Received: 26 November 2018 Revised: 23 February 2019 Accepted: 25 March 2019

DOI: 10.1002/bin.1668

RESEARCH ARTICLE

Pyramidal parent training using behavioral skills

training: Training caregivers in the use of a
differential reinforcement procedure

Sarah M. Conklin | Michele D. Wallace

Special Education and Counseling, California

State University, Los Angeles, California Six caregivers participated in a research study in which
behavioral skills training (BST) was used within a pyramidal
Correspondence
Michele D. Wallace, Special Education and training model to train a differential reinforcement of an
Counseling, California State University, alternative behavior (DRA) procedure. Physical prompting
Los Angeles, CA.
Email: mwallac@calstatela.edu
was utilized to obtain correct responses across the identified
alternative behavior. The caregivers were split into two tiers,
Funding information
comprised of three caregivers each. The experimenter
Graduate Center for Research
trained tier‐one caregivers, who then trained tier‐two care-
givers after meeting a predetermined mastery criterion. A
multiple baseline design across participants research design
was used to evaluate the effectiveness of correct implemen-
tation of the DRA procedure, demonstrating experimental
control across participants. During baseline, caregivers did
not implement DRA correctly. Following training, tier‐one
and tier‐two caregivers demonstrated correct implementa-
tion of the DRA and prompting procedure. Intervention score
was (M = 96%), from a baseline score of (M = 34.6%), for
tier‐one participants. Intervention score was (M = 96.6%),
from a baseline score of (M = 33%), for tier‐two participants.
A follow‐up maintenance probe demonstrated correct
implementation of the DRA procedure with prompting
across both tiers of trained caregivers.

KEYWORDS

behavioral skills training, BST, differential reinforcement of

alternative behaviors, DRA, parent training, pyramidal training

The presented research study was completed in partial fulfillment for the requirements for the MS degree in Counseling by the first author at the California
State University Los Angeles and was funded by the Graduate Center for Research. I want to thank Naomi Chen, Sarah Kagawa, Tessa Marlia, Elisa Sosa,
Alaina Neal, and Sarah Kalin, for their assistance with this project. Michele D. Wallace can be reached at mwallac@calstatela.edu.

Behavioral Interventions. 2019;34:377–387. wileyonlinelibrary.com/journal/bin © 2019 John Wiley & Sons, Ltd. 377
378 CONKLIN AND WALLACE

