The Effectiveness of a Research-Based Parent Mediated Intervention for Youth with ASD Served in Community Service Settings

Background: Children with ASD are increasingly receiving community-based treatment services. Several treatment methods, many that include parent education, have demonstrated efficacy in controlled research settings, and improvement in child/parent functioning. Despite these efficacy data, little is known about the effectiveness of such methods in community settings. Findings from the few studies conducted in community settings suggest feasibility of implementing research-based parent education treatment in these settings, and that outcomes may be similar to those in research settings. However, limitations of this research include lack of a control group, limited attention to parent factors that may impact child outcomes, and no follow-up assessments to measure maintenance of gains.

Objectives: This study examines the effectiveness of a 12-week research-based, parent-mediated naturalistic behavioral/developmental intervention targeting social communication skills delivered in a community setting to children with ASD. This study compares child outcomes for those in the intervention and community comparison conditions from baseline to 12 weeks (immediately post-intervention) and 24 weeks (follow-up). 

Methods: Participants include children ages 18 months-8 years with an “at risk” or diagnosed ASD and their primary caregiver. Children in the intervention condition receive the 12-week Teaching Social Communication (TSC) intervention (Ingersoll & Dvortcsak, 2009) delivered as part of routine care in a community setting.  Families in the community comparison condition are receiving routine community-based services, excluding TSC or similar interventions. Children in the intervention condition are an average age of 46.69 months (SD = 25.72), 81% boys, and 31% Caucasian while children in the comparison condition are an average age of 65.92 months (SD = 18.45), 92% boys, and 36% Caucasian. Child outcomes are measured on the VABS-II Communication and Socialization domains, parent stress is measured on the PSI-SF and parent-child interactions are measured using observational methods. Outcomes are collected at baseline and 12 and 24 week follow up.

Results: Preliminary analyses (one-way ANOVAs using change scores) using data from the first 30 families enrolled (16 intervention; 14 comparison) suggest that children in the intervention condition demonstrate greater gains from baseline to 12 weeks than children in the comparison condition. Specifically, children who received the intervention demonstrated greater improvements on the Communication domain, F (1, 18) = 8.21, p < .05 relative to the comparison condition. The same trend, in which the intervention condition demonstrated greater gains, approached significance on the Socialization domain, F (1, 18) = 2.91, p = .11. Final multi-level analyses and 24-week data will be presented as well as analyses of observed parent-child interactions and parenting stress. 

Conclusions: Preliminary data suggest that the TSC intervention may be effective when delivered by community providers, and highlight the importance of community effectiveness studies. This study offers methodological strengths (e.g., service-as-usual comparison group, follow-up data) relative to existing studies examining community-delivered interventions. While preliminary, results suggest that children in the intervention condition demonstrate improvement in communication and a trend towards improvement in social skills relative to children in the comparison condition. This type of study is particularly important as the number of children with ASD served in community settings increases.