News and Knowledge

Just last month, OAR’s Board of Directors authorized funding for six new applied autism research studies that will begin in 2018. These new grants, totaling $176,090, bring OAR’s total research funding to over $3.6 million since 2002. This is the first of six previews to be featured in The OARacle this year.

Though research has identified effective evidence-based practices for children with autism spectrum disorder (ASD), the majority of families of children with autism do not have access to the high-quality interventions that are known to positively impact children’s developmental trajectories. Access is particularly limited in rural or geographically remote areas, where there are limited services and training opportunities for service providers.

OAR-funded researcher Sarah Rieth, PhD, BCBA-D, an assistant professor of child and family development at San Diego State University and an investigator at the Child and Adolescent Services Research Center, will examine an online training and coaching model for service providers that may help to address the issue of access to high-quality interventions. Her two-year study, “Building Community Capacity: Evaluating a Distance Training Model for Underserved Rural Areas,” will provide web-based training in Project ImPACT for Toddlers, a parent-mediated, naturalistic, behavioral intervention.

Study Goals

The goal of the project is to improve and evaluate the efficacy of a web-based training and coaching model to teach therapists in rural areas to implement Project ImPACT and to assess the impact of the delivery of this model on parents’ use of evidence-based strategies with their young children with ASD.

Study Format

Phase 1 of the project will involve using a focus group to gather feedback from clinicians who have previously participated in the Project ImPACT online training. Data obtained from that focus group will be used to make modifications, additions, and enhancements to the online training program.

In Phase 2, therapists will be recruited from across the country to participate in the training and then use the Project ImPACT intervention with families on their caseload. To be included, they must:

• Work with infants and toddlers, aged 12 to 36 months, including at least three children with social-communication concerns, at risk for ASD, and/or with an ASD diagnosis.
• Have difficulty accessing adequate or desired training to meet the needs of young children receiving early intervention for social communication concerns.

The participating therapists will be split into groups of five to receive training for four, six, or eight weeks. These varying amounts of time will allow Dr. Rieth to isolate the effects of the treatment on behavior change.

The therapists will be asked to submit baseline videos of therapy sessions before training begins and then every two weeks for the duration of their training and the intervention. Once the research team determines that the therapists are able to deliver the Project ImPACT intervention as designed, each therapist will recruit a family with whom to implement the intervention.

In addition to the videos, data collection will include a demographic questionnaire and satisfaction survey to be completed by the therapists. The survey will collect their feedback on the training and implementation experience as well as needed areas of improvement. Parents will also fill out a satisfaction survey that will include questions about the appropriateness of the strategies for their child, ability of their provider to deliver the information effectively, and their opinions on the intervention after receiving the service.

Outcomes

Outcomes of this research will include improved:

• Understanding of effective distance training tools to support learning of evidence-based practices by rural and geographically distant clinicians
• Community capacity for service delivery to families of children with ASD in need of early intervention
• Understanding of therapist and family perceptions of evidence-based strategies for supporting young children with ASD

This information can be used to inform future training models and efforts to expand the community implementation of research-based practices, particularly to underserved rural communities. The project may provide a therapist training model that can be used with other evidence-based practices.

Parent-mediated interventions have been shown to decrease parent stress, improve parent-child relationships, and positively impact parents’ confidence in their ability to influence their child’s development. The ability to achieve these outcomes in community settings, however, rests on the availability of well-trained therapists who can appropriately deliver evidence-based, parent-mediated approaches in their daily practice.

If effective, this training has the potential to provide intervention agencies with a method of ongoing training for therapists, which may address issues of staff turnover and provider shortages. Addressing these goals will improve the quality of services that families receive.