Allison L. Wainer

A comparison of three self-report measures of the broader autism phenotype in a non-clinical sample.

Three self-report measures of the broader autism phenotype (BAP) were evaluated in terms of their internal consistency, distribution of scores, factor structure, and criterion-related validity in a non-clinical sample. All measures showed a continuous distribution. The SRS-A and BAPQ showed expected sex differences and were superior to the AQ in terms of internal consistency. The proposed factor structure of the BAPQ replicated better than the proposed structures of the other measures. All measures showed evidence of criterion validity via correlations with related constructs and each measure incremented the others in predicting related constructs. However, the SRS-A and BAPQ were generally stronger in this domain. Recommendations for the use of these instruments for measuring the BAP in non-clinical populations are discussed.

Disseminating ASD interventions: a pilot study of a distance learning program for parents and professionals

There is a need for the adaptation of training in evidence-based interventions to non-traditional methods, particularly for individuals working with children with autism spectrum disorders (ASD). An internet-based self-directed distance learning program was created to teach reciprocal imitation training, a naturalistic behavioral intervention aimed at increasing imitation in children with ASD. A single-subject multiple-baseline design study evaluated the effect of the program on changes in therapist (sample 1) and parent (sample 2) knowledge and behavior, and changes in child behavior. Adult participants improved their knowledge and use of the intervention techniques, and child participants improved their rates of imitation. Results suggest that a self-directed distance learning program may be effective for disseminating evidence-based practices to individuals working with children with ASD.

Increasing Access to an ASD Imitation Intervention Via a Telehealth Parent Training Program

Systematic research focused on developing and improving strategies for the dissemination and implementation of effective ASD services is essential. An innovative and promising area of research is the use of telehealth programs to train parents of children with ASD in intervention techniques. A hybrid telehealth program, combining self-directed internet-based instruction with remote coaching, was created to introduce parents of children with ASD to an imitation intervention. A single-subject multiple-baseline design study evaluated the effect of the program on changes in parent and child behavior. Parents improved in their use of the intervention techniques and their children demonstrated concurrent increases in spontaneous imitation skills. Parents also indicated that the intervention and telehealth service delivery model were acceptable, useable, and effective. Results suggest that this hybrid telehealth program has the potential to increase access to ASD services.

Initial efficacy of project ImPACT: A parent-mediated social communication intervention for young children with ASD

Project ImPACT is a parent-mediated social communication intervention for young children with ASD that was developed in community settings to encourage dissemination. A single-subject, multiple-baseline design was conducted across 8 preschoolers with ASD and their mothers to examine the efficacy of the model for improving parent intervention fidelity and child spontaneous language. Multilevel modeling was used to examine the relationship between parent fidelity and child language within session. All parents increased their use of the intervention techniques. Improvements in spontaneous use of language targets were observed for 6 of the 8 children. There was a significant association between parents’ use of the intervention strategies and their child’s spontaneous language use.

Pilot study of a school-based parent training program for preschoolers with ASD

This study investigated the feasibility and preliminary effectiveness of a parenting training program designed for early intervention and early childhood special education (EI/ESCE) programs serving students with autistic spectrum disorders. Thirteen teachers representing three intermediate school districts implemented the intervention with 27 students and their parents. Eighty-nine percent of families completed the program. From pre- to post-intervention parents improved their use of the treatment strategies and children increased their rate of language during a parent-child interaction in their home. Parents and teachers reported significant gains in child mastery of social-communication skills and teachers, but not parents, reported a significant decrease in social impairment. Parents reported a significant decrease in parenting stress. Both groups rated the intervention highly in regard to treatment acceptability, perceived effectiveness, and usability. Findings suggest that this intervention can be feasibly implemented in public EI/ECSE settings, filling an important gap in services for intervention programs serving children with autistic spectrum disorders.

Comparison of a Self-Directed and Therapist-Assisted Telehealth Parent-Mediated Intervention for Children with ASD: A Pilot RCT

This pilot RCT compared the effect of a self-directed and therapist-assisted telehealth-based parent-mediated intervention for young children with ASD. Families were randomly assigned to a self-directed or therapist-assisted program. Parents in both groups improved their intervention fidelity, self-efficacy, stress, and positive perceptions of their child; however, the therapist-assisted group had greater gains in parent fidelity and positive perceptions of child. Children in both groups improved on language measures, with a trend towards greater gains during a parent–child interaction for the therapist-assisted group. Only the children in the therapist-assisted group improved in social skills. Both models show promise for delivering parent-mediated intervention; however, therapist assistance provided an added benefit for some outcomes. A full-scale comparative efficacy trial is warranted.

