Journal of Mental Deficiency Research, 1990, 34, 421-428

Evaluation of a parent training programmefor teaching mentally retarded childrenage-appropriate restaurant skills: a preliminaryinvestigation

G. L. ALVEY AND S. R. AESCHLEMAN

Department of Psychology, Purdue University School of Science, Indiana UniversityPurdue University at Indianapolis, Indianapolis, Indiana, USA

ABSTRACT. A programme designed to train parents to teach their mentally retardedchildren age-appropriate restaurant skills was developed and evaluated. After partici-pating in a brief training programme, three mothers attempted to facilitate greaterindependence in their developmentally delayed children during meals at a fast-foodrestaurant. The programme was evaluated by assessing the mothers' and children'sperformance in restaurants using a multiple-probe design. The results indicated thatthe parents' teaching interactions were influenced by the training programme and thattheir children's restaurant skills were enhanced. The results were discussed in thecontext of the normalization principle and deinstitutionalization movement.

I N T R O D U C T I O N

The principle of normalization (Wolfensberger, 1972) and the deinstitutionalizationpolicy have produced a dramatic shift in the population of mentally retarded personsfrom institutional to community environments. While this transfer of services frominstitutions to the community has been a maior achievement, research has consistentlyshown that living in the community, by itself, does not guarantee interaction withcommunity resources (Crapps et al., 1985; Hemming, 1986; Kleinberg & Galligan,1983). Community involvement clearly depends on the acquisition of communityliving skills and the opportunity to use those skills. Accordingly, researchers havedeveloped training programmes to teach a wide range of independent living skills,including grocery shopping (Matson, 1981), public transportation (Neef ei al., 1978),banking (Aeschleman & Gedig, 1985), pedestrian (Page et al., 1976), and restaurantskills (van den Pol et al. 1981).

To date, all community living skill research has been directed toward late-adolescent or adult populations. Although these efforts have provided trainingprogrammes that meet the immediate needs of older, often institutionalized, mentallyretarded persons, training programmes must also be developed for younger mentallyretarded persons currently living in the community. Indeed, the development of suchtraining programmes is especially important because parents of handicapped children

Correspondence: Stanley R. Aeschleman, Department of Psychology, Appalaichian State UniversityBoom, North Carolina 28608, USA.

421

422 G. L. Alvey and S. R. Aeschleman

are often reluctant to involve their children fully in community activities (Cataldo,1984); hence, depriving them of the opportunity to learn community living skills.

The purpose of the present investigation was to evaluate a programme designed totrain parents to teach their mentally retarded children to become more independent inperforming a community living skill. Parents were enlisted as teachers for tworeasons: (1) parental acquisition of teaching skills can help normalize the parent-childrelationship, and (2) parental involvement can enhance generalization and maintenanceof the child's new skills (Bricker et al., 1980). The parents were given a Parent AdviceManual describing general teaching procedures and specific instructions on how togenerate 10 age-appropriate, fast-food restaurant skills. Subsequently, a parenttraining session utilizing verbal instruction, modeling, role playing and descriptivefeedback was conducted in each participant's home. The effectiveness of the trainingprogramme was evaluated by observing both parent and child performance duringrestaurant probes in which the parent was instructed to teach the 10 targetedbehaviours.

M E T H O D

Participants

Famihes of three 7-9-year-old children enrolled in a public school programme formoderately mentally retarded children were recruited to participate in the experiment.Socioeconomically, all three families were middle class. In all three families, only themothers of the handicapped children participated in the parent training programmeand the restaurant probes. The educational levels of the three parental participantswere high-school graduate, college graduate, and master's degree for Parents A, B andC, respectively. For the children, age, IQ and Peabody Picture Vocabulary Test(PPVT) scores, respectively, were: child A—9 years, 44 (WISC), 5 years and7 months; child B—8 years, 36 (Stanford Binet), 2 years and 2 months; child C—7years, 43 (Stanford Binet); 2 years and 3 months.

Response definitions

Child restaurant behaviours. The child restaurant skills were adapted from a study byvan den Pol et al. (1981), in which mentally retarded adults were taught fast-foodrestaurant skills. Following the first author's informal observations of nonhandicappedchildren at a McDonald's restaurant, the task analysis employed by van den Pol et al.(1981) was modified to include the 10 elementary-school age-appropriate skillcomponents shown in Table 1. The performance of each of these skills was rated onthe following four-level scale of independence: (1) does not perform, (2) performsafter two prompts, (3) performs after one prompt, and (4) performs with noassistance.

