Explore the vast range of titles available.

Parent training programs focus on parent knowledge and/or skill development regarding strategies to improve child outcomes. Parent training programs are considered evidenced-based treatments for autism spectrum disorder (ASD). Yet little is known about parent training use for youth with ASD served in community settings. This mixed methods project examined parent training for Medicaid-enrolled youth with ASD under age 21. Data were obtained from Medicaid claims for 879 youth and surveys from 97 applied behavior analysis (ABA) providers. Open-ended survey items were analyzed with content analysis. Results demonstrated that the frequency of parent training was low and providers’ conceptualization of parent training was inconsistent with evidence-based models. Providers are largely unaware of evidence-based components (i.e., modeling, caregiver practice with feedback) and use them infrequently. Implications for increasing parent training in community settings are discussed.

Little is known about the effectiveness of caregiver-mediated naturalistic developmental behavioral interventions (NDBIs) implemented via telehealth for autistic children served in under-resourced settings. This mixed methods pilot study examined social communication outcomes for autistic children whose families received a caregiver-mediated NDBI in a community mental health setting. Twenty-one families of Medicaid-enrolled autistic children aged 2–6 received Project ImPACT (a caregiver-mediated NDBI) via telehealth. Caregivers completed the Autism Impact Measure at 5 timepoints. We fit three, 2-level multilevel models to estimate the effect of time (weeks of Project ImPACT), child age (mean-centered), and the interaction of time x age on the Autism Impact Measure domains of Communication, Social Reciprocity, and Peer Interaction. Six caregivers completed follow-up interviews, which were analyzed using the framework method. There were statistically significant decreases in caregiver-reported peer interaction challenges. Decreases in communication challenges approached statistical significance. Scores for social reciprocity challenges did not significantly change over time. Six qualitative themes centered around how the child- and family-centered aspects of the NDBI strategies led to improvements in the children’s social communication outcomes and suggestions for improving Project ImPACT. Preliminary findings suggest that NDBIs may be feasible and potentially effective in under-resourced settings.

Objectives The theory of planned behavior (TPB) suggests that attitudes, subjective norms, and perceived behavioral control influence intentions to perform a behavior, and that intentions predict behavior. The present studies examined whether the TPB is applicable to community providers’ use of a parent-mediated intervention for children with autism spectrum disorder (ASD) following introductory training and whether TPB constructs can be modified with training. Results Study 1 demonstrated that community providers’ intentions to use the intervention post-training predicted their use of the intervention 6 months later [X 2 (1) = 8.03, p = .005]. Study 2 found that provider education (β = .23, t = 2.27, p = .025), attitudes (β = .21, t = 2.09, p = .039), and perceived behavioral control (β = .21, t = 2.15, p = .035) were all unique predictors of intentions. There was a significant increase in providers’ ratings of subjective norms (Z = − 2.46, p = .014) and perceived behavioral control (Z = − 7.36, p < .001) from pre- to post-training. Attitudes towards parent-mediated interventions were highly favorable pre-training and did not significantly increase. Results expand on previous findings and demonstrate the applicability of attitudes and perceived behavioral control in understanding community providers’ use of evidence-based practices for children with ASD.

The purpose of this review was to estimate the impact of parent engagement strategies tested with underrepresented families of young children with social, emotional, or behavioral disorders, and describe the combinations in which these strategies are commonly used together. We conducted a systematic review using the PracticeWise Engagement Coding System to identify which strategies had the strongest empirical support for engaging underrepresented (i.e., minority race or ethnicity, or low income) families receiving psychosocial services for their children. Social network analyses were used to identify the frequency of strategy use and how strategies were combined to engage underrepresented families. Linear regression was used to estimate the impact of each strategy on parent engagement, using attrition as a proxy for non-engagement. Thirty-five studies met inclusion criteria. Parent attrition was predicted by larger sample sizes, lower maternal education, interventions that were more community or home-based, less therapist monitoring, positive reinforcement from therapists, and more pairing families with peers. Social network analyses suggested that more effective strategies were more frequently implemented alone and less effective strategies were commonly combined with each other. Our findings suggest that researchers and practitioners require guidance in selecting engagement strategies to reduce attrition of underrepresented families in treatment. Although we identified promising strategies for improving parent engagement in treatment for underrepresented children with social, emotional, or behavioral disorders, the frequent combining of engagement strategies in research means that there is little data on the independent effects of interventions to increase parent engagement for this population.

