Prevent-Teach-Reinforce (PTR) is a collaborative, standardized process that was developed as a way to address identified barriers to completing effective functional behavior assessments (FBAs) in public schools. Current research literature documents the effectiveness of the PTR process in decreasing problematic behaviors and increasing social skills and academic engaged time for students in kindergarten through 8th grade. In addition, PTR demonstrates high acceptability by school personnel implementing the process. While PTR has demonstrated success in schools, questions still exist regarding variables that impact the effectiveness of this process. Therefore, the current study investigated the moderating effect of prior teacher training in managing challenging behavior on the effectiveness of the Prevent-Teach-Reinforce (PTR) process. Data regarding students' social skills, behavior problems, and academic engagement were analyzed through a series of mixed factorial analyses in order to determine the effectiveness of the PTR process. Results indicate that teachers' previous preparation in dealing with behavioral problems did not moderate the effectiveness of PTR, thus indicating that the process is equally beneficial to all teachers. However, time and the implementation of PTR were found to be significant in altering trends in student outcomes. Academic engaged time was found to be significantly altered more frequently than social skills or behavior problems. Implications of the findings for using the PTR process to address problematic student behavior in schools are discussed.

Daily routines in the home are typically the most common interactions for children with their siblings and parents. When a child exhibits challenging behavior in these routines, it can cause a strain on the family as well as the child's ability to learn a more appropriate behavior. This study examined the feasibility and potential efficacy of an adapted version of the Prevent-Teach- Reinforce (PTR) intervention with three families of young children with developmental disabilities. The school-based PTR manual was adapted for treatment use in a family context. The study assessed the family adherence to the collaboratively developed PTR intervention, family use of the behavior rating scale, social validity, procedural integrity, and child behavior behaviors during the routines. A multiple-baseline design across children was used to examine the impact of the PTR intervention on child behavior within the routine. Results indicated that the PTR interventions were successful in demonstrating an increase in appropriate behaviors and a decrease in challenging behaviors across children. The results also indicated that parents were able to successfully use the behavior rating scale to measure each child's behavior.

This study evaluated the implementation of the school-based Prevent-Teach-Reinforce (PTR) model within multi-tiered systems of support (MTSS) for elementary school students engaging in high levels of problem behavior. Three students and their classroom teachers in two public schools participated in the team-based PTR process during which they engaged in teaming and goal setting, functional behavior assessment, intervention, and evaluation. A multiple baseline across participants design was used to evaluate the impact of using the PTR model on student problem and replacement behaviors. Direct and indirect observations of student behaviors were conducted across target and generalization academic time periods. Findings indicate that the PTR intervention effectively reduced problem behavior and increased replacement behavior for all three participating students in both target and generalization academic time periods. Social validity assessments with the participating teachers and students indicated high levels of acceptability of and satisfaction with the PTR intervention goals, procedures, and outcomes. Implications for using the PTR model within MTSS for students who are not responding to Tier 2 interventions are discussed.

