4/11/2019 18 25 16 Outcomes Outcomes 14 20 Aggressive Events - PDF document

4/11/2019 18 25 16 Outcomes Outcomes 14 20 Aggressive Events Physical Restraints Mean Number per Week 12 Mean Number per Week (Cascading Effects) (Staff Behavior 15 10 Change) Training Training 8 Post Training 10 Post Training 6 4 5 2 0 0 MBPBS TAU MBPBS TAU PHYSICAL RESTRAINTS AGGRESSIVE EVENTS MBPBS vs. TAU MBPBS vs. TAU Training: t (18) = 3.62, p = 0.002 (Cohen’s d = 1.62). Training: t (18) = 0.21, p = .84 (Cohen’s d = 0.09) Post-training: t (58) = 1.73, p = 0.10 (Cohen’s d = 4.34). Post-training: t (58) = 11.01, p < 0.001 (Cohen’s d = 2.84) 8 12 Outcomes 7 Outcomes 10 6 Use of Stat (Emergency) One-to-One Staffing Medicine for Aggression Mean Number per Week Mean Number per Week 8 (Agency Behavior 5 (Staff Behavior Change) Change) 6 4 Training Training Post Training Post Training 3 4 2 2 1 0 MBPBS TAU 0 STAT MEDICINES MBPBS TAU 1:1 STAFFING MBPBS vs. TAU MBPBS vs. TAU Training: t (18) = 1.73, p = 0.10 (Cohen’s d = 0.77) Training: t (18) = 0.69, p = 0.50 Post-training: t (58) = 11.28, p < 0.001 (Cohen’s d = 2.91) Post-training: , t (58) = 14.80, p = 0.0001 • Randomized controlled trial MBPBS vs. PBS (PBS) Singh, N. N., Lancioni, G. E., • Staff: 60 (MBPBS), 63 (PBS) Medvedev, O. N.., & Myers, • Adults with developmental disabilities: 40 Staff Outcomes R. E., Chan, J., McPherson, (MBPBS),40(PBS) C. L., Jackman, M. M., & • Average age of staff: 44 (MBPBS), 43 (PBS) Perceived Psychological Kim, E. (2018). Comparative • Adults with developmental disabilities: 41 Stress on PSS-10 effectiveness of caregiver (MBPBS), 44 (PBS) training in mindfulness- • Target variables: based positive behavior • Aggressive behavior support (MBPBS) and • Staff Injury positive behavior support • Peer Injury (PBS) in a randomized • Physical restraints for aggressive behavior • Stats (emergency) medicine use controlled trial. • One-to-one staffing for aggressive behavior Mindfulness . • Staff perceived psychological stress • Professional Quality of Life (ProQOL) • Staff turnover • Cost-benefit analysis • Mindfulness training: 7-day intensive Component Analysis • Data collected for 40 weeks 13

4/11/2019 Staff Outcomes Staff Outcomes Compassion Satisfaction Staff Burnout on ProQOL on ProQOL • Number of staff who terminated Staff Outcomes Staff Outcomes their employment with the agency: • MBPBS: 1 staff in 40 weeks Traumatic Stress Staff Turnover • PBS: 6 staff in 40 weeks on ProQOL • MBPBS condition had a marginally significant effect ( p = .05) compared to the PBS condition with standardized β of -0.22 that explained 5% of variance in these data. Comparative costs for 40 weeks MBPBS training • Randomized controlled trial of MBPBS for Singh, N. N., Lancioni, G. E., Karazsia., & Myers, R. E., versus 40 weeks PBS training mothers of children with ASD or with ID Hwang, Y-S, & Anālayo, • Mothers: 47 (ASD), 45 (ID) Bhikkhu (2019). Effects of Mindfulness-Based Positive • Target variables: Behavior Support (MBPBS) • Meditation practice (minutes per day) training are equally beneficial for mothers and children with • Perceived Stress (PSS-10) ASD or with ID. Frontiers in • Children’s aggressive behavior Psychology , 10: 385 • Children’s disruptive behavior • Compliance with mother’s requests • Mindfulness training: 3-day low intensity • Data collected for 40 weeks 14

