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Improving Part C Services and Outcomes for Underserved Children with ASD
Project Number: R40 MC 26193
Grantee: Hugo W. Moser Research Institute at Kennedy Krieger, Inc.
Project Date: 9/1/2013
Rebecca J. Landa, PhD
Faculty - Founding Director, Professor
707 North Broadway
Baltimore, MD 21205
There is a growing gap between research and practice in Part C (early intervention, or EI) services for toddlers with, or at risk for, autism spectrum disorders (ASD) and their caregivers. As the research base of effective early interventions for this population grows, there is a pressing need for research focused on the translation of these interventions for community-based implementation. Furthermore, there is a need for the intervention components to be adapted to reflect the needs and values of the current community provider systems, as well as the culturally diverse populations served. Within these efforts, the effects of increased implementation of evidence-based (EB) EI practices on children and families must be evaluated in order to meaningfully impact the training and service provision standards of the Part C system. The proposed project addresses these needs through a randomized controlled trial (RCT) of 60 Part C practitioners who will be randomized to either a 6-month ‘Evidence Based Practice (EBP)’ training condition designed to increase their implementation of EB EI (i.e., instructional strategies, caregiver coaching, and a developmental child curriculum), or to a ‘Business As Usual (BAU)’ condition. Baseline, pre- and post- professional development training measures of practitioners (fidelity, self-efficacy, attitudes towards evidence-based practice, perception of intervention acceptability), caregivers (engagement, self-efficacy, fidelity), and children (language, social) will be collected, along with a generalization probe to assess practitioners’ implementation with a different child with ASD and their caregiver. Data will be collected through a combination of standardized and experimental measures. The study sample will be drawn from multiple diverse Maryland county Part C programs and will reflect the large proportion of minority and under-resourced (underserved) families in this region. Specific aims of the proposed RCT study are to: (1) improve Part C practitioners’ implementation of EB practices through participation in a manualized professional development program established through prior (NIH, HRSA R40) and current (IES) funding; (2) improve caregiver-child engagement outcomes through training Part C practitioners to coach caregivers in the use of EB EI strategies during caregiver-child interactions; and (3) improve child social and communication outcomes through training Part C practitioners to implement EB EI strategies, caregiver coaching, and a child social and communication development curriculum. Findings from the proposed study will have the potential to advance scientific knowledge of the factors that impact adoption of EB EI practices by community providers, while identifying the impact of increased EB EI implementation on children and caregivers. Furthermore, the proposed study will contribute to the further definition of service delivery standards for toddlers with ASD, and training requirements for practitioners serving this population.
Autism, Clinical Practice, Developmental Disabilities, Early Intervention , Health Education & Family Support , Social & Emotional Development , Cognitive & Linguistic Development , Capacity & Personnel, Special Health Care Needs