Mentors: Seeley, John; Almirall, Daniel; Stormshak, Elizabeth

Purpose: The Principal Investigator (PI) will conduct a program of research to support families of young children with neurodevelopmental disorders while participating in mentoring and training activities to develop knowledge and skills related to implementation science, designs to optimize adaptive interventions and analyze outcomes, and grant writing. Standard home coaching for caregivers focused on children's social communication can lead to gains in children's engagement and communication as well as in caregivers' strategy use; however, this type of coaching is resource intensive and often inaccessible to families in rural communities. Technology-enabled adaptations that provide the most resource intensive services only to those who need them based on individual response to intervention have the potential to conserve resources while increasing access to specialized educational services; however, additional development and testing are needed. The current project will develop a technology-enabled version of an evidence-based caregiver-mediated social communication intervention (JASPER) to be delivered by community-based early educators who are serving families of young children with autism in rural areas.

Research Plan: Following the active implementation framework, the study will progress in three stages. During Stage 1 the PI will establish a core development team of early intervention practitioners and develop initial intervention adaptations to fit the local context. Stage 2 will focus on developing practitioner readiness to implement the intervention, refining fidelity measures specific to the local adaptations, and examining implementation drivers. During this stage, early childhood teachers will participate in field trials and provide feedback on usability. The core development team and caregivers will also complete modules and participate in interviews to provide suggestions for improvement. During Stage 3, the PI will conduct a randomized controlled trial with approximately 80 families to test the feasibility, fidelity, acceptability, and adoption of two initial technology-enabled JASPER caregiver-mediated intervention packages, online and online plus tele-coach as one second stage coaching intervention for slow responders to initial intervention. This stage will also determine the promise of the intervention for improving caregivers' social-communication strategy use and children's joint engagement.

Career Development Plan: Through a career development plan, the PI intends to develop knowledge and skills related to (1) applying implementation science methods and engagement strategies to support intervention adaptation, (2) designing clinical trials to optimize adaptive interventions and analyze outcomes, and (3) developing competitive grant proposals. To achieve these goals, the PI will engage in meetings with mentors, directed readings, workshops on clinical trial design and analysis specific to adaptive interventions, courses and workshops in implementation science, and grant-writing workshops.