(PS9-39) Social Validity of Caregiver-implemented Reciprocal Imitation Teaching in Young Children with Social Communication Delays: A Caregiver-informed Qualitative Study

Social validity is important to consider in the selection and implementation of evidence-based practices. Social validity is multifaceted and includes domains such as intervention effectiveness, importance, feasibility, safety, appropriateness of treatment goals, and usability. Although best practices for young children with or at a high-likelihood for autism are naturalistic and emphasize parent involvement, the complexity of naturalistic developmental behavioral interventions (NDBIs) may render them difficult to integrate, adhere to, and sustain within home and community-based settings. Caregiver-implemented Reciprocal Imitation Teaching (CI-RIT) is a parent-mediated NDBI for children with social communication delays that has been associated with improvement in communication, symbolic play, and social-emotional functioning. This qualitative study evaluated caregivers’ perceptions of the social validity of CI-RIT as implemented in the Part C Early Intervention (EI) system in the context of a hybrid implementation-effectiveness trial. Parents of children with social communication delays (N=19) from four states (MA, MI, IL, WA) who completed CI-RIT with their EI provider participated in a semi-structured interview about their goals and experiences with CI-RIT in their daily lives. Data were analyzed using Rapid Qualitative Coding methods, which involved summarizing study transcripts, creation of a data matrix, and development of themes. Two team members independently derived themes which were subsequently revised iteratively through group discussion. We identified three major themes: (1) Family Motivation, (2) Implementation and Perceived Effectiveness, and (3) Usability. Regarding Family Motivation, caregivers reported a strong alignment between their goals for their children and CI-RIT intervention goals (e.g., communication, social skills). Caregivers also reported developing skills to support their child’s engagement (e.g., enthusiasm, imitation, modeling). Factors influencing the Implementation and Perceived Effectiveness of CI-RIT included the child and caregiver’s mood and current needs (e.g., implementation challenges when the child is tired or hungry), and barriers in the family’s daily schedule or timing of CI-RIT. Caregivers also reported learning many skills that were perceived as effective for their children such as following the child’s lead during play and being intentional in their communication with their child (e.g., getting on the child’s level, being enthusiastic, having patience with their child). In terms of Usability, 17/19 caregivers reported ongoing CI-RIT use post-intervention, both in play and in daily activities (e.g., feeding, on walks, dressing). Study limitations include a small sample and narrow focus on only a few domains of social validity. To gain a more nuanced understanding of social validity, next steps will include mixed methods integration of our qualitative data with quantitative survey data, which will capture additional social validity domains from a larger sample. CI-RIT as delivered in the Part C EI system appears to be socially meaningful, applicable, and perceived as effective for families of children with social communication delays.