1 | I N T R O D U CT I O N

In the field of applied behavior analysis, conceptually systematic procedures and technological methods are individ-
ualized for the application to and reduction of specific problem behaviors. These behaviors are then assessed to
determine the outcomes of such applications (Baer, Wolf, & Risley, 1968). Behavior intervention methods have been
applied in the home, within the community, and across a variety of settings, with the intent to train parents in becom-
ing an integral component of behavioral intervention application for children with developmental disabilities
(Kuhn, Lerman, & Vorndran, 2003). Children both typically developing and those with developmental disabilities
exhibit a range of challenging behaviors that can benefit from behavioral intervention implementation. When
selecting interventions for behavior change, using methods that demonstrate effectiveness can be achieved by
analyzing the procedures in relation to client and environmental needs, (Mayer, Sulzer Azaroff, & Wallace, 2013).
Over the years there has been extensive research on the application and effectiveness of many procedures and
models utilized for training. One area of research involves a training model called pyramidal training. This model is
being used to train parents as behavior change agents, supervisors in organizations, and direct care staff in clinical
settings. Pyramidal training procedures involve training one person to implement a treatment intervention and then
that person trains another or others to implement the same procedure (Kuhn et al., 2003). Training educators in
school settings, parents and caregivers in the home, and staff in clinical settings are among the various areas where
research involving pyramidal training has demonstrated to be an effective and efficient training model. Pyramidal
training has been identified as a cost‐effective method to train parents using peers instead of professionals, teaching
behaviors, and task responses to children with disabilities. The training methods are proficient and generalizable,
establishing the effectiveness of pyramidal training with parents (Neef, 1995).
When training individuals to implement behavior analytic procedures, pyramidal training can be utilized as a
method to transfer training to others by the trainees of such procedures. The use of pyramidal training has also
shown to be effective with staff in clinical settings. Supervisors within organizations have trained direct care staff
to implement functional behavior assessments. Through the proper implementation of antecedent and
consequence‐based strategies treatment staff were able to increase appropriate behaviors of clients in a day treat-
ment program with self‐injurious behaviors (Shore, Iwata, Vollmer, Lerman, & Zarcone, 1995).
When utilizing a pyramidal training model, combining its use with other methods of training can be very beneficial.
Training staff in behavioral procedures can be time‐consuming and take up resources within an agency. Parsons,
Rollyson, and Reid (2012) demonstrated the use of pyramidal training using behavioral skills training (BST) and found
it to be efficient and effective in training behavior change procedures within the human service industry. The results
of the study demonstrated that 8 out of 10 participants reached 100% criterion, and two reached 88% following
intervention for on the job training provided to the other staff. The implications of the study contribute to the dem-
onstration of the effective use of pyramidal training and offer a practical approach to training involving the use of
BST. Several studies determine the effectiveness of BST in several environments training students, caregivers, and
behavior analysts. BST is a six‐step protocol involving a description of the target skillsets, written instructions, a dem-
onstration, practice session, feedback, and repetition to mastery (Parsons et al., 2012).
Training involving the use of BST expands into many environments including the home setting. A BST package
consisting of modeling, rehearsal, and feedback was used to train caregivers to manage noncompliant children (Miles
& Wilder, 2009). Training caregivers to teach noncompliant children using guided compliance is effective with a BST
model. The results of this study suggest that caregivers can be trained to implement a behavioral intervention
without prior experience. Furthermore, the implications of the study demonstrate BST to be an effective method
to teach caregivers with noncompliant children behavior analytic technologies. Studies have shown the effectiveness
of BST to train caregivers, students, and behavior interventionists.
The research on both pyramidal training and BST provide a reliable demonstration of the effectiveness of these
interventions as training strategies across a multitude of settings and participants. Moreover, written descriptions
of programs, data collection, and feedback about correct implementation of procedures have been demonstrated
CONKLIN AND WALLACE 379

as effective training methods within a pyramidal training model (Page, Iwata, & Reid, 1982; Kuhn et al., 2003).
However, as of late, BST has not been incorporated within a pyramidal training model to train caregivers in behavior
change tactics, specifically differential reinforcement of an alternative behavior (DRA). Therefore, the purpose of this
research was to combine BST with pyramidal training, training caregivers in the use of DRA, and prompting correct
responses of the alternative behavior selected by the research participants. The implementation of the BST package
components utilized in this study followed those suggested by Parsons et al. (2012) and include a description of the
targeted skills, written instructions, a demonstration of skills, a practice session, feedback, and repetition of skillsets
to a pre‐set mastery criterion.

2 | METHOD

2.1 | Participants and setting

Six caregivers enrolled in the C. Lamar Mayer Learning Center Saturday school program at the California State
University Los Angeles were selected to participate in the research study. Parents were recruited by the director of
the Saturday program, who handing out a flyer to the parents, and selected parents interested in participating in the
research study aimed at teaching behavior management strategies. It was required that the caregivers all had children
with or without disabilities. The majority of the participant samples are Hispanic from a variety of Latin American
backgrounds and Chinese participants. Four out of the six participants spoke and wrote in the English language.
Two out of the three Chinese female participants did not speak or write in English and were provided with a translator.
At the inception of the research study, Sally was a 41‐year‐old Chinese female. She completed a MS in nursing
and had a 6‐year‐old daughter diagnosed with semantic‐pragmatic disorder, a type of speech impairment. Robin
was a 34‐year‐old Hispanic female. She completed trade school to become a dental hygienist and had a 7‐year‐old
son with a speech disorder. Debbie was a 33‐year‐old Hispanic female who completed some college. She had an
11‐year‐old son diagnosed with attention deficit hyperactivity disorder. Juan was a 36‐year‐old Hispanic male
who completed some college; he had a 6‐year‐old daughter diagnosed with autism spectrum disorder. Lina was a
43‐year‐old Chinese female who completed middle school. She had a 10‐year‐old son with no current diagnosis.
Heidi was a 46‐year‐old Chinese female who had completed high school. She had a 13‐year‐old son and an
11‐year‐old son who were both diagnosed with autism spectrum disorder (Tables 1–3).

