Implementation and Impact of Focused Early Intervention Services

Background:  

Quality early intervention programs emphasize the role of the caregiver in supporting the child at home. However, support and education programs are often difficult to access. In an effort to better equip caregivers with the knowledge base and tools necessary to adequately address the needs of children with Autism Spectrum Disorder (ASD), a university-based institute on ASD and state department of education have collaborated to develop and implement two model early intervention programs for families of young children with ASD and related developmental delays.

Objectives:  

This program evaluation study investigates the feasibility of implementing two different parent education-focused service models with fidelity. In addition, this study assessed parent satisfaction with each service as well as the impact of services on child functioning as perceived by both caregivers and clinicians. 

Methods:  

Approximately 60 families will be provided with services following participation in a psychological evaluation for ASD. All participating families receive 2 home-based evaluation support sessions which include an opportunity to discuss the evaluation report as well as focused consultation and training on evidence-based practices for children with ASD. Approximately half of these families will participate in a parent education series that includes 12 additional sessions guided by the Early Start Denver Model (ESDM). Professionals in the fields of early intervention and applied behavior analysis conduct all visits within both models of service. Procedural fidelity data, satisfaction ratings, and Clinician Global Impression ratings are collected on both services in an effort to evaluate program effectiveness.

Results:  

Preliminary data on families that have completed each service at this time (N = 34; N = 8)  suggest that clinicians were able to apply the training model with over 95% fidelity across families with varying needs. Additional data collected on the application of the ESDM curriculum suggest that clinicians were able to cover over 90% of the ESDM curriculum across the 12 visit model and that parents were able to demonstrate over 70% of those strategies covered within sessions. Preliminary data using a Clinician Global Impressions rating of improvement suggest that both clinicians and caregivers observed improvement following completion of the brief evaluation support service with average ratings of 3.2 and 2.4 respectively on a scale of 1 to 7 with 1 equaling “very much improved” and 4 equaling “no change”. Caregivers and clinicians also observed improvement following completion of the extended parent education service with ratings of 2.1 and 2.4 respectively. In addition, caregivers assigned high ratings to their overall satisfaction with services as well as their own competence in implementing the strategies with overall ratings averaging 3.8 on a scale of 1 to 4. 

Conclusions:  

The preliminary results of this study suggest that early intervention programs emphasizing caregiver support and education can be implemented with high levels of fidelity. Additionally, the results suggest that even brief intervention services focused on providing caregivers with immediate support and education may result in improvements in child functioning and caregiver confidence in supporting their child.