Brief Parent Training in PRT during Jumpstart, a Community Implemented Parent Education and Empowerment Program: Parent and Child Outcomes
Objectives: (1)To compare change in parent fidelity of implementation (FOI) of PRT, child responsivity, parent-reported well-being, and parent-reported self-efficacy between treatment and waitlist control (WLC) groups, and to determine the percentage of parents who achieved FOI within the full sample; (2) To discuss strengths and challenges of this program.
Methods: Participants were 36 parent-child dyads recruited from the JumpStart waitlist, matched on child age, and enrolled in the treatment (n = 18) or WLC (n= 18) group. Children had an ASD diagnosis (83%) or an ‘at-risk for autism’ classification. Diagnostic distributions were identical and Vineland composite scores did not differ between groups at study entry. See Table 1 for participant demographics.
JumpStart meets twice weekly over a 4-week period (weeks 2-5). It includes didactic lessons on autism, obtaining services, and brief training in PRT (i.e., 1.25 hours didactic, 5 hours guided observation, and 5 hours in-vivo coaching). At a study visit 4-6 weeks prior to the program (WLC group only), orientation (week 1), 1-week follow up (week 6), and 3-month follow-up (week 18), parents completed the Parent Stress Index (Abidin, 1995), the Early Intervention Self-Efficacy Scale (Guimond et al., 2008), the Center for Epidemiological Studies Depression Scale (Radloff, 1977), and a 10-minute videotaped probe with their child coded for child responsivity and parent FOI. Of note, ‘week 6’ probes were collected during week 5 due to program restraints and thus reflect only 3.75 hours of in-vivo coaching. Parents completed 1.25 additional hours of coaching after probes were collected.
Results: Depicted in Figure 1, the treatment group demonstrated greater increases in parent FOI (F(1, 33) = 40.43, p < .001) and child responsivity (F(1, 33) = 26.80, p < .001) and decreases in parent-reported depression (F(1, 33) = 4.19, p = .05) compared to WLC. Approaching statistical significance were increases in parenting competence (F(1, 32) = 3.95, p = .06) and decreases in parenting stress (F(1, 33) = 2.99, p = .10). Within the full sample, average FOI at week 6 was 57% (SD = 17.57) and 23% of parents achieved FOI (> 75%).
Conclusions: Parents who participate in JumpStart can begin intervention earlier while arranging a more comprehensive treatment program. Findings suggest that JumpStart yields meaningful outcomes, including gains in child responsivity, parent FOI, and parenting competence, and decreased parent depression and stress. Three-month follow-up data will indicate whether these changes are maintained. Additionally, strengths and challenges of the program will be discussed, including number of families served (60-84 annually), quality of parent training, funding, and a growing waitlist.