2.2 | Problem behavior identification

Prior to training sessions, all participants evaluated their child's current behaviors by completing the Eyeberg Child
Behavior Inventory (ECBI). The ECBI “identifies 36 conduct problems such as non‐compliance, defiance,

TABLE 1 Fidelity checklist for BST

Fidelity check for BST intervention using percentage of opportunity

Fidelity check item Percentage of opportunity

Description of skillsets + −
Instructions list of skillsets + −
Demonstration of skillsets + −
Practice sessions + −
Feedback to trainee + −
Practice to mastery criterion of 100% + −
380 CONKLIN AND WALLACE

TABLE 2 Social validity questionnaire

Post intervention questionnaire on social validity of implementing DRA

Score number Score number defined

1 Strongly disagree
2 Somewhat disagree
3 Neutral
4 Agree somewhat
5 Strongly agree

Question # Question

1 Overall, I believe the parent training of increasing an alternative behavior

has been effective in supporting appropriate behavior for my child.
2 I understand the universal supports for children and have taught specific
behavior expectations to my child based on what I have learned.
3 I feel I have received enough information on increasing an alternative behavior
is and the key components that I need to be using with my child in the home.
4 I feel the key components of increasing an alternative behavior are feasible to
implement in my home.
5 I feel comfortable using the methods of increasing an alternative behavior to
promote positive change in my home.

TABLE 3 Problem behavior identification

Problem behavior identification definition

Participant Problem behavior identification provided by participant

P1. Sally When asked to do homework, my child will continue to read,

play with pencils and crayons, or write messy answers on homework assignment.
P2. Robin When I ask my child to do a task, i.e., Homework, or pick up after himself,
my child will reply with “I am tired,” or “I want to finish watching television.”
He will cry, and say, “mom later,” folds his arms and yells.
P3. Debbie When I ask my child to clean up his toys, he will state, “I do not want to,”
walk around, leave them there, and go to his room.
P4. Juan When I ask my child to perform a task, she will respond with saying “but,” and
needs to be asked more than once. She will also lie and say she did it already.
P5. Linda Starts homework then stops and does not follow teacher's instruction.
P6. Heidi When I ask my child to do something, he goes around it and does not do it.

aggressiveness and impulsiveness,” (Eyberg & Pincus, 1999, p. 1). The ECBI was completed independent of the
participant's age, sex, and socioeconomic status; meaning these were not described minimum requirement categories
for participant completion (Eyberg & Pincus, 1999). The inventory was completed to demonstrate that each partici-
pant had a child with a challenging behavior. Following the completion and assessment of each participant inventory,
the participants identified one problem behavior from the ECBI survey and defined an appropriate replacement
behavior. Participants who did not identify a behavior from the list were asked to describe the current problem
behavior. All participants described a challenging behavior that was identified as defiant and/or noncompliant
behavior but was operationally defined to pass the dead man's test. The identified replacement behavior across all
parent participants was for the child to follow directions when presented with a demand. Participants completed a
CONKLIN AND WALLACE 381

