Family Capacity Building through Parent-Mediated Intervention for Children with Autism

Background: Research and current policy has highlighted the importance of supporting families and building family capacity to support the learning of children with autism spectrum disorder (ASD; Carter et al., 2009; IDEA, 2004). Parents who deliver intervention reported reduced stress and increased confidence in parenting a child with ASD (Woods and Brown, 2011). However, few studies have assessed parent learning and these effects on child outcomes. The aim of this study was to examine parent outcomes from the Joint Attention Mediated Learning (JAML) intervention. JAML was designed to improve preverbal social communication for toddlers with ASD through parent-mediated play-based interaction (Schertz, Odom, Baggett, & Sideris, 2018).

Objectives: To determine differences between intervention and control groups in parents’ use of mediated learning principles and in parent-child social engagement

Methods: Intervention Coordinators (ICs) conducted weekly 1-hour home-based sessions with parents for 32 weeks. The ICs facilitated parents’ learning of five mediated learning principles: focusing on social interaction (FO), organizing/planning for engagement (OP), encouraging self-reliance (EN), giving meaning and promoting motivation for engagement (GM), and expanding engagement across environments. Each week parents received conceptual guidance on the use of principles to promote child learning based on the child’s current targeted outcome. This guidance included “Ideas Other Parents Have Used” in verbal and written forms and with video examples of other parents applying the principles. Further, ICs guided parent reflection on their use of the principles by reviewing videos of parent-child interaction. Control group participants were not exposed to the intervention until after post-intervention data were collected.

A total of 58 parent-child dyads from the larger three-site JAML study (the first 20 participants from each site minus two with missing data) were included in this study. Toddlers aged 30 months or younger who met ASD criteria were randomly assigned in pairs within sites to experimental or control groups. The Mediation of Social and Transactional Engagement Measure (MOSTE; Schertz & Horn, 2018, unpublished) was used to assess FO, OP, GM, and EN, parent and child demeanor/affect (PD & CD), and transactional social orienting (SO). Using 10-minute parent-child interaction videos that had been recorded pre- and post-intervention for intervention and control group participants, three independent observers coded 40 15-second intervals for occurrences of targeted outcomes. Inter-rater reliability was established and maintained between coders (kappa=.85). A one-way MANOVA was used to examine the group differences.

Results: No pre-intervention differences were found between groups in FO, OP, EN, GM(d=.11, p=.29). Significant advantages were found for the experimental group in FO, OP, EN, GM and PD (d=.24, p=.01) at post intervention assessments, indicating that parents in the experimental group increased their learning of mediated learning principles. Significant differences also favored the experimental group for SO (d=.14, p=.02) at post intervention assessment.

Conclusions: The results support the usefulness of targeted professional guidance in parent-mediated intervention to help parents build their capacity to mediate child learning. Replication is needed to further validate the effects of JAML or other interventions on parent mediation of child learning and its relation to child outcomes.