The Impact of Community-Implemented Esdm on Parents' Ratings of Parenting Reward and Providers' Sense of Competence

Poster Presentation
Thursday, May 2, 2019: 5:30 PM-7:00 PM
Room: 710 (Palais des congres de Montreal)
M. R. Talbott1, G. S. Young2, M. E. Miller1, A. C. Stahmer1 and S. Rogers3, (1)Psychiatry and Behavioral Sciences, University of California at Davis MIND Institute, Sacramento, CA, (2)Psychiatry and Behavioral Sciences, University of California at Davis, MIND Institute, Sacramento, CA, (3)Department of Psychiatry and Behavioral Sciences, The Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, UC Davis School of Medicine, University of California Davis, Sacramento, CA

Background: Infants and toddlers at-risk for ASD frequently receive early intervention through federally regulated Part C services, which typically address family needs and general developmental and heath needs of children via transdisciplinary assessment and parent guidance, rather than disability-specific interventions. While research studies have demonstrated positive effects for parent-implemented ASD-specific interventions, none of these empirically supported approaches have been adapted and tested in existing community Part C service systems. A randomized controlled trial analyzing the efficacy of one such model, Community-Early Start Denver Model (C-ESDM), is currently underway to fill this gap. Here, we examine the effects of this model on the providers receiving training and on the families being served.

Objectives: To evaluate the effects of C-ESDM on 1) parents’ ratings of parenting reward and child developmental progress, and 2) community-based early intervention providers’ sense of competence.

Methods: Agencies and providers serving toddlers at-risk for ASD in low resource communities were recruited across 4 states: Alabama, California, Colorado, and Pennsylvania. Participating providers assisted with recruitment of families on their caseload. Agencies were randomly assigned to receive training in C-ESDM or a general developmental education program. The research team used telehealth to disseminate intervention materials to providers in both groups. Training consisted of: (1) provider webinars (general review of child development for the control group and training in C-ESDM strategies and autism for the experimental group); and (2) access to web-based materials for families (videos describing strategies to encourage general child development across domain areas for control group or a smartphone app, called Help is in Your Hands with multimodal materials to help parents implement key features of the C-ESDM at home). At intake and exit (6 months), providers completed a Sense of Competence Scale (PSOC) and parents completed Ratings of Parenting Reward (RPR) and Parent Rating of Child Progress (PRCP).

Results: To date, 32 providers (19 C-ESDM) and 33 parents (19 C-ESDM) have completed data for at least one time point (Provider: T1 n = 31; T2 n = 9; Parent: T1 n = 31; T2 n = 9). Preliminary findings suggest no differences between the randomization groups at baseline on any measure (PSOC, RPR, PRCP, all p’s >.4). There are no significant main effects of time for any measure (all p’s >.1), but non-significant differences between the groups over time in the expected direction (more positive improvements for C-ESDM group) are observed for the PSOC and PRCP measures. Time 2 data are expected to be available for all 32 providers and 33 families prior to the meeting.

Conclusions: These preliminary findings highlight the need to consider the effects on practitioners and parents when adapting laboratory-based empirically-validated interventions for use in existing early intervention service systems. Positive effects of an adapted intervention on providers and parents will support implementation and sustainment of evidence-based strategies in the community.