behavior identification form with two components: describing the identified problem behavior to decrease and a
replacement behavior to be prompted during the treatment phase, as demonstrated in Table 3.
None of the participant children participated in the research study, and therefore, there was no behavioral
assessment process conducted to determine the function maintaining identified problem behaviors from the ECBI
or parent descriptions. Follow through of task presentation, and caregiver requests were identified as the appropriate
replacement behavior for the purpose of teaching the participants to implement the DRA procedure.
The participants had little or no experience with implementing behavior analytic treatment interventions to typical
or atypical developing children, as demonstrated during baseline measures of correct implementation of the DRA
procedure. The confederate who was the experimenter and graduate student acted as the child with the problem
behavior during baseline, and intervention sessions since there were no child participants.

3 | PROCEDURE

3.1 | Pyramidal training combined with BST procedure

A training setting was assigned to conduct the research study on the CSULA campus. The room is an L‐shaped staff
conference room with one large table, and a long counter with a sink, one fridge, and two file cabinets. The room is
approximately 15 feet wide by 25 feet long. Following the completion of the ECBI survey, the participants were
divided into two tiers. Tier one participants remained in the training room, and tier two participants were dismissed.
Tier one participants consisted of three primary caregivers who were trained by the experimenter. Each training com-
prised of the use of the six component BST model and took approximately 1 hr.
Following training of the tier one caregivers, tier two participants returned to the training room and were then
trained by tier one participants. Each tier one participant trained one of the three participants in tier two representing
a secondary caregiver and the pyramidal training model. The tier one participants followed the same training model as
the experimenter had utilizing the six‐component BST model. One participant was selected at a time for baseline data
collection. The other participants in tier one waited outside the room until they were called upon. Tier one partici-
pants were prompted to respond as they naturally did with their child to the confederate emitting 10 opportunities
to respond to behaviors previously selected by the confederate. The participants were given a list of 10 demands, for
example, comb hair, brush teeth, and wash face. The participants would read off each behavior, such as stating “comb
hair,” and the confederate either complied or refused to comply. For refusal, the confederate would not pick up the
comb, cross arms, and say “I do not want to comb my hair.” Compliance was defined as following the demand
presented by the participant. The compliance and refusal components were randomly selected, but in equal distribu-
tion between refusal and non‐refusal, giving five opportunities to respond to each one.

3.2 | Dependent variable and measurement

The dependent variable measured was the correct implementation of the DRA procedure measured by percentage of
opportunities implemented correctly with a confederate. The confederate is the experimenter who acted as the
participant's child during training sessions, exhibiting the parent defined problem behavior.

3.2.1 | Baseline measure

Percentage of opportunity was utilized to measure correct implementation of the DRA procedure. Correct
responding following the confederate's compliant response was defined as the participants providing verbal feedback
in the form of verbal praise. Correct responding following confederate's noncompliance was defined as physically
guiding the confederate through with the demand. Participants were given a + if they responded by providing praise
382 CONKLIN AND WALLACE

such as, “good job” or “thank you.” The participants were given a − if they did not provide praise following the
confederate's compliant response. For inappropriate responding the participant would be marked with a + if the
participant prompted the confederate through the demand, the extinction component of DRA, and provided praise.
The participant received a − for inappropriate responding if they argued, negotiated, did not prompt confederate
through demand, and did not provide praise following compliance. Once baseline data were stable, tier one partici-
pants received training utilizing the BST model to learn effective implementation of the DRA procedure.

