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Characterizing the Relationship Between Intervention Delivery and Outcomes Within Part C Community Settings.

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Parent-mediated interventions (PMI) for autism in early intervention (EI) show that provider fidelity impacts caregiver strategy use, but not child outcomes. Adaptations may improve caregiver alliance.

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Area of Science:

  • Developmental Psychology
  • Clinical Psychology
  • Applied Behavior Analysis

Background:

  • Parent-mediated interventions (PMI) are effective for children with autism spectrum disorder (ASD).
  • Early Intervention (EI) services provide a context for delivering PMIs.
  • The impact of PMI adaptation on caregiver engagement and learning requires further investigation.

Purpose of the Study:

  • To characterize the delivery and outcomes of an autism PMI, Project ImPACT, in an EI Part C system.
  • To examine the relationship between provider fidelity, adaptations, and caregiver outcomes.
  • To assess the impact of PMI delivery on caregiver engagement, self-efficacy, and child social communication.

Main Methods:

  • 21 EI providers and 23 caregivers participated in Project ImPACT.
  • Provider sessions were video-recorded and coded for fidelity and adaptations.
  • Caregivers rated engagement and alliance; completed self-efficacy and child social communication measures.

Main Results:

  • Provider fidelity was not associated with caregiver alliance or engagement.
  • Session adaptations correlated with higher caregiver alliance, but not engagement.
  • Provider fidelity was linked to caregiver use of teaching strategies, but not child social communication outcomes.

Conclusions:

  • The relationship between autism PMI delivery and caregiver outcomes is complex.
  • Holistic delivery models supporting adaptations are valuable.
  • Adaptations may enhance caregiver alliance in early intervention settings.