Journal of Child and Family Studies

, Volume 27, Issue 9, pp 2844–2861 | Cite as

Transforming Coercive Processes in Family Routines: Family Functioning Outcomes for Families of Children with Developmental Disabilities

  • Joseph M. LucyshynEmail author
  • Lynn D. Miller
  • Christy Cheremshynski
  • Sharon Lohrmann
  • Bruno D. Zumbo
Original Paper


Single case design research on family centered positive behavior support (PBS) over the past 20 years has provided evidence of the approaches acceptability, effectiveness and durability when implemented with families of children with developmental disabilities and problem behavior. Although quality of life is a key tenet of PBS, only a few studies of PBS with families have measured quality of life outcomes. The purpose of this study is to present family functioning results from the second half of a longitudinal study that investigated the consequential validity of an ecological approach to family centered PBS. The approach aimed to transform coercive into constructive family processes in family routines during a process of comprehensive assessment, multicomponent plan design and implementation support in collaboration with families. Ten families of children with developmental disabilities participated. Settings were 32 family routines, with two to four routines per family. Family functioning measures were family quality of life, parental stress, parental locus of control and social support. A repeated measures, quasi-experimental group design across mothers and fathers evaluated the statistical significance of changes in family functioning when comparing baseline to intervention and follow-up phases. Results evidenced significant improvements for mothers in family quality of life and parental stress during intervention and follow-up, and in parental locus of control during follow-up. Results evidenced significant improvements for fathers in parental stress during intervention and follow-up, but no significant improvements in family quality of life or parental locus of control. Results are discussed in terms of contributions to the literature, implications for practice, limitations, and future research.


Positive behavior support Family centered service delivery Autism Developmental disabilities Family quality of life Coercive processes 



We thank the 10 families for their participation in the longitudinal study, and for their contributions to our knowledge about improving child behavior and child and family quality of life. We thank Robert Horner and Michael Stoolmiller for their contributions as formal consultants to project. We thank Roger Bakeman, Larry Irvin, Gerald Patterson and Paul Yovanoff for their contributions to the research methodology. We thank Lauren Binnendyk, Lauren Elkinson, Brenda Fossett, and Laura Green for their contributions as family interventionists. We thank Sophia Khan for her contributions as project coordinator. We also thank the many research assistants for their contributions as well.

Authors Contributions

JML: designed and executed the study, provided training and supervision to family interventionists and research assistants, and wrote the first manuscript draft. LDM: provided clinical supervision of interventionists working with families enrolled in the study, psychological counseling support to three parents enrolled in the study, and editorial input on the manuscript draft. CC: implemented the intervention with two families, provided supervision and training to research assistants, and provided editorial input on the manuscript draft. SL: led the implementation of the research project at the consortium site, implemented the intervention with two families, provided supervision and training to research assistants, and provided feedback on the manuscript draft. BDZ: assisted in monitoring the quality of the data throughout the study and guided the analysis and write-up of the statistical analysis procedures employed in the study; that is, planned comparisons using non-parametric statistics.


The research project was supported by grant 5R01HD041671 from the National Institute of Child Health and Human Development (NICHD) of the National Institutes of Health (NIH) to the University of British Columbia. The project was additionally supported by a consortium agreement with Rutgers Robert Wood Johnson Medical School (RWJMS).

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in the study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The Behavioral Research Ethics Board at the University of British Columbia, and the Institutional Review Board at the University of Medicine and Dentistry of New Jersey specifically approved this study.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


