A Pilot Study of an Innovative Service Delivery Model for Training Intervention Providers: Combining Web-Based Learning, Live Instruction and Remote Consultation

Background: Individuals with ASD often require intensive and specialized intervention. Despite this need, significant barriers often impede access to evidence-based ASD services in community settings. Given the significant service-need discrepancy experienced by this population, efforts must be made to improve strategies for training community-based service providers in effective ASD intervention. Frequently, community-based service providers gain access to new intervention techniques via written manuals and/or attendance at in-person training workshops. However, there is limited evidence to support the effectiveness of manuals in increasing providers’ ability to implement intervention techniques, and intensive training workshops can be both prohibitively costly and time intensive.  Thus, it is critical to identify alternative training formats that can better support the dissemination and implementation of evidence-based ASD interventions to community settings. One promising area of research has explored the use of web-based programs to supplement, or even replace, traditional in person provider training models.  However, the feasibility and acceptability of such training models in community settings is still largely unknown. 

Objectives: An innovative and systematic training protocol was developed to introduce community-based service providers to an evidence-based, social communication intervention, Project ImPACT. The primary goal of the current study was to assess the degree to which community-based service providers found this training protocol to be feasible, acceptable and effective for helping them to implement the Project ImPACT intervention techniques. A second goal of the current study was to determine the effectiveness of the components of the protocol for training providers to effectively implement the intervention techniques.

Methods: Thirty one community-based service providers participated in the current study. Participants engaged in the training protocol, which included: 1) a self-directed web-based tutorial; 2) a one-day interactive workshop; 3) up to three remote skype coaching/supervision sessions. Providers were asked to complete a series of questionnaires and videotaped provider-child interactions at 4 different time points: 1) before completing any training (Time 1); 2) after completing the web-based tutorial (Time 2); 3) after completing the in-person interactive workshop (Time 3); and 4) at six-month follow-up (Time 4). Provider perceptions of the intervention and training protocol, as well as provider fidelity of implementation, were evaluated at each time point.

Results: Results indicate that service providers found this training protocol to be feasible, acceptable and effective for increasing their ability to implement strategies from Project ImPACT. Providers also improved in their fidelity of the Project ImPACT intervention techniques as they progressed through the training protocol.

Conclusions: This study provides initial evidence for the acceptability and effectiveness of an innovative protocol utilizing internet-technology in conjunction with brief in-person instruction and remote supervision to train community-based service providers in evidence-based social communication intervention strategies. Results suggest that a program like this may serve to overcome barriers associated with traditional provider training models, and may ultimately increase access to evidence-based intervention services for children with ASD in community settings.