessimistic
thoughts

17. Disputation - A strategy for
challenging beliefs
• Step 1: Identify the negative belief
• Step 2: List evidence that supports the
belief.
• Step 3: Find alternative explanations for
the problem
• Step 4: Evaluate the usefulness of
maintaining the belief.

18. Substitution
• Replace the pessimistic ideas with
positive thoughts or affirmations (e.g..,
“This is a difficult situation and I am
handling it well. I am a committed,
loving parent. If I can follow through
with my plan, things will get better.”)

19. Post-Treatment Results

20. Quality of Life
• The PFI group reported
improvement on these questions;
• My child will be limited in the kind of
work he/she can do to make a living.
• I get almost too tired to enjoy myself.
• There is a lot of anger and
resentment in our family.
• I am worried much of the time.

21. Self-Efficacy
• The PFI group responded more
positively than mothers in the PBS
group on these qestions;
• I feel less tense when I take my child
out in public.
• I am less likely to avoid taking my
child out in public.
• Members of our family get to do the
same kinds of things other families
do.

22. Standardized Behavior Change Data
SIB-R GMI (N=34)
PBS PFI
SIB-R-GeneralMaladaptiveBehaviorIndex
-40
-30
-20
-10
0
Serious
Moderately
Serious
Marginally
Serious
Normal
Pre
Post
Pre
Post

23. Observational Data
Intervention Condition
PBS PFI
%ofIntervals
0
10
20
30
40
50
Pre
Post

24. Parental Reactions to
Challenging Behaviors

25. PFI
PFI
PBS
PBS
0
10
20
30
40
50
60
70
80
90
100
PROACTIVE PASSIVE
PercentageofIntervals
Post Intervention - Group Parent Data

26. PFI
PFI
PBS
PBS
0
10
20
30
40
50
60
70
80
90
100
PROACTIVE PASSIVE
PercentageofIntervals
One Year Follow-Up - Group Parent Data

27. Pre-Intervention

28. Follow-Up PBS

29. Pre-Intervention

30. Follow-Up PFI

31. Summary of Results
• Both PBS and PFI result in significant
improvements in child behavior
• These improvements continue after one
year
• Parents report overall improvements on
QoL

32. Summary of Results
• PBS families tend to use avoidance
strategies to improve child behavior
• PFI families tend to use more active
strategies
• PFI families report more community
involvement with their children and less
anxiety

33. The Concession Process
• The tendency to change
environments and approaches to
avoid problem behavior

34. Why ASD?
• Blame disorder (child efficacy)
• Self Efficacy
• Failure to back down in the face of
discipline escalation

36. Why ASD?
• Blame disorder (child efficacy)
• Self Efficacy
• Failure to back down in the face of
discipline escalation
• Subjective reaction to distress
Esposito, G., Nakazawa, J., Venuti, P., & Bornstein, M. H. (2012).
Perceptions of distress in young children with autism compared to
typically developing children: A cultural comparison between Japan and
Italy. Research in Developmental Disabilities, 33(4), 1059-1067.

37. Positive Family Intervention
• Addresses the needs of children with
challenging behavior
• Addresses the need of family members
who carry out the plans
• Better outcomes when we address both

38. Positive Family Intervention
• Durand, V.M. & Hieneman, M.
(2008). Helping parents with
challenging children: Positive family
intervention, Facilitator’s guide.
New York: Oxford University Press.
• Durand, V.M. & Hieneman, M.
(2008). Helping parents with
challenging children: Positive family
intervention, Workbook. New York:
Oxford University Press.

39. Optimistic Parenting
• Durand, V.M. (2011).
Optimistic parenting: Help
and hope for you and your
challenging child. Baltimore,
MD: Paul H. Brookes.