3.2.2 | BST measure

Tier one participants were provided with a description of the DRA skills and a step‐by‐step instruction list on how to
implement the skills. Each component in the instructions list was reviewed with the participants. When the partici-
pants verbally stated they understood the instructions list, the experimenter provided a demonstration of how to
implement the skills to the tier one participants. One of the graduate students, who collected interobserver agree-
ment (IOA) data, acted as the confederate during the demonstration of correct DRA implementation. The experi-
menter then demonstrated how to implement the DRA procedure when an inappropriate response was emitted.
A role‐play session followed the demonstration where the participant was given the opportunity to respond to the
experimenter who was acting as the confederate. The experimenter provided feedback to the participant after each
role‐play on correct and incorrect responses in correspondence with the steps of the procedure. For correct
responses the experimenter stated that the procedure was implemented correctly in relation to the steps. Corrective
feedback and modeling correct implementation was provided if the procedure was incorrect. An example of correc-
tive feedback was to explain to the participant what to do different next time in correspondence with the procedural
steps. Once feedback was provided each tier one participant practiced the DRA procedure with the experimenter
until they reached a mastery criterion of 100%. The DRA procedure consisted of two steps: (1) Physically guide
the confederate through the task we presented with noncompliant responses, the third step in three‐step prompting,
acting as the DRA extinction component and (2) reward the confederate with verbal praise such as “thank you, or
“good job”.
Data were collected by the experimenter to determine when the criterion was met; training was considered
complete when the participants could implement the DRA across three consecutive sessions at 100%. Tier one par-
ticipant's implementation was measured using percentage of opportunity measuring correct implementation of the
procedure. Correct implementation of the DRA procedure was defined as the tier one participants providing a verbal
praise, as explained above, to the confederate for emitting the alternative behavior. In addition, participants had to
physically prompt the confederate for refusal and provide verbal praise following the alternative behavior.
The correct implementation procedures were divided by the total number of procedural steps and multiplied by
100 to obtain a percentage of steps implemented correctly during treatment implementation. Proper treatment
implementation had to meet 100% mastery criterion, as described step‐by‐step from the BST instructions list.
When tier one participants met 100% criterion, they trained the tier two participants using the same six‐
component BST training model as the experimenter. The tier two participant's implementation of the intervention
was measured using percentage of opportunity and followed the same calculation procedure for the tier one
participants.

3.2.3 | Social validity measure

Following the training, tier one and tier two participants completed a survey, measuring the social validity and effec-
tiveness of using BST in a pyramidal training model to train a DRA procedure. The survey consisted of five questions,
utilizing a Likert scale with a rating between 1 and 5, listed in Table 2. The total score for each survey was 25, if par-
ticipants selected all fives. The average mean score for the survey was 22.8 with a range score selection from 3 to 5.
CONKLIN AND WALLACE 383

Tier one participants were asked to return 1–2 weeks following intervention to participate in a follow‐up mainte-
nance probe, to calculate the retention of the DRA procedure. Both tiers scored 100% in the maintenance probe.

3.2.4 | Interobserver reliability

IOA data were collected across 79% of baseline sessions. The mean IOA score was 95.8% (range, 33–100%). IOA
data were collected across 100% of intervention trials. The mean IOA score is 98.9% (range, 90–100%). IOA data
were collected across 100% of the maintenance probes.

3.2.5 | Procedural integrity

Correct implementation of the intervention was measured using a fidelity checklist, demonstrated in Table 1.
The checklist was a representation of the instruction list of the BST package. All training steps performed by the
experimenter were checked off as correct or incorrect, during intervention. The participant's fidelity was measured
using the same checklist. The number of agreements was divided by the total number of instructions and multiplied
by 100 to obtain a percentage of correct responses. A second fidelity checklist with seven steps was provided to the
fidelity monitor to check the fidelity of the experimentation process from survey completion to intervention
implementation, to account for all the steps in the research study.
Each correct response was checked off in sequence as the BST training package was implemented. The exper-
imenter trained Juan, Heidi, and Robin, receiving 100% fidelity during BST implementation. Juan trained Sally and
received 100% fidelity. Heidi trained Lina and received 90% fidelity. Robin trained Debbie and received 100%
fidelity.

