Brief Parent Training in PRT during Jumpstart, a Community Implemented Parent Education and Empowerment Program: Parent and Child Outcomes

Thursday, May 12, 2016: 11:30 AM-1:30 PM
Hall A (Baltimore Convention Center)
N. L. Matthews, B. C. Orr, B. Harris and C. J. Smith, Southwest Autism Research & Resource Center, Phoenix, AZ
Background: Beginning behavioral intervention for autism as early as possible is important for facilitating optimal outcomes (e.g., Dawson et al., 2012). This effort is often hindered by long waitlists, lack of qualified interventionists, and cost. JumpStart is a short-term, group-format education and empowerment program for parents of recently diagnosed children. It is implemented by community practitioners at a non-profit autism center, includes brief parent training in pivotal response treatment (PRT), and equips families to navigate service systems.  

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.