  1. Abidin, R. R. (1995). Parenting stress index (3rd Edition). Lutz, Florida, Psychological assessment resources, Inc. Google Scholar
  2. Barry, L. M., & Singer, G. H. S. (2001). A family in crisis: Replacing the aggressive behavior of a child with autism toward an infant sibling. Journal of Positive Behavior Interventions, 3, 28–38.CrossRefGoogle Scholar
  3. Beach Center on Disability (2003). Family quality of life conversation guide. Lawrence, KS: Beach Centeron Disability, University of Kansas.Google Scholar
  4. Binnendyk, L., & Lucyshyn, J. M. (2009). A family-centered positive behavior support approach to the amelioration of food refusal behavior in a child with autism: A case study analysis. Journal of Positive Behavior Interventions, 11, 47–62.CrossRefGoogle Scholar
  5. Brown, R. I., Hong, K., Shearer, J., & Wang, M. (2010). Family quality of life in several countries: Results and discussion of satisfaction in families where there is a child with a disability. In E. Diener, W. Glatzer, T. Moum, M. A. G. Sprangeres, J. Vogel & R. Veenhoven (Eds.), Enhancing quality of life of people with intellectual disabilities: From theory to practice (pp. 377–398). New York, NY: Springer.CrossRefGoogle Scholar
  6. Brown, R. I., MacAdam-Crisp, J., Wang, M., & Iarocci, G. (2006). Family quality of life when there is a child with a developmental disability. Journal of Policy and Practice in Intellectual Disabilities, 3(4), 238–245.CrossRefGoogle Scholar
  7. Buschbacher, P., Fox, L., & Clarke, S. (2004). Capturing desired family routines: A parent-professional behavioral collaboration. Research and Practice for Persons with Severe Disabilities, 29, 25–39.CrossRefGoogle Scholar
  8. Campis, L., Lyman, R. D., & Prentice-Dunn, S. (1986). The parental locus of control scale: Development and validation. Journal of Clinical and Consulting Psychology, 15, 260–267.Google Scholar
  9. Carr, E. G., Dunlap, G., Horner, R. H., Koegel, R. L., Turnbull, A., Sailor, W., Anderson, J. L., Albin, R. W., Koegel, L., & Fox, L. (2002). Positive behavior support: Evolution of an applied science. Journal of Positive Behavior Interventions, 4, 4–16.CrossRefGoogle Scholar
  10. Cho, H. C., & Abe, S. (2013). Is two-tailed testing for directional hypotheses test legitimate? Journal of Business Research, 66, 1261–1266.CrossRefGoogle Scholar
  11. Dunlap, G., & Fox, L. (2007). Parent-professional partnerships: A valuable context for addressing challenging behaviours. International Journal of Disability, Development and Education, 54, 273–285.CrossRefGoogle Scholar
  12. Dunlap, G., Strain, P. S., Lee, J. K., Joseph, J. D., Vatland, C., & Fox, L. (2017). Prevent-Teach-Reinforce for families: A model of individualized positive behavior support for home and community. Baltimore: Brookes.Google Scholar
  13. Dunst, C. J., Bruder, M. B., Trivette, C. M., & Hamby, D. W. (2006). Everyday activity settings, natural learning environments, and early intervention practices. Journal of Policy and Practice in Intellectual Disabilities, 3(1), 3–10.CrossRefGoogle Scholar
  14. Durand, V. M., Hieneman, M., Clarke, S., Wang, M., & Rinaldi, M. L. (2013). Positive family intervention for severe challenging behavior I: A multi-site randomized clinical trial. Journal of Positive Behavior Interventions, 15, 133–143.CrossRefGoogle Scholar
  15. Dykens, E. M., Fisher, M. H., Taylor, J. L., Lambert, W., & Miodrag, N. (2014). Reducing stress in mothers of children with autism and other disabilities: A randomized trial. Pediatrics, 1324(2), 454–463.CrossRefGoogle Scholar
  16. Feldman, M. A., Condillac, R. A., Tough, S., Hunt, S., & Griffiths, D. (2002). Effectiveness of community positive behavioral intervention for persons with developmental disabilities and severe behavioral challenges. Behavior Therapy, 33, 377–398.CrossRefGoogle Scholar
