A recent large study showed that caregivers learn ESDM strategies better when early intervention providers use partnership strategies (such as collaborative goal setting, avoiding the “expert-model” approach, prioritizing the caregiver-child relationship) and coach with reflective practice and mutual planning to support caregiver learning. We also worked with the community to develop and test a program that could be used by early intervention providers and families to learn ESDM strategies through a combination of online lessons and videos accompanied by coaching from their early intervention provider. Caregivers and early intervention providers used Help is in Your Hands (helpisinyourhands.org), to learn ESDM content through brief web-based lessons with video examples. Early intervention providers coached caregivers in use of the strategies during daily activities with their own child. Overall, ESDM-trained providers improved in their caregiver coaching and partnership skills, and caregivers made strong gains in their use of the ESDM strategies after training. This study was deliberately conducted in rural areas of the United States with families living in poverty to determine how well this approach would work for historically underserved families.
In another recent study we examined child and family outcomes from a community-based, pilot test of Project ImPACT. Twenty-five families of toddlers with social communication challenges received either Project ImPACT or their usual care early intervention through Part C. In Project ImPACT, from the very first appointment, the caregiver is involved in choosing treatment goals and provides input throughout the course of treatment regarding treatment progress, strategies, and fit. Caregivers and early intervention providers work together to carefully plan the use of Project ImPACT intervention strategies at home. In the pilot trial, we found that early intervention providers trained in Project ImPACT used more caregiver coaching strategies and partnered well with families. In turn, we saw greater improvements in positive caregiver-child interactions for Project ImPACT families with accompanying larger changes in children’s social and communication skills. Half of the families in the study indicated they were Hispanic/Latinx and almost a third received the intervention in Spanish. We are currently conducting a larger study to further explore use of Project ImPACT by early intervention providers in California. Participating early intervention providers receive training in Project ImPACT free of charge. This study will give us more information about usual care for caregiver-mediated intervention for young children with high likelihood of autism and if early intervention provider training in Project ImPACT improves outcomes for children and families. To learn more about this study click here: https://bridgecollaborative.com/training, ongoing study recruitment is happening now.
Research studies such as these would be impossible to do without strong partnership between researchers and community stakeholders such as community providers, funders, caregivers, and autistic individuals. Community stakeholders who partner with researchers directly contribute to the development of adaptations that support use of evidence-based intervention in community programs across varied cultures. Researchers and community stakeholders have worked together to make prospective user-informed adaptations and then conduct studies to make sure the adapted versions of the interventions continue to have the intended positive benefit for children and families. This process contributes greatly to the collective effort to ensure evidence-based practice interventions are available to ALL families who desire them.