2 - (SYM 115) Leveraging Community Partnerships to Develop Implementation Strategies to Support the Use of Caregiver Coaching for Autism

Coaching caregivers to deliver interventions for young autistic children is an evidence-based practice for improving child and family outcomes. Coaching promotes caregivers’ ability to support their child’s development. Infants and toddlers with developmental disabilities, such as autism, are eligible for publicly funded early intervention (EI) services through Part C of the Individuals with Disabilities Education Act. Family-centered care and coaching caregivers are central to the tenets and mandates set forth through Part C. However, observations of community EI sessions repeatedly find that EI providers rarely coach caregivers of young autistic children, especially with families from minoritized and under-resourced backgrounds. There is an urgent need to develop targeted implementation strategies to improve EI providers’ use of caregiver coaching. We used a community-partnered process to develop a toolkit of implementation strategies to improve caregiver coaching in EI. The Parent Empowerment and Coaching in Early Intervention (PEACE) toolkit is a theory-informed, modular toolkit of strategies that map onto identified implementation barriers to caregiver coaching. We identified these strategies through an iterative community partnered process using the Consolidated Framework for Implementation Research to operationalize the implementation barriers, and the Expert Recommendations for Implementing Change taxonomy to identify and map implementation strategies onto those barriers. We conducted a preliminary evaluation of the toolkit’s effectiveness using a non-concurrent multiple baseline design across groups of Part C providers and caregiver-child dyads. We directly observed providers’ caregiver coaching fidelity weekly for twelve weeks and calculated effect sizes for change using the percentage of non-overlapping data (PND) for single case research design (PND range = 64-100%). We assessed changes in caregivers’ use of responsive intervention techniques after twelve weeks, with moderate growth observed. We evaluated providers’ perceptions of the acceptability, appropriateness, and feasibility of the toolkit using standardized measures (mean = 5 out of 5 for all). Findings suggest that a toolkit of implementation strategies developed in partnership with community constituents was acceptable, feasible, led to improvements in caregiver coaching, and shows promise for improving caregivers’ use of supportive parenting techniques in community EI.