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Comparative Efficacy of a Self-directed and Therapist-assisted Telehealth Parent Training Intervention for Children with ASD

Age

  • Toddlerhood (13-35 months)
  • Early Childhood (3-5 years)

Abstract

Research indicates that early, intensive intervention can lead to significant improvements for children with ASD. There has been a dramatic increase in the prevalence of ASD over the past two decades, but not a corresponding growth in availability of evidence-based intervention services. This has led to high levels of unmet service needs for individuals with ASD and their families. Parent training is one cost-effective and ecologically valid approach to increase access to intervention. Additional benefits include increases in parenting self-efficacy and decreases in parenting stress. Yet, there continue to be barriers involved with the dissemination of training to parents. Telehealth interventions have the potential to replace, or at the least augment, traditional service models to increase access to evidence-based services, particularly in rural and medically underserved areas. There is increasing evidence to suggest that such programs can reduce patient and provider costs and increase provider system coverage relative to traditional in-person service delivery models. Although there has been growing interest in extending telehealth interventions to parent training for children with ASD, empirical evaluations of such programs are limited, and little is known regarding the relative benefits of self-directed and therapist-assisted telehealth interventions. Thus, the objective of this project is to conduct a randomized control trial to compare the efficacy of a novel, telehealth parent training intervention, ImPACT Online, delivered in a self-directed or therapist-assisted format, and to examine moderators and mediators of treatment outcomes. Ninety families of young children with ASD will be randomized to the self-directed ImPACT Online, therapist-assisted ImPACT Online, or web-based information control condition, and will receive treatment for 4 months. Outcome assessments will occur at post-treatment and a 3-month follow-up. The specific aims of the study are: a) to examine the comparative efficacy of the two telehealth intervention models on parent fidelity and parent self-efficacy (Primary Outcomes); b) to examine the comparative efficacy of the two e-health interventions on child language at the 3-month followup (Secondary Outcome); c) to determine whether pre-treatment parenting stress moderates the effects of ImPACT Online on parent fidelity and parent self-efficacy; d) to examine whether gains in parent fidelity and parent self-efficacy mediate the effects of the ImPACT Online on child verbal language at the 3-month follow-up; and e) to identify predictors of adherence to ImPACT Online. This study has the potential to greatly increase access to evidence-based intervention strategies for children with ASD, especially those living in rural and underserved areas.

Publications

Listed is descending order by year published.

Ingersoll B, Shannon K, Berger N, Pickard K, Holtz B. Self-Directed Telehealth Parent-Mediated Intervention for Children With Autism Spectrum Disorder: Examination of the Potential Reach and Utilization in Community Settings. J Med Internet Res. 2017 Jul 12;19(7):e248.


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