Introduction to the Special Issue: Focus on Families

Positive behavior support (PBS; Dunlap et al., 2014) is an approach designed to improve quality of life and lead to effective, acceptable, and sustainable implementation of behavioral interventions in school, community and home environments. Within each of these contexts, engaging with stakeholders and interventionists is critical. While there are emergent models for engaging families in PBS (e.g., Garbacz et al., 2016), the home context remains an understudied area in PBS research (Hieneman & Fefer, 2017).

According to family systems theory, caregivers, parents, and other family members influence and are in turn influenced by the child’s behavior (Epstein & Dattilio, 2020). Indeed, caregivers of children with challenging behavior and/or disability report higher levels of stress, depression, and low self-efficacy (Neece et al., 2012). The COVID-19 pandemic highlighted the challenges families experience in supporting their children’s social, emotional, and behavioral development (Musa & Dergaa, 2022; Sun et al., 2022), and accelerated the need for research and practice guidelines on accessible and ecologically valid training and support for the use of PBS in the home context.

The five articles in this Special Series represent a range of examinations of PBS with families that advance research and offer implications for improving family access, involvement, and benefit from PBS frameworks and practices. The first article in this issue (Ash, Feinberg, Meyer, and Garbacz) explores family-school partnerships as a critical element of Positive Behavior Interventions and Supports (PBIS). Three of the articles showcase advances in adapting manualized intervention for telehealth delivery to improve family access to services (Dumproff & Dowdy; Gould et al.; Hodges, Strain, & Roberts). Four of the articles evaluate or synthesize the training practices reported in caregiver-mediated interventions aimed at improving family involvement and child access to PBS (Dumproff & Dowdy; Gerow et al.; Gould et al.; Hodges, Strain & Roberts). Importantly all the articles represent research with families of children ranging from birth through adolescence. This serves as a reminder and demonstration that PBS must reach families at all stages of caregiving.

Over the past three decades, PBS research has shifted from a primary focus on natural change agents delivering PBS interventions in natural settings with most articles using single-case experimental designs to examine the effects of the intervention to more clinician-led and systems focused research with increased use of other research methods (Kincaid, 2018). As evidenced by several of the articles within this special issue, PBS researchers continue to rigorously evaluate the effects and social validity of caregiver implemented interventions, particularly with children and adolescents with significant behavioral and social emotional support needs. However, increased interest and focus on systems change research has led researchers to ask new questions regarding intervention access, acceptability, adaptation, and integration into educational and behavioral health systems, contextual fit, effectiveness, feasibility, sustainability, and scalability for PBS involving families (Ai et al., 2022; Duchnowski & Kutash, 2009; Garbacz et al., 2018; McLaughlin et al., 2012; Strydom et al., 2020; Weist et al., 2018). As the research questions related to PBS evolve, so do the methodologies required to answer those questions. In a testament to this, this issue presents two single case experimental designs, one survey study, one mixed-method study, and one systematic literature review. The variety of research methods used, and the broadened scope of research questions explored within the studies in this special issue provides an optimistic snapshot of the still central role caregivers of children and adolescents with and without disabilities play in PBS whether implemented in school or community-based contexts. The mission of the Journal of Positive Behavior Interventions (JPBI) is to extend the research and practice of PBS for individuals in school, home, and community settings, with a focus on comprehensive outcomes in the lives of children, youth, and adults (Rispoli & Machalicek, 2021). Toward these aims, we encourage researchers to harness the available array of research methods, intervention modalities, and interdisciplinary collaborations to implement scholarly agendas to inform the scaled-up implementation of PBS in a variety of geographic, community- and school-based contexts with racially/ethnically caregivers of individuals with varying intensities of behavioral and social emotional support needs.

Ash, Feinberg, Meyer, and Garbacz surveyed 70 PBIS school teams regarding their use of family-school partnership practices. The researchers examined teams’ reported implementation of family-school PBIS practices and adherence to recommended family-school partnership practices to identify areas of strength and growth. Finally, the authors analyzed which school characteristics were related to use of recommended practices for family-school partnerships and offer recommendations based on these findings for improving family-school partnerships.

Gould and colleagues conducted a mixed-method study to evaluate the efficacy and social validity of the manualized RUBI-Telehealth program with families of children with autism. In addition to evaluating the RUBI-Telehealth program on patient implementation fidelity and child challenging behavior, the researchers also measured child adaptive skills and parent stress. Focusing on feasibility of the program via telehealth in rural areas, the authors present quantitative, qualitative, and the convergence of these results pertaining to program duration, clinician and parent implementation fidelity, acceptability of the program content, and telehealth delivery.

Showcasing the importance of supporting families of older children, Dumproff and Dowdy evaluated a remote parent training intervention of the Cool Versus Not Cool social skills intervention for families of adolescents with autism. Through a single case design, the researchers evaluated the remote training with three parents on caregiver acquisition, maintenance, and generalization of intervention implementation fidelity, adolescent social skills, and social validity from both caregiver and adolescent participants.

Family access to manualized programs, such as Prevent-Teach-Reinforce for Families, may be limited by several factors, including geographic location and potential reactivity of children and families to service providers enter the home. Hodges, Strain, and Roberts conducted a single case design study to evaluate a remote delivery option for Prevent-Teach-Reinforce for Families in which the program was delivered via telehealth. Through video conferencing coaching and text message prompts, three caregivers were taught to embed Prevent, Teach, Reinforce strategies with their child within family routines. Results on caregiver implementation fidelity, child challenging behavior, and caregiver perspectives on the social validity are presented.

Synthesizing the research literature on caregiver-mediated intervention is essential for identifying evidence-based practices for promoting positive social and behavioral outcomes for young children and for identifying the caregiver coaching practices that facilitate these outcomes. Gerow and colleagues conducted a comprehensive systematic literature review of caregiver-implemented home-based early childhood interventions for challenging behavior and social-emotional skills. They identified 57 studies and report on study characteristics, interventions implemented, caregiver coaching strategies, resources required for these interventions, and study quality.

The studies showcased in this special issue on families inform and advance the efforts of researchers to conduct research benefiting our understanding of evidence-based and socially valid practices for caregiver-implemented interventions to address the behavioral and social emotional support needs of children and adolescents and inform our understanding of school team perceptions and use of best practices related to family-school partnerships. We also believe that these findings will be of interest to audiences outside of JPBI who are interested in the development, evaluation, and spread of meeting the needs of families of individuals across the lifespan with behavioral and social-emotional support needs.

Central to the PBS framework is the recognition of the essential role of caregiver-implemented interventions and supports in improving the quality of life for their children (Kincaid, 2018). However, the outsized negative impact of the COVID-19 on families of children, especially those with behavioral and social emotional support needs, underscored the necessity of renewed and expanded focus on developing effective and contextually valid interventions for diverse families. Indeed, there is a pressing global need for effective and accessible interventions and supports for caregivers of children with social emotional and behavioral support needs (Sanders et al., 2022). Caregivers across the world urgently need positive, non-aversive, flexible and open-sourced evidence-based solutions that can flexibly address the needs of all caregivers and children, families and children at risk, and those with need for specialized services and supports (Sanders et al., 2022). We urge researchers in PBS to leverage the lessons learned from the studies within this special issue, and other extant research on caregiver implemented intervention, implementation science, and family involvement within school-wide PBS to push forward research agendas posed to answer those research and practice questions important to diverse families around the world.