Les enfants ayant un trouble du spectre de l’autisme (TSA) présentent parfois des comportements problématiques, comme des comportements agressifs ou stéréotypés. L’émission de tels comportements peut avoir des conséquences néfastes, tant pour l’enfant que pour son entourage. Ainsi, l’enfant peut être limité dans ses apprentissages et vivre de l’isolement social. Leurs parents peuvent quant à eux vivre un niveau élevé de stress parental. Afin de répondre à ces besoins, cette thèse doctorale vise l’évaluation d’une adaptation parentale du Prevent-Teach-Reinforce (PTR, Dunlap et al., 2010), un programme initialement conçu pour diminuer les comportements problématiques et augmenter les comportements désirables des enfants en milieu scolaire. Basé sur les principes du soutien comportemental positif, ce programme prévoit l’atteinte des objectifs suite à la mise en place d’une intervention comportementale qui tient compte de la fonction du comportement problématique. L’intervention comprend des stratégies d’intervention pour modifier les antécédents, pour enseigner des comportements désirables et pour modifier les conséquences. Une étude randomisée a montré l’efficacité du PTR auprès d’enfants en milieu scolaire et deux études l’ont évalué à l’aide de devis expérimentaux à cas uniques en milieu familial pour des enfants ayant des troubles développementaux. Cette thèse, comprenant trois articles, constitue la première évaluation randomisée du PTR en contexte familial pour diminuer les comportements problématiques d’enfants ayant un TSA. Le premier article décrit les adaptations apportées au programme initial en prévision d’une implantation en contexte d’intervention comportementale précoce et en milieu familial, pour les enfants ayant un TSA. De plus, un parallèle est fait entre le programme et les principes clés de l’intervention psychoéducative. Le deuxième article présente les principaux résultats du projet de thèse, dans lequel 24 familles ont reçu deux interventions distinctes : le PTR durant huit semaines ou une formation théorique d’environ trois heures. Des analyses de variance ont été menées afin de statuer sur l’efficacité du programme. En somme, les comportements problématiques des enfants appartenant aux deux groupes ont diminué et les comportements désirables ont augmenté. Il n’est donc pas possible de statuer sur l’efficacité unique du PTR à diminuer les comportements problématiques. Les parents ont implanté le PTR avec une grande fidélité et ont accordé un score élevé de validité sociale au programme. Le troisième article présente les résultats en lien avec le stress parental. Les scores initiaux de stress parental ont été associés à la sévérité des comportements problématiques, montrant une corrélation modérée entre les deux concepts. Par ailleurs, une analyse de variance a permis de montrer que le stress parental a diminué uniquement chez les parents qui ont implanté de PTR. En conclusion, cette thèse a montré que le PTR semble être efficace pour diminuer les comportements problématiques et augmenter les comportements désirables des enfants ayant un TSA lorsque leurs parents l’implantent, mais davantage d’études sont nécessaires pour confirmer cette hypothèse. Ces études devraient comporter davantage de sujets et comparer le PTR à un groupe ne recevant aucun type d’intervention pour diminuer les comportements problématiques. / Children with an Autism spectrum disorder (ASD) diagnosis sometimes show challenging behaviors such as aggressive or stereotyped behaviors. The presence of such behavior can have harmful consequences for both the children and the people living with them. For example, the child may be limited in his or her learning and experience social isolation. Parents may experience high levels of parental stress. In order to respond to these problems, this thesis evaluated a parental adaptation of the Prevent-Teach-Reinforce model (PTR; Dunlap et al., 2010), a program designed to reduce children’s challenging behaviors and increase their desirable behaviors in school settings. Based on the principles of positive behavioral support, this program aims to achieve its objectives by implementing a behavioral intervention taking into account the behavioral function of the challenging behavior. The intervention includes intervention strategies to modify the behavior’s antecedents, to teach desirable behaviors and to modify the behavior’s consequences. A randomized controlled study demonstrated the effectiveness of the PTR for school-aged children and two studies evaluated it in home settings for children with developmental disorders, using single case experimental designs. This thesis, comprising three articles, is the first randomized study evaluating the PTR in family settings to reduce challenging behaviors of children with ASD. The first article describes the adaptations made to the initial program in order to implement it with children with an ASD diagnosis receiving early intensive behavioral intervention or in family settings. In addition, a parallel was made between the PTR and the key principles from the psychoeducation field. The second article presents the main results of this thesis, with the 24 families which received two distinct interventions: the PTR for eight weeks or a theoretical training for about three hours. Analyzes of variance were conducted to evaluate the effectiveness of the PTR. In sum, children of both groups saw a reduction in challenging behaviors and an increase in desirable behaviors. It is therefore not possible to rule on the unique effectiveness of the PTR to reduce challenging behaviors. Parents implemented the PTR with great fidelity and rated the PTR with a very high level of social validity. The third article presents the results on parental stress. Initial parental stress scores were associated with the severity the child’s problem behaviors, showing a moderate correlation between the two concepts. On the other hand, an analysis of variance showed that parental stress only decreased for parents who implemented the PTR. In conclusion, this thesis has shown that PTR may be effective in decreasing problem behaviors and in increasing desirable behaviors of children with ASD. However, more studies are needed to confirm these hypotheses. These studies should include more subjects and compare the PTR to a group of children not receiving any type of intervention to reduce challenging behaviors.