  17. Feldman, M. A., & Werner, S. E. (2002). Collateral effects of behavioral parent training on families of children with developmental disabilities and behavior disorders. Behavioral Interventions, 17, 75–83. Scholar
  18. Fixsen, D. L., Blasé, K. A., Duda, M. A., Naoom, S. F., & Van Dyke, M. (2010). Implementation of evidence-based treatments for children and adolescents: Research findings and their implications for the future. In J. R. Weisz & A. E. Kazdin (Eds.), Evidence-based psychotherapies for children and adolescents. 2nd ed. (pp. 435–450). New York, NY: Guilford.Google Scholar
  19. Gallimore, R. (2005). Behavior change in the natural environment: Everyday activity settings as a workshop of change. In C. R. O’Donnell & L. A. Yamauchi (Eds.), Culture and context in human behavior change: Theory, research, and applications (pp. 207–231). New York, NY: Peter Lang.Google Scholar
  20. Grotevant, H. D., & Carlson, C. I. (1989). Family assessment: A guide to methods and measures. New York, NY: Guilford.Google Scholar
  21. Hayes, S. A., & Watson, S. L. (2013). The impact of parenting stress: A meta-analysis of studies comparing the experience of parenting stress in parents of children with and without autism spectrum disorder. Journal of Autism and Developmental Disorders, 43, 629–642.CrossRefPubMedGoogle Scholar
  22. Hoffman, L., Marquis, J., Poston, D., Summers, J. A., & Turnbull, A. (2006). Assessing family outcomes: Psychometric evaluation of the Beach Center Family Quality of Life Scale. Journal of Marriage and Family, 68(4), 1069–1083.CrossRefGoogle Scholar
  23. Hoffman, C. D., Sweeney, D. P., Hodge, D., Lopez-Wagner, M. C., & Looney, L. (2009). Parenting stress and closeness: Mothers of typically developing children and mothers of children with autism. Focus on Autism and Other Developmental Disabilities, 24(3), 178–187. CrossRefGoogle Scholar
  24. Huberty, C. J., & Morris, J. D. (1989). Multivariate analysis versus multiple univariate analysis. Psychological Bulletin, 105(2), 302–308.CrossRefGoogle Scholar
  25. Kennedy, C. H., Horner, R. H., Newton, J. S., & Kanda, E. (1990). Measuring the activity patterns of adults with severe disabilities using the resident lifestyle inventory. Journal of The Association for Persons with Severe Handicaps, 15, 79–85.CrossRefGoogle Scholar
  26. Lloyd, T., & Hastings, R. P. (2009). Parental locus of control and psychological well-being in mothers of children with intellectual disabilities. Journal of Intellectual & Developmental Disabilities, 34(2), 104–115.CrossRefGoogle Scholar
  27. Lucyshyn, J. M., Albin, R. W., Horner, R., Mann, J., Mann, J., & Wadsworth, G. (2007). Family implementation of positive behavior support with a child with autism: A longitudinal, single case experimental and descriptive replication and extension. Journal of Positive Behavior Interventions, 9, 131–150.CrossRefGoogle Scholar
  28. Lucyshyn, J. M., Albin, R. W., & Nixon, C. D. (1997). Embedding comprehensive behavioral support in family ecology: An experimental, single-case analysis. Journal of Consulting and Clinical Psychology, 65, 241–251.CrossRefPubMedGoogle Scholar
  29. Lucyshyn, J. M., Dunlap, G. & Albin, R. W. (Eds.) (2002). Families, and positive behavioral support: Addressing problem behaviors in family contexts. Baltimore: Paul H. Brookes.Google Scholar
  30. Lucyshyn, J. M., & Fossett, B. (2015). Twenty years of PBS research with families: Lesson learned and future directions. Paper presented at the 12th Annual International Conference on Positive Behavior Support, Boston, MA.Google Scholar
  31. Lucyshyn, J. M., Fossett, B., Bakeman, R., Cheremshynski, C., Miller, L., Lohrmann, S., Binnendyk, L., Khan, S., Chinn, Kwon, S., & Irvin, L. K. (2015). Transforming parent-child interaction in family routines: Longitudinal analysis with families of children with developmental disabilities. Journal of Child and Family Studies, 24, 3526–3541.CrossRefPubMedPubMedCentralGoogle Scholar