4 | RESULTS

The results of the study demonstrate the ability for the participants to acquire a procedure and teach it to another
caregiver. Therefore, the aim is for the procedure to generalize across other family members and caregivers in the
child's environment, following the research study as well as be a change tactic for problem behavior reduction and
increasing desired behaviors.
The research was conducted using a multiple baseline across subject's research design. Baseline data were col-
lected over several sessions until stability was determined. Stability was based on tier one and tier two caregiver
implementation of the differential reinforcement procedure prior to BST training. Prior to the intervention package,
and training of the DRA procedure, tier one and tier two participants had a low percentage of correct responses,
shown in Figure 1. Tier one participants were Robin, Juan, and Heidi, trained by the experimenter. Percent correct
responding for Robin was a mean of 34.4% during baseline (range, 10–50%). Percent correct responding for Juan
was a mean of 32.8% in during baseline (range, 10–50%). Percent correct responding for Heidi was a mean of
36.6% during baseline (range, 30–40%). Tier two participants were Sally, Debbie, and Lina, trained by the tier one
participants, shown in Figure 2. Percent correct responding for Sally was 30% across both baseline sessions. Percent
correct responding for Debbie was a mean of 19% during baseline between (range, 10–40%). Percent correct
responding for Lina was 50% correct responding across three baseline sessions. After participants received training
on the DRA procedure using BST, there was a significant increase in correct implementation, compared to baseline
levels. Intervention score was (M = 96%), from a baseline score of (M = 34.6%), for tier‐one participants. Intervention
score was (M = 96.6%), from a baseline score of (M = 33%), for tier‐two participants. All participants responding
resulted in a mean average of 96% (range, 80–100%).
384 CONKLIN AND WALLACE

FIGURE 1 Experimenter trains tier one parents in differential reinforcement of an alternative behavior (DRA)
procedures. Parents appropriate responding following training sessions involving DRA procedures

5 | DISCUSSION

The implications of the research using BST within a pyramidal training model contribute to the field of applied
behavioral analysis, specifically in training caregivers to implement a DRA procedure where no current research is
provided. Furthermore, the importance of this research is to exemplify a cost‐effective method to train caregivers
as the behavior change agents of children with developmental and disabilities, in relation to using paid professionals.
This outcome is consistent with Neef (1995), using peers to train parents to teach behaviors and task responses to
children, therefore demonstrating a cost‐effective training model. The use of the BST model was effective in the
process of obtaining mastery over the trained procedures for DRA and prompting replacement behaviors.
This outcome was similar to Miles and Wilder's (2009), in their demonstration using a BST package, training parents
to manage noncomplaint children.
The research involving the use of BST within a pyramidal training model to train caregivers in the use of a DRA
procedure demonstrates to be an effective training method. Both tier one and tier two participants demonstrated
an increase in the percentage of correct responding from baseline levels following training. Moreover, all six compo-
nents of the BST package involving a description of the target skillsets, written instructions, a demonstration of
skillsets, practice session, feedback, and repetition to mastery of skillsets were implemented and demonstrated to
be an effective method to train primary caregivers as well as secondary caregivers. Lastly, using a pyramidal training
model to train caregivers is cost efficient, and training outcomes are expected to generalize to other caregivers in
the home and to other settings.
CONKLIN AND WALLACE 385

FIGURE 2 Tier one parents train tier two parents in differential reinforcement of an alternative behavior (DRA)
procedures. Parents appropriate responding following training sessions involving DRA procedures

Some limitations were identified during the study and are specified to provide insight to the development of
future research. These limitations are related to the training environment, participants, time constraints, and limited
assessment processes. The limitations will be discussed in detail below, as this is not an exhaustive list.
Training procedure used in this study took place outside of the participants the natural environment. Replication
of the training model utilized in this study could be used in the participants' natural environment where problem
behaviors occur, such as inside the home where the caregivers and child reside, to observe behaviors in the natural
setting.
In addition, data were collected only on the caregiver participants, demonstrating correct implementation of
the DRA procedure and the utilization of the BST package during training. Not only did Miles and Wilder
(2009) train parents using a BST package, they demonstrated a reduction in noncompliant behaviors. Although
the participants identified a problem behavior for their child, there were no data collected on the child's behavior,
nor did the children of the caregiver participants, participate in the study. Moreover, data on the children were not
collected to show a decrease in the problem behavior or an increase in the replacement behavior identified during
the research study, after participants reached a mastery criterion of the DRA procedure. In order to identify
whether the intervention procedure is effective in increasing appropriate responding following task demands in
the children of the participants, data should be collected on the child's behavioral responses to parent demands
before and after training.
386 CONKLIN AND WALLACE