4/11/2019 Mothers’ Outcomes for Outcomes Adolescents with Perceived Stress ASD Aggressive behavior Disruptive behavior Compliance with mother’s requests • Aim Outcomes for Component Analysis • To assess the effectiveness of the MBPBS Adolescents with package, versus MB (mindfulness) alone, and MBPBS vs. MB vs. PBS ID PBS (alone) across parent (perceived psychological stress) and child (aggressive Aggressive behavior behavior, disruptive behavior, compliance with Disruptive behavior parental requests) variables Compliance with mother’s • Experimental Design requests • Three-arm randomized controlled trial • MBPBS vs. MB vs. PBS • Four experimental phases: • 10-week control condition • Training in each active experimental condition • 30-week implementation condition • 3-years of followup post-implementation condition Parents’ Perceived Psychological Stress Children’s Aggressive Behavior Parent Stress (PSS) MBPBS MB PBS 35.00 30.00 25.00 Stress 20.00 15.00 10.00 W1 W10 W40 1 Year 2 Years 3 Years Assessment Time 15

4/11/2019 Children’s Disruptive Behavior Children’s Compliance with Requests The PREVENTION Study CONSORT Diagram MBPBS vs. Control Long-term effects of Mindfulness- Based Positive Behavior Support (MBPBS) program on mothers and their children with Autism Spectrum Disorder: A randomized controlled trial—Year 1 • MBPBS • Mothers • 3-day stepped-care version of MBPBS protocol Procedures Outcome Measures • Parent stress (Perceived Stress Scale-10)— MBPBS vs. Control MBPBS vs. Control measured 3 times: in the week before • Control training (Pre); 6 months and 12 months • No experimental variables were manipulated following training • The mothers utilized training and treatment procedures available in their own communities. • Mothers’ meditation practice: Daily log of • Follow-up meditation in minutes • Every 6 and 12 months for 3 years • Data reported for Year 1 16

4/11/2019 • Children with ASD • Changes in Mother-Child Interactions • Experimental • Mother’s engagement with her child • Inhibitory Control Task (Dinky Toys Task; Outcome Measures Outcome Measures Kochanska et al., 2000). • Behavioral observation of video-taped MBPBS vs. Control MBPBS vs. Control • Children’s Behavior Questionnaire (Rothbart interactions et al., 2001) • 1 Hour • Anger/Frustration • Partial Interval Recording • Attentional Focusing • 10 sec observation, 5sec recording • Impulsivity • Inhibitory Control • 240 intervals • Physical Integration: • Context of engagement • Physical engagement in community activities in • Child learning activities the same places that children without disabilities • Child leisure activities live, learn, work and play • Social integration: • Proportion of engagement leading to child • Social engagement in community activities with disruptive behavior children and adults other than those s/he lives • Learning activities with or are paid to provide services—with friends and people who are significant in the • Leisure activities child’s life • Physical aggression • Hitting, biting, kicking, and slapping directed at others Trajectory of Mothers’ Perceived Stress Trajectory of Mothers’ Daily Meditation 28.03* * * 24.14* 22.36 19.88* 17.33* * * Note: * Significant mean difference between groups and over time, p < .001 Note: * Significant mean difference between groups, p < .001 Children’s Anger/Frustration Children’s Inhibitory Control Task * * * * * * * * Note: * Significant mean difference between groups and over time, p < .001 Note: * Significant mean difference between groups, p < .001 17

4/11/2019 Children’s Impulsivity Children’s Attentional Focusing * * * * * * * * Note: * Significant mean difference between groups and over time, p < .001 Note: * Significant mean difference between groups, p < .001 Trajectory of Children’s Social Integration Trajectory of Children’s Physical Integration * * * * * * * * Note: * Significant mean difference between groups, p < .001 Note: * Significant mean difference between groups, p < .001 Trajectory of Children’s Physical Aggression Trajectory of Mothers’ Engagement with Child * * * * Note: * Significant mean difference between groups, p < .001 18