Evaluating the Impact of Statewide Community-Based Training for Early Intervention Providers
The Washington State ASAP! Program was designed to build capacity among birth-to-three providers to implement evidence-based screening and intervention practices with young children for whom ASD is suspected. Toward this end, free workshops offer training on the use of the Screening Tool for Autism in Toddlers (STAT) as a level 2 screener and the use of Reciprocal Imitation Training (RIT) as a low-cost, easily implementable, ASD specialized intervention. The present study reports on the preliminary effectiveness of RIT workshops and the acceptability of RIT for use by birth-to-three providers. RIT is a short-term, play-based behavioral intervention that uses a naturalistic approach to teach object and gesture imitation to children with ASD (Ingersoll, 2010).
To evaluate the effectiveness of RIT training workshops in increasing community providers’ knowledge about, and implementation of, ASD-specialized early intervention.
Four full-day RIT training workshops have been conducted to date in different areas of the state, and 150 service providers have attended. The majority of participants had backgrounds in either early childhood special education (44%) or speech-language pathology (19%), and their average number of years working with children with ASD was 4.94 (SD= 5.78). Workshops combine didactic presentations, group discussion, live demonstrations, and hands-on practice with performance-based feedback and coaching. Providers completed surveys assessing their knowledge, comfort working with young children with ASD, and implementation of RIT at 3 time points: before training, immediately after training, and 3 months following training. Survey items were rated on a scale from 1-4, with 4 indicating the most positive assessment or strongest agreement
Workshop evaluations revealed high levels of overall satisfaction (M= 3.7; SD=.29), with hands-on practice (21%) and video examples (35%) spontaneously listed by attendees as particular strengths. The percent of participants demonstrating mastery of RIT principles increased from 7% before training to 65% following the single-day training, χ2 (1)= 3.97, p<.05. Three-month follow-up surveys have been sent to 46 providers thus far, 21 of whom (46%) responded. Of the 19 responders currently working with children with ASD, 14 were using RIT and 5 indicated that they intend to start using RIT. Providers who were implementing RIT reported that RIT was effective in improving children’s imitation skills (M= 3.5, SD=.52) and other social-communicative behaviors (M= 3.5, SD=.52). In addition, providers reported increased comfort from pre-training to 3-month post-training in providing direct intervention to young children with ASD, t(16)= -3.04, p<.01, coaching parents, t(16)=-3.11, p<.01, identifying treatment goals, t(11)=-3.55, p<.01, and discussing treatment goals with parents, t(17)=-2.36, p<.05.
These preliminary results suggest that the ASAP! RIT workshops were well-received and resulted in increased knowledge about and use of RIT with families. Importantly, more generalized improvements were found in providers’ comfort working with young children with ASD, coaching parents, and setting treatment goals. Data collection and follow-up assessments are continuing.