In relation to the claim made that pyramidal training using peers and/or other caregivers as a cost‐effective
training model, there was no assessment to determine this claim. Future researchers may want to determine the
average hourly rate a BCBA acquires in providing such services, in relation to family members training others in their
environment and the time required for training.
Due to time constraints, the maintenance probe for all the participants took place within 1–2 weeks following the
intervention. To ensure that the training maintains over a longer period, future researchers may want to extend the
probing period.
Two of the six participants were Chinese, and a translator was provided who could translate the training methods
in Mandarin. Due to the translation from English to Mandarin, it is possible that some of the training methods and
procedures were difficult to understand. Both participant's selection of scores on the social validity and effectiveness
survey were lower in comparison to the other participants. Although a fidelity check was provided during training,
which scored the correct implementation of procedures, further analysis of non‐English language speakers should
be conducted.

6 | R E C O M M E N D A T I O N S F O R F U T U R E R E S E A RC H

In relation to the limitations of the study, ideas for future research are identified to increase the effectiveness of
using BST within a pyramidal training model to effectively teach a DRA procedure. Furthermore, recommendations
have also been identified for participants from different cultural backgrounds, with low educational level, and who
are non‐English language speakers.
First, the implementation of the DRA procedure, using BST within a pyramidal training model should take place in
the caregivers and child's natural environment. Second, the identified problem behaviors of the children should be
recorded at baseline and intervention to show an increase in appropriate behavior and a decrease in inappropriate
behavior following caregiver demands within the natural setting. Third, it may be important to identify differences
in cultural diversity related to parenting techniques and strategies prior to conducting future research. In relation
to cultural diversity, a preliminary survey that identifies parenting styles should be conducted. Following the survey,
researchers can identify differences in parenting styles between diverse cultures, and better understand parenting
styles and techniques. Moreover, education level may be an important factor in the understanding of the training
procedures. Fourth, future research might want to investigate the relationship between parenting practices, parent
education level, buy in to the intervention procedures, and fidelity of implementation. It may be that opposing
parenting practices, low education level, and/or low buy in may reduce treatment fidelity. Fifth, future research will
want to expand the time between the intervention and the maintenance probe. A longer period between the inter-
vention and maintenance probe may be more accurate in demonstrating the retention of the learned DRA skillsets,
and if responding occurs at the preset criterion level.
The current research provides an effective training model allowing parents to identify problem behaviors and
learn effective intervention implementation strategies to increase desirable behaviors. Moreover, the results of the
study demonstrate an increase in appropriate responding from baseline levels, therefore establishing caregivers as
quality behavior change agents through acquisition of skills on differential reinforcement procedures. By training
caregivers to become behavior change agents and providing them with the skillsets to train others in the child's
environment, we can expect treatment to generalize and provide efficient and cost‐effective intervention options
to families with children with disabilities. The research can also expand to other areas of study where parent training
and increasing appropriate responding are desired.

ORCID
Sarah M. Conklin https://orcid.org/0000-0001-6517-9855
CONKLIN AND WALLACE 387

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How to cite this article: Conklin SM, Wallace MD. Pyramidal parent training using behavioral skills training:
Training caregivers in the use of a differential reinforcement procedure. Behavioral Interventions.
2019;34:377–387. https://doi.org/10.1002/bin.1668