Building Community Capacity for Evidence-Based, Parent-Mediated Early Intervention: Effectiveness of a Train-the-Trainer Approach
Objectives: The objective of this presentation is to demonstrate training outcomes from a train-the-trainer study of an evidence-based, parent-mediated NDBI for community early interventionists (Project ImPACT for Toddlers or PI for T; Ingersoll & Dvortscak, 2010).
Methods: A multiple probe design was used to examine effectiveness of the training model. Fourteen leaders from 12 publicly-funded community agencies participated. Agencies included school-based early intervention (N=2), infant and early childhood services (N=6), speech language (N=1), ASD specific agencies (N=1) and a Children’s Hospital ASD clinic (N=1), and family health programs (N=1). Agency leaders received 12 weeks of training in PI for T from the research team. Leaders were trained in groups of 4-5, per the multiple probe design. After agency leader training was complete, each leader returned to their individual agency to deliver training to 2-3 interventionists (45 providers total). Intervention fidelity in PI for T was measured across the training period (before, during and after) at multiple time points. A total of nineteen fidelity criteria were rated on a 1-5 scale, where 1 = does not implement and 5 = implements competently and consistently.
Results: Agency leaders (n=14, 100%) were successfully delivered training at their agencies, utilizing both online (n=3) and in-person approaches (n=11). Intervention fidelity data are variable but demonstrate growth for strategies that providers were not implementing at baseline. On average, providers were using 21% of strategies correctly at baseline strategies (M=3.5 or above), including limiting distractions in the environment (baseline M = 4.1) and adjusting animation (baseline M=3.6). After training, on average, providers were using 74% of strategies correctly; waiting for a child response (baseline M=3.2, post-training M=3.8) and making comments/avoiding questions (baseline M=3.3, post-training M=4) demonstrated the most change. Specific support for sustainment beyond the training period (e.g., assistance securing public funding) facilitated agencies’ continued use of the approach. Differences in post-training fidelity based on provider and agency characteristics will also be explored.
Conclusions: A train the trainer model is an effective method to build community capacity for evidence-based early intervention across a range of service settings. It may be possible to deliver training more efficiently by tailoring training to gaps in provider knowledge.