Project Activities
Research plan
The research aims included (1) examining EI providers' current use of coaching when working with caregivers of young children with ASD; (2) identifying barriers and facilitators to using caregiver coaching in Part C service systems; (3) partnering with community stakeholders (EI agency leaders, providers, and caregivers) to develop a toolkit of implementation strategies to improve the use of caregiver coaching by EI providers; and (4) pilot testing the feasibility, promise, and acceptability of the implementation toolkit with dyads of EI providers and caregivers of children with or at risk for ASD. The aims were addressed through four phases. In phase 1, the PI conducted observations of Part C intervention sessions to examine how EI providers coach caregivers of children with ASD. During phase 2, the PI used semi-structured interviews and validated questionnaires with EI providers, caregivers, and agency leaders to identify barriers and facilitators to provider implementation of caregiver coaching. In phase 3, the PI partnered with a community advisory board to iteratively develop a toolkit of implementation strategies that addresses identified barriers and supports to improve EI provider implementation of caregiver coaching. Finally, in phase 4, the PI pilot tested the implementation strategy toolkit using a multiple-baseline single-case design to determine its feasibility and promise for improving EI providers' use of caregiver coaching, caregivers' use of the strategies taught in Project IMPACT, and children's communication outcomes. Observational data was analyzed using a validated coding system. Interview data was coded and mixed methods approaches were used to integrate findings with those from quantitative measures and observations. Visual analysis was conducted and effect sizes were calculated to analyze data from the pilot study.
Career plan
Through a career development plan, the PI (1) expanded knowledge of coaching strategies for caregivers of young children; (2) gained expertise in mixed-methods research; (3) gained in-depth understanding of community-partnered participatory research and implementation science; and (4) developed competitive grant proposals. To accomplish these goals, the PI engaged in monthly meetings with mentors; courses; seminars; conferences; training institutes on research methods, statistical techniques, and implementation science; and grant-writing workshops.
Key outcomes
The main findings of this project, as reported by the PI, are as follows:
- Observations of usual Part C early intervention sessions indicated that EI providers implemented caregiver coaching strategies with low fidelity and that fidelity varied across providers and components of caregiver coaching.
- Findings from the qualitative inquiry identified specific barriers and facilitators to the use of caregiver coaching in Part C early intervention. Providers identified poor self-efficacy, lack of training, lack of cohesion and communication among service providers working with the same child, misperceptions of parents’ preferences for child-directed intervention, and providers’ beliefs about the fit of coaching with certain families. Importantly, providers identified social and structural factors, including perceived family characteristics and stigma, that influenced their beliefs about the fit of coaching with families from structurally marginalized groups.
- The community-partnered toolkit development process led to the development of the Parent Empowerment and Coaching in Early Intervention (PEACE) toolkit. PEACE is a modular toolkit of strategies including an online resource library of self-paced modules, videos, infographics, and tip sheets; a virtual chat space to improve collaboration and cohesion among providers; and facilitation meetings to engage providers in reflection, problem-solving, and direct feedback about their use of caregiver coaching.
- Findings from the pilot test indicated that the toolkit showed promise for improving EI providers’ overall fidelity to the core components of caregiver coaching following introduction of the PEACE toolkit. Providers rated the toolkit as highly acceptable and feasible. Caregivers demonstrated moderate growth in their use of supportive parenting techniques and slight improvements in children’s social-emotional reciprocity and restrictive and repetitive behavior were observed.
People and institutions involved
IES program contact(s)
Project contributors
Products and publications
Publications:
ERIC Citations: Find available citations in ERIC for this award here.
Additional project information
Additional Resources
Inside IES Research Blog: Autism Awareness & Acceptance Month
Questions about this project?
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