5 - (SYM 22) Tailored Implementation Support to Improve Caregiver Coaching for Minoritized Autistic Children in an Urban Early Intervention System

Caregiver coaching interventions are a best practice for young autistic children (Hume et al., 2021). However, early interventionists infrequently provide high-quality caregiver coaching (Pellecchia et al., 2022). The Parent Empowerment And Coaching in Early Intervention (PEACE) toolkit provides tailored implementation strategies to address barriers to caregiver coaching in under-resourced community settings. In the PEACE toolkit, implementation support increases from online resources to group consultation to individual consultation, based on provider training needs. The toolkit was developed with partners in an urban early intervention system, including families of autistic children, early interventionists, and administrators. The present trial, which will be the largest autism intervention trial to date (N = 200 providers and 400 families), uses an adaptive SMART design to examine the effects of varying levels of implementation support on caregiver coaching competency. Early interventionists from a large, publicly funded service system are trained to use Project ImPACT, an evidence-based caregiver coaching intervention to support social communication development.  

This presentation will: 1) overview PEACE toolkit resources for delivering caregiver coaching with families from low-income and minoritized backgrounds (e.g., family-friendly videos, online chat space for providers to share coaching questions); and 2) describe preliminary results from an ongoing trial of the PEACE toolkit. 

Data collection is ongoing; we will have complete data from 3 cohorts (N = ~ 70 early intervention providers; N = ~120 families of children aged 5 and under identified as having a high likelihood of autism). We will use hierarchical linear modeling to examine approximately 360 recorded sessions across 3 time points and the effects of consultation dosage (i.e., hours) and consultation format (i.e., group, individual, both) on provider caregiver coaching competency over time, controlling for demographic factors such as provider discipline (e.g., speech therapist, special instructor), provider age, and years of experience in early intervention. Coaching competency will be assessed via the PEACE fidelity tool, which is behaviorally coded using a 1-5 Likert scale, yielding an overall competency score and scores for 5 sub-domains.  We will discuss implications for executing large-scale tailored implementation efforts of behavioral interventions in under-resourced settings.