Examining Coaching Outcomes in the Social ABCs Parent-Mediated Intervention

Poster Presentation
Thursday, May 2, 2019: 5:30 PM-7:00 PM
Room: 710 (Palais des congres de Montreal)
E. M. Dowds1, A. Solish2, T. McCormick3, S. Macwilliam4, L. Zwaigenbaum5, S. E. Bryson6 and J. A. Brian2, (1)Autism Research Centre, Holland Bloorview Kids Rehabilitation Hospital-Autism Research Centre, Burlington, ON, Canada, (2)Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada, (3)IWK Health Centre, Halifax, NS, CANADA, (4)IWK HEALTH CENTRE, HALIFAX, NS, CANADA, (5)University of Alberta, Edmonton, AB, Canada, (6)Dalhousie University, Halifax, NS, Canada
Background: The Social ABCs is a parent-mediated intervention (Brian et al., 2016; 2017) based on empirically supported Pivotal Response Treatment (PRT; Koegel & Koegel, 2006). The main targets of the Social ABCs are functional early (vocal/verbal) communication and positive affect sharing between child and caregiver for infants/toddlers who have suspected or diagnosed Autism Spectrum Disorder (ASD).

Objectives: The present study examines the training for Social ABCs parent coaches with a focus on the training of parent coaches across multiple Canadian sites in both research and clinical contexts. We present data on the consistency of coaching fidelity across training sites, and highlight that the success of training coaches, will increase community capacity for implementation.

Methods: Our team has trained a total of 15 coaches, with a range of educational, clinical, and research backgrounds, across 4 major Canadian cities in 3 provinces; Toronto and Hamilton (Ontario), Halifax (Nova Scotia), and Edmonton (Alberta). From this population of coaches, we have 3 identified trained-trainers, and 3 trained supervisors who are PhD-level clinical psychologists. Using video-coded indices, fidelity of the parent coaches has been analyzed using (1) a measure of coaching fidelity across 3 separate parent/child dyads and (2) fidelity of parent implementation for 3 separate parent/child dyads, across 15 coaches. The parents’ implementation served as a proxy measure for the overall success of the coaches’ skill level.

Results: Coaching fidelity and parent implementation fidelity were consistently high across research sites, and slightly higher in the community cohort of coaches, with parent fidelity ranging from 80-100% by week 12 of the intervention, demonstrating that the coaches are highly skilled at training parents in the Social ABCs. The length of time required to train parent coaches has decreased significantly over time. In the Social ABCs pilot study (Brian et al 2016) the training of the first coaches took 1 year of intense supervision until independent coaching began. Currently, training takes half the time (about 6 months), a training process which has been maintained from our initial Randomized Control Trial (Brian et al., 2017). This has remained as a successful model for training within a large community demonstration project currently underway. More recently, in a group-based clinic-delivery model, our team has trained two experienced Speech-Language Pathologists to provide parent-coaching in a shorter, 3-month period.

Conclusions: We define coaching within the Social ABCs as providing live, moment-to-moment, positive coaching strategies. These positive strategies are defined as the verbal acknowledgement of correct in-the-moment behaviours exhibited by the caregivers with the child, and setting families up for success in using the techniques. It is this positive coaching which supports caregivers in learning the Social ABCs strategies. All 15 parent coaches have achieved a high level of coaching fidelity across research sites and community settings. Our increased efficiency in training coaches contributes to the feasibility and sustainability of this model.