Impact of Collaborative Caregiver Training Models on Caregivers, Children, and Early Interventionists

Background:  

Children identified with Autism Spectrum Disorder during toddlerhood often turn to their state Part C early intervention (EI) system for care. Recommended practices in EI emphasize the use of family routines as the intervention context and the role of the EI in teaching parents to embed intervention strategies into daily routines. As a result, there has been an increased emphasis on the value of caregiver-implemented intervention approaches. Therefore, EI providers are charged with a need to not only be knowledgeable in evidence-based treatment strategies for young children with ASD but also how to teach and coach caregivers to use these strategies.

Objectives:  

This program evaluation study assesses the impact of a university-driven caregiver training model that includes opportunities for collaboration and consultation with state level EI providers.

Methods:  

Approximately 90 families will be provided with services following participation in a psychological evaluation for ASD. All participating families receive 2 home-based evaluation support sessions led by a professional in the field of applied behavior analysis which include focused consultation and training on evidence-based practices for children with ASD. Following completion of this initial service, families are recommended for an additional 2 to 12 caregiver training sessions dependent on location and age at the time of referral. This second round of services includes 2 to 4 live and/or remote collaborative sessions with each family’s EI and well as ongoing remote consultation opportunities. Surveys were developed to assess caregiver perceptions of impact on self and child as well as EI perceptions of impact on self and family.

Results:  

63 families have completed or are currently engaged in services. Using a Clinician Global Impression rating of improvement (CGI-I) to rate child behavior, caregivers have provided average ratings of 2.9 on a scale of 1 to 7 with 1 equaling “very much improved” and 4 equaling “no change”. In addition, caregivers have assigned high ratings to their overall satisfaction with services as well as their own competence in implementing the strategies with overall ratings averaging 3.4 on a scale of 1 to 4. A general satisfaction survey was sent to EI providers to assess perceptions of benefit to the families they work with; ratings averaged 3.3 on a scale of 1 to 4. In addition to the satisfaction survey, surveys were also sent to EIs to assess knowledge gained through participation in collaborative visits and consultation. Results suggest that EIs used recommended strategies 75-100% of the time. When asked to rate how collaboration with the clinician had impacted the interventionists ability to use those recommended strategies, the interventionists responded with an average rating of 3.8 (1 = not at all, 4 = significantly).

Conclusions:  

The preliminary results of this project support effectiveness of caregiver training within the community setting. Early intervention providers as well as caregivers reported high levels of satisfaction with services, and early interventionists indicated that they had opportunities to use learned skills with other children creating potential for an impact on greater numbers of children within systems.