Kathleen M. Baggett

Technologies for expanding the reach of evidence-based interventions: Preliminary results for promoting social-emotional development in early childhood

In great demand are efficient mechanisms for delivery of evidence-based interventions for promoting social-emotional development and early positive behavior of all children, and especially for those with or at risk for disabilities. The rise of Internet use has created potentially new avenues for intervention delivery, which, when paired with the many recent advances in computer networking and multimedia technology, is fueling this demand. This article describes the development of an Internet-based, computer-delivered parent-training intervention, Infant Net, with infants at risk for poor social-emotional outcomes. Results of a randomized control trial of the Infant Net intervention with 40 parent-infant dyads showed significant increase, reflecting a medium to large effect size, in infant social engagement and engagement with the environment for infants in the intervention group as compared to the control group. Implications are discussed with regard to future research.

Expanding the Reach of Preventive Interventions Development of an Internet-Based Training for Parents of Infants

There are major obstacles to the effective delivery of mental health services to poor families, particularly for those families in rural areas. The rise of Internet use, however, has created potentially new avenues for service delivery, which, when paired with the many recent advances in computer networking and multimedia technology, is fueling a demand for Internet delivery of mental health services. The authors report on the adaptation of a parenting program for delivery via the Internet, enhanced with participant-created videos of parent-infant interactions and weekly staff contact, which enable distal treatment providers to give feedback and make decisions informed by direct behavioral assessment. This Internet-based, parent-education intervention has the potential to promote healthy and protective parent-infant interactions in families who might not otherwise receive needed mental health services.

Enhancing Parenting Practices of At-risk Mothers

This study evaluated the effectiveness of an intervention designed to improve early parenting by increasing understanding of infant developmental needs and promoting maternal responsiveness as indicated by increased positive behavior support for infants and decreased psychological control. At-risk mothers were randomly assigned to control or treatment conditions, the latter consisting of training in parental responsiveness, developmental knowledge, and loving touch. Following the intervention, treatment mothers reduced their controlling tendencies; they were less rigid, less intrusive, and more flexible than control mothers. Treatment mothers provided more parental support indicated by higher quality verbalizations, more demonstrative teaching, and lower role-reversal tendencies. Editors’ Strategic Implications: Further replication will be necessary, but the results for the “My Baby and Me” program are promising. The authors provide crucial information for parent educators about the pairing of basic knowledge transfer with the active engagement of parents with their infants in practicing new parenting skills.

Designing Studies to Evaluate Parent-Mediated Interventions for Toddlers With Autism Spectrum Disorder

Given recent advances in science, policy, and practice of early identification in autism spectrum disorder (ASD), questions about the effectiveness of early intervention have far-reaching service and policy implications. However, rigorous research evaluating the efficacy and effectiveness of intervention programs for toddlers with ASD faces a multitude of novel scientific challenges. The Autism Speaks Toddler Treatment Network (ASTTN) was formed in 2007 to provide an infrastructure for ongoing communication between the investigators of eight research projects evaluating parent-mediated interventions for toddlers with ASD. The present article describes and compares the research studies of the ASTTN; highlights specific challenges with regard to research design, participants, recruitment, eligibility criteria, enrollment, and intervention approach; and outlines practical considerations that may guide the next generation of parent-mediated intervention studies involving toddlers with ASD.

Behavioral Outcomes of Young Children Prenatally Exposed to Illicit Drugs: Review and Analysis of Experimental Literature

The purpose of this article was to review the findings from existing peer-reviewed experimental studies describing the behavioral and developmental outcomes associated with prenatal exposure to illicit drugs. Forty-six such studies and 460 individual outcomes occurring from birth to 60 months were identified. Only half of these outcomes (49.8%) were statistically significant, indicating adverse effects of prenatal exposure. The greatest number of outcomes were identified for infants younger than 1 month of age and within the neurodevelopmental domain. The contrast between these outcomes derived from experimental studies and those reported in the popular press is discussed.

A Randomized Controlled Trial Examination of a Remote Parenting Intervention: Engagement and Effects on Parenting Behavior and Child Abuse Potential:

Technology advances increasingly allow for access to remotely delivered interventions designed to promote early parenting practices that protect against child maltreatment. Among low-income families, at somewhat elevated risk for child maltreatment, there is some evidence that parents do engage in and benefit from remote-coaching interventions. However, little is known about the effectiveness of such programs to engage and benefit families at high risk for child maltreatment due to multiple stressors associated with poverty. To address this limitation, we examined engagement and outcomes among mothers at heightened risk for child abuse, who were enrolled in a randomized controlled, intent-to-treat trial of an Internet adaptation of an evidence-based infant parenting intervention. We found that engagement patterns were similar between higher and lower risk groups. Moreover, an intervention dose by condition effect was found for increased positive parent behavior and reduced child abuse potential.

Parent-Reported Repetitive Behavior in Toddlers on the Autism Spectrum.

Toddlers with autism spectrum disorder (ASD) were assessed on the Repetitive Behavior Scale-Revised (RBS-R), which we found to have acceptable internal consistency. Stereotypical subscale scores showed a negligible association with cognitive level, but correlated more strongly with adaptive and social indicators. Relative to earlier reported RBS-R scores for older age groups, toddlers’ scores trended toward higher stereotyped behavior and lower ritualistic/sameness behavior. Our findings on associations with developmental indicators align with those of researchers who used more resource-intensive repetitive behavior measures. The convergence of these findings with those derived from other measurement methods suggests that the RBS-R, a cost effective parent-report measure, is a viable means of assessing repetitive behavior in toddlers with autism.