Parent restaurant behaviours. During restaurant probes, the parents were evaluated ontheir appropriate use of social reinforcers. Correct use of reinforcers was defined assome type of verbal praise (e.g. 'Good girl. I'm glad you know how to order your

Age-appropriate restaurant skills 423

Table 1 Definitions of appropriate child restaurant behaviours

Skill Appropriate response

1. After entering restaurant, child accompanies parent to counter within 15 s.2. Child orders an appropriate meal within 10 s after a cue from the cashier.3. Child takes napkin and straw from dispensers within 15 s after the order is filled.4. Child carries tray to the dining area.5. Child finds and sits at a clean, unoccupied table within 2 min after receiving tray.6. Child eats food placed on paper, rather than on the table.7. Child uses a napkin when necessary (i.e. when food is on face or hands), for wiping

face and hands.8. When child spills food, child picks up item but does not eat it.9. After eating, child carries tray to trash container.

10. Child empties trash into container and places tray on top of container before leavingrestaurant.

food.') that immediately (within 5 s) followed the child's correct performance, eitherprompted or unprompted, of one of the 10 skill components.

Materials

The parent Advice Manual' is a 12-page manuscript which briefly describes generalteaching methods (e.g. differentially reinforcing behaviour, assisting with successivelymore intrusive prompts), and specific instructions for teaching the 10 age-appropriaterestaurant behaviours during meals at fast-food restaurants. The specific instructionsadvised parents to allow their children to perform each skill component independently,gave examples of both appropriate and inappropriate child responses, and providedexamples of prompts and reinforcers that the parents could use to teach each of theskill components.

Experimental procedures

Baseline. A minimum of four baseline probes were conducted for each family at aMcDonald's restaurant located near the family's home. One week prior to the firstbaseline probe, the parents were given a two-page handout describing the 10 targetedchild restaurant behaviours. The parents were told that their child's performancewould be evaluated and that they should try to facilitate those 10 skill components.However, no suggestions were given as to how the behaviours could be taught. Thetrainer (the first author) was present at all probes to help in the event that anembarrassing situation occurred; however, no assistance was required on any of theprobes. No feedback was given to the parents at any time during the baseline phase.

Parent training. After the baseline phase and before the training session, the parentswere given and asked to read the Parent Advice Manual. Approximately one weekafter the Parent Advice Manual was given to the parent, a 2'5-h training session was

'A copy of the Parent Training Manual is available from the second author.

424 G. L. Alvey and S. R. Aeschleman

conducted in the parent's home. The goal of the training was to teach parents methodsthat would allow them to generate greater independence in their children duringmeals at fast-food restaurants. No children were present at these parent trainingsessions. Training proceeded by first teaching reinforcement skills followed by theprompting strategies. For each of the 10 skill components, the trainer verballydescribed the correct and various incorrect child behaviours, demonstrated someexamples of appropriate parent responses to each child behaviour, and finallyconducted a role-playing trial in which the trainer played the role of the child and theparent played herself. During these role-playing trials, the trainer praised andprovided informative feedback for correct responses. Following an incorrectresponse, the trainer demonstrated and described the difference between the correctresponse and the incorrect response just performed by the parent. The trainingcriterion was 100% correct responses to all 10 skill components during a role-playingtrial that contained some correct and incorrect child behaviours. All parents achievedthis criterion within the first 2'5-h training session.

Post-training. During the post-training phase, four probes across a 5-week period wereconducted at the same McDonald's restaurant used during baseline probes. Post-training probes were identical to baseline probes with the exception that after theformer feedback was given to the parent by the trainer. The feedback consisted ofdescribing and praising correct parent performance and describing and offeringsuggestions and how the parent could improve incorrect performance.

Follow-up. Following the post-training phase, two generalization probes and twomaintenance probes were conducted in the same manner as baseline probes (i.e. nofeedback was given to the parent at any time). The maintenance probes wereconducted one and 3 months following the last post-training probe in a novel fast-foodrestaurant chosen by each parent (parents A, B and C chose Wendy's, Burger Kingand Taco Bell restaurants, respectively).

