The Autism Research Program (ARP) Idea Award calls for high-impact, innovative research that leads to improved quality of life for individuals with autism spectrum disorders (ASD). Research indicates that early and intensive intervention can lead to significant improvement in long-term outcomes for children with ASD. However, the growing numbers of young children with ASD and their significant educational needs make it a challenge for public agencies to provide services at the needed level of intensity. Parent training is a cost-effective approach to intervention that can improve child outcomes by increasing the number of hours of intervention a child with ASD receives. Parent training has also been shown to decrease parent stress and depression. Although parent training is considered an essential component of early intervention programs for children with ASD, it is rarely provided in community-based early intervention settings due to a lack of appropriately trained providers. Further, effective parent training programs for children with ASD require frequent parent coaching by a therapist. Thus, the absence of reliable transportation, lack of child care, cost of treatment, and limited flexibility in scheduling, can significantly affect access to these services. These barriers are particularly a problem in rural and underserved areas. The development of more sophisticated technology has created the opportunity for distance learning of intervention strategies. Thus, the objective of this project is to develop and pilot an internet delivered parent training program for caregivers of children with ASD. The intervention will be based on an evidence-based curriculum that uses a blend of developmental and behavioral intervention strategies during daily routines and activities.
This project has two aims. First, we will modify an existing evidence-based parent training curriculum so that it can be delivered over the internet. During this phase, we will create 12 self-administered modules containing the intervention content that can be presented over the internet with remote, video-based parent coaching. Throughout this process, we will obtain information on the structure of the program by conducting a series of 2 focus groups with parents, intervention providers, and program administrators, and will incorporate this feedback into the final program. Second, we will conduct a pilot study of the experimental intervention vs. usual care with 30 families in preparation for a clinical trial. We will conduct pre-treatment assessments, randomly assign families to treatment (n=15) or usual care (n=15), and reassess parent and child behavior at post-treatment. We will examine the effect of the intervention on parent use of the intervention strategies, treatment compliance, treatment acceptability, and parent satisfaction. We will also examine the effect of the program on child language, play, and social engagement. Finally, we will examine changes in parent stress, depression, and sense of competence. This proposal addresses the ARP identified research needs by using a highly innovative treatment approach to target ASD-specific deficits in social communication. We expect that the results will reveal that internet-based instruction in an evidence-based parent training intervention will lead to better social-communication skills for young children with ASD, and will lead to decreased parent stress and depression and increased parent feelings of competence. The distance learning aspect of the treatment is ideal for improving dissemination of evidence-based intervention practices, particularly for rural and/underserved populations.