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

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.