Introduction to the Special Issue on Technology 2.0: A Focus on the Newest Technological Advances in Child Maltreatment Research

Nearly a decade ago, our field entered the exploratory phase of considering how technology applications may advance child maltreatment (CM) research and practice. Emergent articles demonstrated the use of technology in areas ranging from professional data sharing (Johnson-Reid & Drake, 2008) and training in evidence-based practices (Funderburk, Ware, Altshuler, & Chaffin, 2008) to family engagement assessment (Lefever, Howard, Lanzi, Borkowski, et al., 2008), intervention augmentation (Bigelow, Carta, & Lefever, 2008), and intervention delivery (Feil, Baggett, Davis, Sheeber, et al., 2008). Since that time, the rapid expansion and advancement of technology have drastically changed our personal and professional lives. For instance, in the United States, 95% of adults now own a cell phone, the vast majority of which are smartphones (http:// www.pewinternet.org/fact-sheet/mobile/). Accordingly, it felt critically important both to revisit the first-generation literature, which illustrated initial possibilities of technology implementation and called for embracing technology in CM practice and research, and to shed light on emerging areas of nextgeneration CM research to better evaluate our field’s current progress in technology applications. So, where have we ventured over the last decade in this arena? The articles in this issue confirm that we have moved beyond descriptive and proof-of-concept research, which were the state of the field, to a new generation of technology research employing methodology to assess CM-related physiological outcomes, evaluate effectiveness and efficacy of technologyenhanced and -delivered CM interventions, and address barriers to the implementation of evidence-based practice. The initial article in this issue is the first to provide objective data on adherence to home collection of diurnal cortisol among maltreating families via the application of an electronic monitoring device (Valentino, De Alba, Hibel, Fondren, & McDonnell, 2017, this issue). This important study offers a technology-based approach that allows researchers to move beyond the standard self-report measures most often used, to the efficient inclusion of more rigorous measures less influenced by external bias and which provide better benchmarks for assessment-based studies and intervention research. Next, various applications of innovative technology are examined within the context of intervention studies. Breitenstein and colleagues (2017, this issue) view engagement and adherence metrics within a randomized controlled trial of an e-parenting program that is fully delivered via the Internet and therapy progress is driven by the participant. Lefever et al. (2017, this issue) examine the effectiveness of a technologyaugmented evidence-based home-visiting intervention in a randomized trial to explicate the potential benefits of mobile phones on family retention and child outcomes. The four remaining articles report results of randomized controlled trials examining the effectiveness of technology-delivered interventions, all of which show significant depth in contrast to the literature a decade ago. Baggett and colleagues (2017, this issue) focus on improving parenting practices and reducing CM potential among mothers and their babies via an intervention that is fully delivered through technology and includes both parent-driven and coach-guided components. Strengthening proof of concept, Stewart et al. (2017, this issue) report on a community practice trial of a telehealth intervention for youth who have experienced trauma such as CM. Ondersma and colleagues (2017, this issue) conducted a randomized controlled trial of a community-based home-visiting program supplemented with a brief computer-delivered intervention component designed to improve early parenting outcomes. This article highlights the crucial role of implementation fidelity monitoring for understanding outcomes of effectiveness and efficacy trials of technology-delivered intervention. Finally, SelfBrown et al. (2017, this issue) report on a randomized controlled trial that focuses on implementation science and examines the effects of technology on provider implementation, time, burden, and fidelity, within an evidence-based homevisiting program. Notably, implementation science was also a burgeoning field at the time of the last technology-focused CM special issue.

Special Issue: Technology 2.0: A Focus on the Newest Technological Advances in Child Maltreatment Research

Child Maltreatment: Journal of the American Professional Society on the Abuse of Children is preparing an upcoming special issue of the Journal focused on rigorous evaluation of the effects of technology-delivered interventions for reducing child maltreatment. Purpose: In 2008, a special issue of Child Maltreatment was dedicated to articles focusing on how emerging technology could inform child maltreatment prevention and intervention, including several papers describing technology-delivered interventions. The acceleration of technology development is driving expansion and methodological advancements in child maltreatment research relevant to surveillance, intervention delivery, and dissemination. Accordingly, Child Maltreatment is soliciting manuscripts for a special issue on technology to highlight recent advances in technology applications to address child maltreatment. This includes studies demonstrating how technology can be used to advance surveillance, etiology, intervention research, and dissemination. This issue is intended to publish papers that report empirical findings, and nonempirical papers or reviews are unlikely to be accepted for publication. All submitted manuscripts will undergo the regular peerreview process. The deadline for submitting manuscripts is May 15, 2016. Full-length manuscripts should be limited to 30 double-spaced pages, including tables and references, be formatted according to the sixth addition of the Publication Manual of the American Psychological Association, and be accompanied by a letter requesting that the manuscript be considered for this special issue on technology applications addressing child maltreatment. Additional submission guidelines may be found in the journal and at http://cmx.sagepub.com/. The manuscript should be submitted to Child Maltreatment via the online portal ScholarOne Manuscripts at http://mc.manu scriptcentral.com/childmaltreatment. First-time users will need to create an account before submitting. Follow the prompts in the Author Center to complete the submission. Questions about this special issue can be directed to Kathleen Baggett (kbaggett@ku.edu) or Shannon Self-Brown (SSelfBrown@gsu.edu). Authors are encouraged to discuss paper ideas with Drs. Baggett or Self-Brown to assess their fit with this special issue.