News and Knowledge

Amount of OAR Funding

$30,000.00

Researcher

Laurie A. Vismara, PhD, BCBA-D

Purpose

The purpose of the proposed study is to demonstrate the efficacy of a telemedicine-delivered parent coaching program for providing innovative, individualized interventions to families of children with autism spectrum disorders (ASD). The project’s overall goal is to develop and test the use of telemedicine technology to deliver a manualized, parent-implemented intervention for families of children with ASD, ages 15-48 months. The intervention will use an Internet-based video conferencing program to teach families how to integrate the parent curriculum of the Early Start Denver Model into natural, developmentally and age-appropriate play activities and caretaking routines in their homes.

At the end of the study, Dr. Vismara plans to have created written materials involving interactive treatment manuals, fidelity measures, and procedural implementation materials for providing remote intervention and support to parent-child interactions as they occur in daily routines as well as a proposal for a larger scale, controlled study.

Why Is This Study Needed?

As families know, there are various challenges to receiving care for a child with ASD, including long waiting lists and few specialist services. Barriers to service delivery and utilization are even more exacerbated for families living in rural or remote areas, often resulting in limited access to preventative mental health services in general and parenting ASD interventions in particular. Telecommunication technology can support long-distance clinical health care; however there is little information as to how this resource may translate into practice for families with ASD.

Study Methodology In Brief

Eight parent-child pairs will be recruited to participate. The children will range in age from 18 months to 4 years old with a diagnosis of ASD. Families will participate in 12 weekly sessions. Each week, they will be taught a specific topic of the Early Start Denver Model (ESDM) Parent Curriculum through a live, two-way interactive video conferencing program and webcam with split screens, allowing participants to see, communicate with, and hear one another in real time.

ESDM is a developmentally based, relationship-focused, and behaviorally informed intervention developed to be delivered by parents within typical parent-child play and caretaking activities.

During the study, parents can access the program from any computer or laptop, enabling families to practice the ESDM interactive procedures anywhere in their homes (e.g., play room, bedroom, kitchen, backyard) and to solicit coaching and feedback on unlimited types of child behaviors (e.g., communication, self-help, play, problem behaviors).

Weekly online sessions will involve seven segments that include:

1. A brief dialogue and observation of a parent-child interaction to review practices from the previous session (this will also serve as the data sample for weekly measures)
2. Parent-therapist discussion and feedback of the interaction
3. Therapist introduction of the new teaching topic with videos to demonstrate key principles and behaviors
4. Parent-child interaction in a play or caretaking routine with therapist coaching on the new point
5. Parent-therapist discussion of the interaction
6. Parent-child interaction to practice the new point in a different activity with therapist coaching
7. Closing or a final review of the new point and other developmental objectives that have been observed

At the end of each session, summary sheets, video examples, and suggested practice exercises of each coaching topic will be uploaded to a collaborative secure website, allowing parents to access the material and to carry out the activities with their child during the remainder of the week. Parents will also be asked to record one or two additional activities from a category activity list that what was not targeted during the session to be uploaded onto the Web site, which will be reviewed and discussed during weekly check-in calls scheduled with families before each session.

Researchers

Laurie Vismara, PhD, BCBA-D, is a board-certified behavior analyst and an assistant research scientist in the Department of Psychiatry and Behavioral Sciences at the University of California Davis Medical Center in Sacramento, Calif. She specializes in conducting treatment research with young children with autism and their families. She is collaborating with Sally Rogers, PhD, in examining treatment efficacy and effectiveness in autism using the ESDM, as well as developing a coaching curriculum and parent education model for immediate provision of intervention to at-risk infants and toddlers. In addition, she studies the effectiveness of distance coaching through the use of telemedicine technology, as well as various teaching modalities to best disseminate evidence-based intervention models to families and community-based service providers.