Creating Sustainable Systems of Support for Toddlers at Risk for ASD: Caregiver Perceptions and Knowledge Acquisition

Background: According to the National Research Council (2001), early detection and 25 hours per week of active engagement promotes optimal success for young children with autism spectrum disorder (ASD) in kindergarten. Evidence-based practices such as naturalistic and parent-implemented interventions have been identified as “established treatments” for individuals with ASD (Wong et al., 2014; National Standards Project, 2015). Although most research in ASD treatment has focused on clinician-based interventions, there has been increased focus on parent-mediated interventions, as parents are the most community-viable agents of change for children at risk for ASD (U.S. Department of Health & Human Services, U.S. DOE, 2014). However, there remains a scarcity of research on the relationship between parents’ ability to provide supports to promote active engagement and their own perceptions of comfort level.

Objectives: This ongoing project aims to increase knowledge of adult-learning strategies, early red flags for ASD, and supports to promote active engagement for toddlers at risk for ASD by improving collaborative coaching proficiencies of early intervention providers (EIPs) across Georgia. This investigation will focus on the relationship between caregivers’ self-reported comfort and confidence in providing supports and actual level of supports provided.

 Methods: This study is tracking the progress of 19 EIPs across Georgia, coached to coach caregivers on increasing active engagement in toddlers at risk for ASD. Coaching of EIPs is conducted in-person quarterly, with all other weekly coaching sessions occurring via technology. Effectiveness of the coach-the-coach model is assessed using SEE-KS™ (Rubin, E. et al., 2014) three-point rating scales to measure caregiver-provided supports. SEE-KS™ is a coaching framework based on Universal Design for Learning encompassing the principals of SCERTS® (Prizant et al., 2005).

 Results: SEE-KS™ and Caregiver Survey values were summarized at pre- and post-coaching time points for families using means and standard deviations. Paired t-tests were employed to gauge the change in each measure for statistical significance. Results from the SEE-KS™ indicate a significant increase from baseline in supports provided by caregivers to foster engagement (p<0.001) and to support understanding (p<0.001) and expression (p<0.001) during the project (see Table 1). No significant changes were seen from baseline in caregiver self-reported comfort and confidence (p=0.545) (see Table 1).

Conclusions: Though no significant changes were seen in caregiver comfort before and after coaching, data indicate high caregiver comfort and confidence throughout the coaching process. These data also show that the current coach-the-coach model resulted in significantly increased caregiver-provided supports to promote engagement, understanding, and expression in toddlers at risk for ASD.