The Broader Autism Phenotype and Friendships in Non-clinical Dyads

The broader autism phenotype (BAP) is a set of subclinical traits qualitatively similar to those observed in autism spectrum disorders. The current study sought to elucidate the association between self- and informant-reports of the BAP and friendships, in a non-clinical sample of college student dyads. Self-informant agreement of the BAP and friendship similarity was evaluated, and the Actor-Partner Interdependence Model was used to test how both friends’ BAP characteristics jointly and uniquely contribute to the experiences of friendships. Results suggest self-informant agreement about the BAP, friendship closeness, quality, and conflict. Actor effects were observed for the BAP and friendship values, quality, conflict, and loneliness. Findings suggest that the BAP relates in meaningful ways to self-perceptions of friendship variables in the general population.

A mixed-method evaluation of the feasibility and acceptability of a telehealth-based parent-mediated intervention for children with autism spectrum disorder

Research within the autism spectrum disorder field has called for the use of service delivery models that are able to more efficiently disseminate evidence-based practices into community settings. This study employed telehealth methods in order to deliver an Internet-based, parent training intervention for autism spectrum disorder, ImPACT Online. This study used mixed-methods analysis to create a more thorough understanding of parent experiences likely to influence the adoption and implementation of the program in community settings. Specific research questions included (1) What are parents’ perceptions of the online program? (2) How does ImPACT Online compare to other services that parents are accessing for their children? And (3) Do parents’ experience in, and perceptions of, the program differ based on whether they received a therapist-assisted version of the program? Results from 28 parents of a child with autism spectrum disorder indicate that parents saw improvements in their child’s social communication skills and their own competence during the course of the program, regardless of whether they received therapist assistance. However, qualitative interviews indicate that parents who received therapist assistance were more likely endorse the acceptability and observability of the program. These findings support the potential for Internet-based service delivery to more efficiently disseminate evidence-based parent training interventions for autism spectrum disorder.

Remembering parents in parent-mediated early intervention: An approach to examining impact on parents and families

The goal of this review is to advance the discussion regarding meaningful outcomes of early intervention for children with autism spectrum disorder. The rapid growth in the development and evaluation of early intervention approaches for autism spectrum disorder includes both therapist-driven and parent-mediated interventions. The majority of research on both approaches to early intervention focuses on promoting child outcomes (e.g. language acquisition) with less emphasis on family and parent outcomes (e.g. quality of life, self-efficacy). Given that parent buy-in is essential for parent-mediated interventions to be effective over time, increased attention to family outcomes that are of value to families and have the potential to be impacted positively by these interventions is needed to develop, disseminate, and sustain high-quality interventions in community settings. In this review, we draw from work on parent and family outcomes targeted in related fields (e.g. Part C early intervention, pediatric chronic illness, behavior management parent training) that we propose are particularly relevant for evaluating the impact of parent-mediated interventions in early intervention for autism spectrum disorder.

Understanding the Landscape of Psychosocial Intervention Practices for Social, Emotional, and Behavioral Challenges in Youth With ASD: A Study Protocol

ABSTRACT Introduction: There is a significant gap between research and practice for mental health services for youth with autism spectrum disorder (ASD). Despite increased numbers of individuals with ASD treated in community settings, little is known about the array of practices used with this population and the extent to which providers are aware of and use evidence-based strategies. The goal of this article is to describe a protocol for developing a more comprehensive understanding of the landscape of current intervention practices and attitudes regarding the treatment of psychosocial issues in youth with ASD in community settings within the United States. Methods: This article describes our research protocol for developing a comprehensive survey—the Usual Care for Autism Survey (UCAS)—to capture the depth and breadth of practices for youth with ASD and attitudes of community-based providers. Phase 1 will involve a comprehensive review of published literature to identify intervention practices for social difficulties, anxiety, and externalizing symptoms in youth with ASD (7–22 years). Phase 2 will involve developing and piloting the UCAS using the qualitative approaches and Delphi methodology. In Phase 3, we will distribute the UCAS to approximately 700 providers across the United States to ascertain the frequency of intervention practices being delivered to youth with ASD and provider attitudes toward practices in usual care practice settings. Conclusions: Results will assist the work of researchers, clinicians, and policymakers to support the implementation of effective practices and improve the quality of services for youth with ASD.