IS IT WORKING? Monitoring the Effectiveness of Treatments

Young child sleeping soundly with head resting on arms.

IS IT WORKING? Monitoring the Effectiveness of Treatments

Have you ever wondered if a therapy, treatment, or intervention your child was receiving was really working? Have you ever questioned a professional who said something was working when you didn’t see any changes for your child? Families of children with special needs (especially autism) often spend considerable resources, time, and energy on treatments for their children in hopes of providing them with a better life. As parents, we would do anything for our children, but we also want to make sure the treatments are worthwhile. We cannot tell if children are experiencing internal changes (e.g., feeling better, understanding), but we can evaluate changes in behavior that are observable. Using simple strategies to monitor behavioral outcomes will help parents decide whether treatments are everything they are ‘cracked up to be.’ Without an objective way to track progress, parents are left to operate on gut instinct or rely completely on professionals providing services to report outcomes. Parents are therefore encouraged to work with professionals providing services to adopt or design monitoring systems that are both understandable and meaningful to everyone involved. If professionals are unwilling to do so (which would be unusual), parents can still gather their own data to guide treatment decisions and evaluate interventions.

The following steps may be used to establish a plan for monitoring outcomes of your child’s treatment:

Consider what behavioral changes are most important to you. For example, you might want your child to communicate his/her needs with words, complete particular skills more independently, sleep through the night, or eat a wider array of foods. Ask the therapist or service provider if those are the behaviors you should expect to see change through the treatment? If there is a mismatch in your desired changes and those related to the treatment, other services may be more appropriate for your child. Identify no more than 5 behaviors to track, making recording doable.

Design a system that captures the behaviors you hope to see change on a schedule that is reasonable and will clearly show you if changes are occurring. These changes should occur during day-to-day life, not just during treatment sessions. Monitoring can be as simple as recording the number or hours your child sleeps each night, keeping a list of foods your child consumes, or tallying behavior problems (e.g., hitting) daily. There are ”apps” for recording behavior; in fact, a parent with whom we worked noted each time her child used words (instead of pointing, leading, or grunting) to ask for activities or items, tracking her communication development over time.

You can also create a checklist of skills or behaviors you want your child to perform each day, rating his/her level of cooperation or proﬁciency. See Example Chart A

Finally, rating scales – although not perfectly accurate – may be helpful when tracking changes over time. See Example Chart B

Begin gathering data before starting treatments and avoid changing more than one treatment at the same time whenever possible so you can see the change that is a result of the intervention. Set a schedule to review the data, hopefully with the professional(s) providing services. This may be weekly, monthly, or quarterly – depending on how fast you anticipate changes occurring. Compare your child’s progress to previous reviews. If he is sleeping or eating more, using a wider array of words, and/ or getting more smiley faces than sad faces, the treatments are working.

Celebrate improvements and make necessary changes. Seeing the results of treatments that require energy and resources is energizing. Recognizing that treatments are not working as anticipated is just as empowering. Objective data allow you to make good decisions and work more collaboratively with the professionals providing services.

Meme Hieneman, has a Ph.D. in Special Education and is nationally certified as a behavior analyst. She has published a variety of articles, chapters, and books including “Parenting with Positive Behavior Support: A Practical Guide to Resolving Your Child’s Difficult Behavior.” In her professional career, Meme has worked with children with severe behavior problems for more than 20 years.

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This post originally appeared on our September/October 2014 Magazine

IS IT WORKING? Monitoring the Effectiveness of Treatments

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