Design and data collection

A multiple-probe design across participants was used (Horner & Baer, 1978), withtwo post-training probes administered to the parent who had just completed trainingbefore training was initiated with the next parent.

An observer was present on all restaurant probes to collect data on parent and childperformance. Independent observations by two observers were made on 33% of allprobes with at least one reliability check during each phase for each family. Duringthe probes, the observers positioned themselves so that they could see and hear theparticipants while being as unobtrusive as possible. The observers were graduate andundergraduate psychology majors trained by the first author, and all were naive to thetraining conditions in effect. Observer records were compared following datacollection and interobserver reliability scores were compared by dividing the numberof agreements by the number of agreements plus disagreements and multiplying by100. This formula was used to compute percentage agreements for the children'sindependence scores on the 10 restaurant behaviours and the parent's correct use of

Age-appropriate restaurant skills 425

reinforcers. The reliability checks yielded mean scores of 95-2% and 80-8% for thechild and parent behaviours, respectively. The relatively low interobserver reliabilityscores for the parent behaviours was due primarily to the ambient noise in therestaurant interfering with accurate recordings of auditory responses.

Social validity. Several months after the final follow-up probe, a graduate studentmajoring in psychology contacted the parents who participated in the study todetermine their subjective evaluation of the training programme (Wolf, 1978). Theparents were asked to rate, on a five-point scale, their satisfaction with the trainingprogramme (l = 'very dissatisfied', 5 = 'very satisfied'), and their current use of theskills taught in the training programme both at fast-food restaurants and at othercommunity activities with their children (1 = 'very infrequently', 5 = 'very frequently').

R E S U L T S

Figure 1 shows the per cent independence score for each child across the threeexperimental phases. This score was obtained by multiplying the total possiblebehaviours on each probe by 4 (i.e the highest possible score), dividing the productinto the independence score achieved on that probe, and multiplying the quotient by

100

80

60

40

200

S 100

I 80g- 60•o•S 40

I 20fe 0"- 100

80

60

40

20

0

Baseline

\

Post-training

Trainings i t e — • '

Follow-up

Generalizationsite

Child A

I D Child B

•V Child C

10 30 3515 20 25Probe sessions

Fig. 1. Per cent independence scores for each child during restaurant probes.

40

426 G. L. Alvey and S. R. Aeschleman

Table 2 Mean f)er cent correct use of reinforcers by parents

Parent Baseline Post-training Follow-up

ABCTotal mean across parents

12-2210-8711-9111-67

77-0875-9717-7156-92

35-1384-5355-9355-93

100. The raw data were converted to percentages because occasionally the opportunityto perform all 10 skill components was not available (e.g. no trash container waspresent.) Although no child achieved total independence on the 10 behaviours, theparents were able to produce mean post-training independence scores of 70-6%,64-3% and 62-5% for children A, B and C, respectively. Relative to baseline levels,these scores represent mean gains of 10-9% for child A, 25-3% for child B, and 29-3%for child C. Moreover, mean performance during the four follow-up probes increasedto 78-5%, 59-0%, and 69-3% for children A, B and C, respectively.

Table 2 shows the mean per cent correct use of reinforcers for each parent in thethree experimental phases. Again a percentage score was obtained because thenumber of opportunities to reinforce child behaviours varied across probes. Thisdirect measure of the parent training programme reveals that parents A and B showeddramatic post-training phase improvement while the gains for parent C were modest.Scores during the follow-up phase were varied, with parent A showing a performancedecrement, parent B maintaining a high score, and parent C showing an increase overher post-training performance. The increase in the follow-up phase by parent Cappeared to be due to a general improvement in her relationship with her child thatwas produced, in part, by the increase in her child's appropriate behaviours.

Results to the social validity questions indicated that, although the parents reportedbeing satisfied (mean score=3-67) with the training programme, there was onlymoderate continued use of the skills acquired by the parents during meals with theirchildren at fast-food restaurants (mean score=3-33) and during other communityevents with their children (mean score=3 00).

DISCUSSION

The present study demonstrates that parents, after receiving a brief trainingprogramme, were able to improve their children's fast-food restaurant skills, and thatthese skills maintained for 4 months and generalized reasonably well to a novelenvironment. Moreover, the direct assesssment of the parents' behaviour suggestedthat the training programme influenced the parents' teaching interactions with theirchildren.

