From the Community to the Lab (and back): Identifying Important Treatment Components of a Parent Training Intervention

Background:  Project ImPACT is a parent training program for young children with ASD based on best practices that teaches social communication within daily routines and interactions (Ingersoll & Dvortcsak, 2010).  This program was developed within community settings with the express purpose of identifying program elements that would assist community providers in implementing parent training. 

Objectives:  To better understand how the intervention affects parent and child behavior, we conducted a series of controlled evaluations in a lab setting using single-subject design (SSD) methodology.   

Methods:  Two, multiple-baseline SSDs were conducted with young children with ASD to evaluate the active ingredients of the intervention.  In study 1, therapists implemented the intervention with young children with ASD (n=9) for 2-hrs per week for 8 weeks to examine the efficacy of the intervention package.  In study 2, parents were trained to use the intervention with their children with ASD (n=8) once or twice per week for 12 weeks to evaluate the efficacy of the parent training model.  Child language use was examined using behavioral coding of session tapes.

Results:  The children increased their rates of expressive language during treatment in Study 1, providing preliminary evidence for the efficacy of the intervention package when implemented by trained therapists.  The parents increased their use of the intervention techniques in Study 2, providing preliminary evidence for the efficacy of the parent training model.  Improvements in the children’s expressive language were also observed, although results were not as robust with parents as with therapists.  A panel analysis with fixed effects for concurrent time series designs demonstrated a significant association between parents’ use of individual intervention strategies and their child’s language use.  Specifically, parents’ use of responsiveness-based strategies (following the child’s lead and imitating the child) and language prompting were both unique predictors of children’s spontaneous language use within session. 

Conclusions:  The results provide preliminary support for the efficacy of key components of a parent training program that can be feasibly implemented in community preschool settings, and identify the active ingredients of the intervention (responsiveness-based strategies, language prompting).  The next step is to empirically evaluate the effectiveness of the intervention in preschool programs, as implemented by community providers.