  32. McLaughlin, T. W., Denney, M. K., Snyder, P. A., & Welsh, J. L. (2012). Behavior support interventions implemented by families of young children: Examination of contextual fit. Journal of Positive Behavior Interventions, 14(2), 87–97.CrossRefGoogle Scholar
  33. McStay, R. L., Trembath, D., & Dissanayake, C. (2014). Stress and family quality of life in parents of children with autism spectrum disorder: Parent gender and double ABCX model. Journal of Autism and Developmental Disabilities, 44, 3101–3118.CrossRefGoogle Scholar
  34. Messick, S. (1988). The once and future issues of validity: Assessing the meaning and consequences of measurement. In H. Wainer & H. I. Braun (Eds.), Test validity (pp. 33–45). Hillsdale, NJ: Lawrence Erlbaum.Google Scholar
  35. Neece, C. L., Green, S. A., & Baker, B. L. (2012). Parenting stress and child problem behavior: A transactional relationship across time. American Journal of Developmental Disabilities, 117(1), 48–66.Google Scholar
  36. O’Neill, R. E., Horner, R. H., Albin, R. W., Sprague, J. R., Storey, K., & Newton, J. S. (1997). Functional assessment and program development for problem behavior: A practical handbook. Pacific Grove, CA: Brooks/Cole Publishing.Google Scholar
  37. Patterson, G. R. (1982). Coercive family process. Eugene, OR: Castalia Publishing.Google Scholar
  38. Repp, A. C., & Horner, R. H. (1999). Functional analysis of problem behavior: From effective assessment to effective support. Belmont, CA: Wadsworth.Google Scholar
  39. Sarason, I. G., Levine, H. M., Basham, R. B., & Sarason, B. R. (1983). Assessing social support: The Social Support Questionnaire. Journal of Personality and Social Psychology, 44, 127–139.CrossRefGoogle Scholar
  40. Singer, G. H., Goldberg-Hamblin, S. E., Peckham-Hardin, K. D., Barry, L., & Santarelli, G. E. (2002). Toward a synthesis of family support practices and positive behavior support. In J. M. Lucyshyn, G. Dunlap & R. W. Albin (Eds.), Families and positive behavior support: Addressing problem behavior in family contexts (pp. 155–183). Baltimore: Paul H. Brookes.Google Scholar
  41. Singh, N. N., Lancioni, G. E., Winton, A. S. W., Fisher, B. C., Wahler, R. G., McAleavey, K., & Sabaawi, M. (2006). Mindful parenting decreases aggression, noncompliance and self-injury in children with autism. Journal of Emotional and Behavioral Disorders, 14, 169–177.CrossRefGoogle Scholar
  42. Singh, N. N., Lancioni, G. E., Winton, A. S. W., Karazsia, B. T., Meyers, R. E., Latham, L. L., & Singh, J. (2014). Mindfulness-based positive behavior support (MBPBS) for mothers of adolescents with autism spectrum disorder: Effects on adolescents’ behavior and parental stress. Mindfulness, 5, 646–657.CrossRefGoogle Scholar
  43. Smith-Bird, E., & Turnbull, A. P. (2005). Linking positive behavior support to family quality-of-life outcomes. Journal of Positive Behavior Interventions, 7, 174–180.CrossRefGoogle Scholar
  44. Turnbull, A. P., & Ruef, M. B. (1996). Family perspectives on problem behavior. Mental Retardation, 34, 280–293.PubMedGoogle Scholar
  45. Wang, M., & Singer, G. H. S. (2016). Supporting families of children with developmental disabilities: Evidence-based and emerging practices. New York, NY: Oxford University Press.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Educational and Counseling Psychology and Special Education, Faculty of EducationUniversity of British ColumbiaVancouverCanada
  2. 2.Family Centred Practices GroupVancouverCanada
  3. 3.The Boggs Center, Rutgers Robert Wood Johnson Medical SchoolNew BrunswickUSA

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