Although each child's overall level of independence was enhanced, no child reliablyperformed all skill components independently. The present study provided both abrief parent training programme and a contracted period for the children to acquire

Age-appropriate restaurant skills 427

the skills taught by their parents. An obvious goal for future research is to determinewhether performance can be further enhanced by intensifying parent training and/orprolonging the child training interval. Indeed, the relatively high educationalattainment of the parents in the present study was probably partly responsible for thegains achieved after such an abbreviated parent training programme. Trainersworking with parents with lower educational levels are cautioned to expect slowerlearning.

Although the actual maintenance and generalization of the targeted parenting skillsbeyond the 4-month follow-up phase is unknown, the parents reported only moderatecontinued use of the reinforcement and prompting techniques. It is also not knownwhat effect this relatively low reported frequency of use has had on the behaviour oftheir children. Future research needs to more adequately evaluate the maintenanceand generalization of skills acquired by both the parents and children, and developeffective strategies to facilitate extra-training gains.

Despite recommendations from special educators to utilize curricula that teachfunctional skills (Brown et al., 1979; Wilcox & Bellamy, 1982), there is a dearth ofresearch evaluating methods to teach community involvement in children. Thepresent study provides an initial step toward the development of a technology forteaching age-appropriate community living skills to developmentally delayedchildren. In addition to the development of time- and cost-efficient trainingprogrammes, this technology awaits the specification of socially validated traininggoals for this younger population.

REFERENCESAeschleman S.R. & Gedig K.S. (1985) Teaching banking skills to mildly mentally retarded

adolescents. Applied Research in Mental Retardation 6, 449-64.Bricker D., Seibert J.M. & Casuso V. (1980) Early intervention. In: Advances in Mental

Handicap Research, Vol. 1, J. Hogg & P.J. Mittler (eds), pp. 225-66. John Wiley and Sons,Chichester.

Brown L., Branston M., Baumgart D., Vincent L., Falvey M. & Schroeder J. (1979) Using thecharacteristics of current and subsequent least restrictive environments in the developmentof curricular content for severely handicapped students. AAESPH Review 4, 407-24.

Cataldo M.F. (1984) Clinical considerations in training parents of children with specialproblems. In: Parent Training, R.F. Dangel & R.A. Polster (eds), pp. 329-57. GuilfordPress, New York.

Crapps J.M., Langone J. & Swaim S. (1985) Quantity and quality of participation incommunity environments by mentally retarded adults. Education and Training of theMentally Retarded 20, 123-9.

Hemming H. (1986) Follow-up of adults with mental retardation transferred from largeinstitutions to new small units. Mental Retardation 24, 229-35.

Horner R.D. & Baer t).M. (1978) Multiple-probe technique: a variation of the multiplebaseline. Journal of Applied Behavior Analysis 11, 189-96.

Kleinberg J. & Galligan B. (1983) Effects of deinstitutionalization on adaptive behavior ofmentally retarded adults. American Journal of Mental Deficierwy 88, 21-7.

Matson J.L. (1981) Use of independence training to teach shopping skills to mildly mentallyretarded adults. American Journal of Mental Deficiency 86, 178-83.

Neef N.A., Iwata B.A. & Page T.J. (1978) Public transportation training: in vivo versusclassroom instruction. Journal of Applied Behavior Analysis 11, 331-44.

428 G. L. Alvey and S. R. Aeschleman

Page T.J., Iwata B.A. & Neef N.A. (1976) Teaching pedestrian skills to retarded persons:Generalization from the classroom to the natural environment, yourwa/ of Applied BehaviorAnalysis 9, 433-44.

van den Pol R.A., Iwata B.A., Ivanic M.T., Page T.J., Neef N.A. & Whitley F.P. (1981)Teaching the handicapped to eat in public places: acquisition, generalization, andmaintenance of restaurant skills. Journal of Applied Behavior Analysis 14, 61-9.

Wilcox B. & Bellamy G.T. (eds) (1982) Design of High School Programs for SeverelyHandicapped Students. Paul H. Brookes, Baltimore.

Wolf M.M. (1978) Social validity: the case for subjective measurement of how applied behavioranalysis is finding its heart. Journal of Applied Behavior Analysis I t , 203-14.

Wolfensberger W. (1972) The Principle of Normalization. National Institute on MentalRetardation, Toronto.

Received 20 March 1989; revised 20 December 1989