Symposia
Treatment - Other
Katherine Pickard, Ph.D.
Assistant Professor
Emory University School of Medicine
Atlanta, Georgia
Nicole Hendrix, Ph.D.
Assistant Professor
Emory School of Medicine, Department of Pediatrics, Division of Autism and Related Disabilities
Atlanta, Georgia
Natalie Brane, M.S.
Speech Pathologist
Children's Healthcare of Atlanta
Atlanta, Georgia
Karen Guerra, M.S.
Speech-Language Pathologist
Children's Healthcare of Atlanta
Atlanta, Georgia
Kathryn Ulven Hopkins, M.S.
Speech-Language Pathologist
Children's Healthcare of Atlanta
Atlanta, Georgia
Objective: As knowledge of efficacious interventions for autistic children evolves, it is critical to understand factors that impact service engagement. Parent-mediated interventions (PMIs) have been linked with increases in social communication outcomes for young autistic children, yet high rates of attrition are observed when PMIs are implemented in underserved community settings (Kasari et al., 2015). One way to increase the engagement of marginalized communities may be to understand how PMI is able to be flexibly implemented such that it is responsive to the complex needs of families. Although intervention adaptation is inevitable within community settings (Chambers & Norton, 2016), including in response to patient needs (Kim et al., 2020), very little research has examined the relationship between PMI adaptation, treatment engagment, and treatment outcomes. The current study aimed to address this gap by examining adaptation of an evidence-based PMI—Project ImPACT (Ingersoll & Dvortcsak, 2019)— within an outpatient setting.
Methods: Data collection is ongoing within a children’s hospital in a major metropolitan area serving primarily Medicaid populations. Participants were families of children between the ages of 12 and 40 months (M = 28.5 months) at risk for or diagnosed with autism participating in an outpatient model using Project ImPACT. Following each session, clinicians documented and described any adaptation to the Project ImPACT curriculum. Responses were coded using the Augmenting and Reducing adaptations framework (Lau et al., 2017). Regression analyses were modeled to examine relationships between race/ethnicity, reported Augmenting/Reducing adaptations, treatment attendance, and goal attainment.
Results: Preliminary data from 45 families suggest that the presence of Reducing adaptations predicted an increased number of Project ImPACT sessions attended (b = -0.15, t(38) = 2.23, p = .03). Additionally, the presence of Augmenting adaptations predicted increased goal attainment (t(42) = 2.59, p = .01). Results from a larger sample will be presented, as well as data from qualitative interviews describing the types of adaptations made and their rationale.
Conclusion: This study presents preliminary data on adaptations that take place within an outpatient setting to an evidence-based PMI. Preliminary findings suggest that responsive PMI adaptation may increase family engagement.