Parent Perceptions of an Adapted Evidence Based Practice for Toddlers with Autism in a Community Setting

Background:  

Although data from parent-implemented Natural Developmental Behavioral Interventions (NDBIs) have shown positive effects on decreasing core symptoms of autism, there has been limited examination of the effectiveness of NDBIs in community settings. Additionally, parent perspectives of their involvement in parent-implemented early intervention have not been well studied. Project ImPACT is an NDBI that teaches families techniques to improve child social engagement, language abilities, imitation skills, and play (Ingersoll & Dvortscak, 2010). Rigorous single-subject methodology demonstrates children receiving Project ImPACT demonstrate gains in targeted skills, and parents use the intervention with fidelity in research settings. 

Objectives:  

The purpose of the current study is to examine parent perspectives and the initial impact on parent behaviors of Project ImPACT for toddlers at-risk for ASD when delivered by community providers. Specifically, mixed quantitative and qualitative methods were used to assess (1) observed changes in parent use of strategies to facilitate their child’s social communication skills following community-implemented Project ImPACT; and (2) parent perceptions of effectiveness and feasibility of Project ImPACT. 

Methods:  

Participants included thirteen parents and their children with risk for ASD, recruited from four community-programs. Primary eligibility criteria included referral to a community provider trained in Project ImPACT and a child with a diagnosis of ASD or risk for ASD who was under 24 months of age at intake. Mean child age at intake was 15 months (SD= 3.01; range = 8-21 months) and a majority (76%) of families self-identified as Caucasian.

All families received a 12-week Project ImPACT curriculum to support their use of strategies to facilitate interaction and skill building in their children during daily routines and activities. Measures utilized for the current study included parent fidelity of implementation as rated by the research team, a satisfaction survey completed by the parents at the end of intervention, and qualitative, semi-structured exist interview completed with the parents by a member of the research team. 

Results:  

Significant improvements in parents’ overall fidelity were observed from baseline (M=3.13) to 12 weeks (M=3.77; p< .01). Twenty percent of parents were considered to have met overall fidelity at baseline compared to 90% of parents at 12 weeks. Parent improvement on individual strategies will be examined and discussed.

Parents reported overall high satisfaction with the intervention (M=6.46; SD= .41; range = 5.7-7, out of 7 possible). Parent responses in the interviews also supported that general satisfaction was very high; all parents indicated they “believed” in the approach.  Results will be described based on the emergent interview themes related to the parent coaching process, impressions of the intervention, and impact of the intervention on their own and their child’s behavior.

Conclusions:  

Findings from both qualitative and quantitative data indicate that parents had very positive perceptions of the feasibility, utility, and effectiveness of Project ImPACT when implemented by community early intervention providers.  Further, observational data indicate that parents were able to learn and implement the Project ImPACT strategies in the relatively brief 12-session intervention period. Implications for the feasibility of adopting a parent-implemented treatment program will be discussed.