Symposia
Dissemination & Implementation Science
Katherine Pickard, Ph.D.
Assistant Professor
Emory University School of Medicine
Atlanta, Georgia
Nicole Hendrix, Ph.D.
Assistant Professor
Emory School of Medicine, Department of Pediatrics, Division of Autism and Related Disabilities
Atlanta, Georgia
Although parent-mediated intervention (PMI) is an effective intervention approach for young, autistic children (Nevill et al., 2018), there is high attrition when implemented in structurally marginalized communities (Kasari et al., 2015). Strategies added to PMI to enhance caregiver engagement have had mixed results and may reflect an assumption that PMI content should engage families and, when not, that engagement must be targeted separately so that fidelity is maintained. The emphasis may restrict how PMI is delivered, at times, placing it at odds with the diverse needs of families that arise in session. The current study examined the delivery of an evidence-based PMI, Project ImPACT (Ingersoll & Dvortcsak, 2019), when delivered within a Part C Early Intervention system. Objectives were to examine: 1) providers’ fidelity to Project ImPACT; 2) decisions weighed in the delivery of Project ImPACT; and 3) the perceived impact of these decisions.
Participants were multidisciplinary providers delivering services to children 12-30 months of age with an increased likelihood of having autism. Providers completed Project ImPACT training and submitted video of their Project ImPACT sessions, which were scored for fidelity. Providers also completed an open-ended survey after each session that asked about how the session played out, the decisions that factored into their delivery of Project ImPACT, and the perceived impact of the decisions.
Preliminary data from 25 providers indicate significant improvement in Project ImPACT fidelity. Across a sample of 50 Project ImPACT sessions, providers reported responding to events that impacted delivery in about 40% of sessions. These events represented acute stressors (e.g., housing eviction), chronic needs (e.g., extended family illness), response to acute child needs (e.g., challenging behaviors), and stated preferences. In response to these events, providers indicated pausing Project ImPACT to provide support with an intent to return to Project ImPACT content. This study provides insight into how providers delivered an evidence-based PMI within a state-funded system and the decisions they weighed in program delivery. Preliminary findings highlight the perceived need to pause intervention content to support family needs.