Purpose Although there is growing interest in telehealth to deliver parent-mediated intervention for autistic children, empirical evaluations are limited, and little is known regarding the relative benefits of self-directed and therapist-assisted telehealth interventions. This study examined the effect of self-directed and therapist-assisted ImPACT Online on parent learning and well-being, moderators of treatment, and predictors of program engagement. Method Sixty-four young autistic children and their primary caregiver participated. Children were matched on age and developmental quotient and randomly assigned to a therapist-assisted, self-directed, or resource support control group. Participants were assessed at intake, after 6 months (post), and at a 3-month follow-up. Results There was a significant treatment effect for parent learning for the therapist-assisted but not self-directed program; when analysis was limited to parents who completed the program, treatment effects were observed for both groups. There were no treatment effects for parent self-efficacy or parenting stress; however, there was an effect on parents’ perception of their child’s positive impact. Parenting stress did not moderate the effect of group on parent outcomes. Parent age, program satisfaction, and therapist assistance were all significant predictors of parent program engagement. Conclusion This study supports the efficacy of therapist-assisted telehealth parent-mediated intervention for teaching parents intervention strategies to support their child’s social communication and improving their perceptions of their child’s positive impact, and suggests that self-directed programs may be beneficial for parents who fully engage with the program.

Decades of research have established that racial ethnic minority, low-income, and/or non-English speaking children with autism spectrum disorder (ASD) are diagnosed later than white children, and their families experience greater difficulty accessing services in the USA. Delayed access to timely diagnosis and early intervention may impact child outcomes and family quality of life. Despite their cognition of these disparities and their significant impact on the lives of those affected, explanations for the barriers experienced by underserved families are elusive, likely due to the complex interaction between structural and family factors. This study used qualitative methods to gather family and provider perspectives of perceived barriers and facilitators to obtaining an ASD diagnosis and accessing ASD-related services for underserved families. Themes from focus groups and interviews with families from three cultural groups (black, Hispanic/Latino, and Korean) and three primary languages (English, Korean, and Spanish) highlight specific barriers related to family, community, and systemic challenges as well as facilitators to accessing care for these populations. Family experiences are expanded upon with viewpoints from the providers who work with them. Recommendations are made for reducing disparities in the existing ASD service system including increasing professional, family, and community education; increasing culturally responsive care; improving provider-family partnerships; and addressing practical challenges to service access.

Parent training, in which providers train parents to address their child's maladaptive behavior or skill development, is an underutilized evidenced-based treatment for autism spectrum disorder (ASD). This mixed methods project examined the use of parent training as part of the Michigan Medicaid Autism Benefit, which covers applied behavior analysis (ABA) services for Medicaid-enrolled children with ASD under age 21 in Michigan. Descriptive statistics and multiple regression were used to analyze Medicaid claims data for 879 children and survey data from 97 ABA providers who service Medicaid-enrolled children with ASD. Content analysis was used to analyze open-ended survey items and phenomenological analysis was used to analyze interviews from a subset of 13 providers. Results demonstrated that: a) frequency of parent training encounters was very low, with evidence to suggest that Hispanic/Latino children receive fewer encounters; b) ABA providers' conceptualization of parent training is inconsistent with the literature; c) providers report using evidence-based parent training strategies at a moderate-to-high level on the survey, but infrequently mention strategies in interviews; d) providers use sessions for other purposes; e) providers report having limited related training; f) providers report numerous barriers and facilitators which are related to their reported extensiveness of parent training; and g) parent training and family-centered care are significantly related. Implications for increasing use of parent training for this population are discussed.

Please note that the middle name of coauthor Francisco Reinosa Segovia was misspelled (as \"Rienosa\") is this article as originally published.Please note that the middle name of coauthor Francisco Reinosa Segovia was misspelled (as \"Rienosa\") is this article as originally published.