(PS4-66) Role of Stress and Access on Fidelity and Attendance Within Parent-mediated Intervention

Parents of young autistic children report consistently higher stress than parents of children without autism spectrum disorder (e.g., Hayes & Watson, 2013). The role of parent stress on treatment outcomes remains understudied, despite evidence that stress has varying influences on child intervention outcomes (DesChamps et al., 2020) and parent-child interactions (Loncarevic et al., 2023). It is then necessary to explore parent characteristics at the initiation of parent-mediated interventions and how these may influence parent and child treatment outcomes. This study occurred alongside standard clinical care provided within an outpatient clinic in a large children’s hospital. Participants included young autistic children and children with social communication delays (Mage = 37.48 months; SD = 7.87; range: 21-51). Clinical services centered on use of Project ImPACT (Ingersoll & Dvortcsak, 2019) within a 12- to 15-week model. Families completed the 10-item Perceived Stress Scale (PSS; Cohen & Williamson, 1988) and Social Communication Checklist (SCC; Ingersoll & Dvortcsak, 2019) prior to treatment. Scores of the PSS are interpreted as low: 0-13; moderate: 14-26; and high: 27-40. The SCC was also completed following treatment, and attendance was tracked using the electronic medical record. An initial sample of 27 parents who completed Project ImPACT with their young child reported moderate stress prior to treatment (M = 20; SD = 3.40). Preliminary regression analyses were conducted with parent stress and insurance type (public or private) as predictors for average parent change in fidelity from first to last coaching session and for parent attendance. Caregiver stress was marginally predictive of parent change in fidelity, F(1, 24) = 3.54, p = .073, but not attendance, F(1, 24) = .95, p = .34. Parent stress was also not predictive of child social engagement and communication outcomes when controlling for child skill prior to intervention, ps > .05. Data collection is ongoing with 80 additional families. Considering parent characteristics at the initiation of early autism services can have great impacts on clinical decision-making and guide adaptations to coaching around parent-mediated interventions.