(PS12-96) In-person vs Telehealth: Examining the Use of Caregiver Coaching Strategies in the Part C Early Intervention System

Abstract Text: Caregiver coaching is best practice in early intervention (EI) for young children with autism. While services in the Part C EI system have traditionally been conducted in-person, there has been an increase in telehealth in recent years. It is important to understand how delivering EI services in person or over telehealth influences service delivery in the Part C EI system, particularly the use of caregiver coaching. This study sought to characterize the use of caregiver coaching conducted via telehealth (TH) vs in-person (IP) in the Part C Early Intervention system. 134 Part C EI providers were recruited from 4 states to participate in a hybrid community-effectiveness trial of a caregiver-coached intervention for children with early signs of autism (RISE study). Baseline provider surveys assessed providers’ current use of coaching strategies, percent of their caseload that is IP vs. TH, and percent breakdowns of how much time they typically spend in different activities with the caregiver and child during a typical IP vs TH session. Providers’ sessions with families were coded with the Parent Empowerment And Coaching in Early Intervention (PEACE) Caregiver Coaching Fidelity Tool (Pellecchia et al., 2023) to evaluate the quality of their use of 4 coaching strategies: Collaboration, Demonstration, In-Vivo Feedback, and Reflection & Problem Solving. Three-level multi-level modeling was used to analyze how session type affects the quality of the 4 coaching strategy categories. Analyses included 238 videotaped in-person EI sessions and 42 telehealth sessions. During IP sessions, providers reported a greater percent of time working directly with the child (M=35.98, SD=22.73) than TH sessions (M=8.51, SD=11.66), t(90) = 12.20, p< .001. During TH sessions, providers reported a greater percent of time coaching the parent (IP: M=32.35, SD=21.15; TH: M=39.55, SD=24.09), t(90)= -2.59, p=.01, talking to the parent about the child (IP: M=18.68, SD=10.87; TH: M=32.81, SD=22.13), t(90) = -6.56, p< .001, and talking to the parent about parenting and other family issues (IP: M=12.44, SD=8.45; TH: M=15.23, SD=11.27), t(90)= -2.43, p=.02, than IP sessions. There was also a positive correlation between the percent of the providers’ caseload that is TH and their reported use of coaching strategies, r(134) =.21, p< .05. Additionally, observed quality of Collaboration was significantly higher in TH than IP sessions t (148) = 2.95, b = .41, p=.004, which aligns with the self-reported data. No significant differences were found in the quality of other coaching strategies between IP and TH sessions. The use and quality of caregiver coaching appears to differ in IP and TH sessions, with a greater use of coaching, communication, and collaboration with the caregiver in TH compared to IP sessions.