Alyssa M Hernandez, Diondra Straiton, David S Mandell, Brooke Ingersoll, Samantha Crabbe, Sarah Rieth, Melanie Pellecchia
{"title":"Short report: Associations of family characteristics and clinicians' use of caregiver coaching in early intervention.","authors":"Alyssa M Hernandez, Diondra Straiton, David S Mandell, Brooke Ingersoll, Samantha Crabbe, Sarah Rieth, Melanie Pellecchia","doi":"10.1177/13623613251317780","DOIUrl":null,"url":null,"abstract":"<p><p>There is a great demand for quality early intervention services for autistic children and their families. Caregiver-mediated interventions are critical components of evidence-based early intervention. However, their implementation in publicly funded systems is often done with poor fidelity. Qualitative evidence suggests that family characteristics impact clinicians' use of caregiver-mediated intervention coaching strategies. We estimated associations between family characteristics and clinicians' use of a caregiver-mediated intervention in a publicly funded early intervention system, leveraging data from a pilot randomized trial. Data were collected from 12 clinicians and 34 families. We used multiple linear regression models to estimate associations. The association between household income and clinicians' overall coaching fidelity demonstrated a quadratic trend (<i>b</i> <i>=</i> -10.4, standard error = 4.1, <i>p</i> < 0.05) with low fidelity for low- and high-income families relative to middle-income families. Use of in vivo feedback, one component of coaching, was similarly associated with income (<i>b</i> <i>=</i> -0.5, standard error = 0.2, <i>p</i> < 0.05). Clinicians' coaching fidelity was lower among families in exclusively English-speaking homes than for families who speak other languages (<i>b</i> = 18.4, standard error = 8.8, <i>p</i> < 0.05). Results suggest that associations between family characteristics and clinician behavior may be more nuanced than previously understood.Lay abstractThere is a high demand for quality early intervention services for autistic children and their families. A key part of effective early intervention is teaching caregivers how to support their child's development through caregiver-mediated interventions. However, in publicly funded programs, these strategies are often not followed correctly. Some studies suggest that family characteristics may influence how well clinicians apply these coaching methods. In this study, we explored the connection between family factors, like household income and language spoken at home, and the way clinicians coached families. We found that clinicians used coaching strategies less consistently with both lower- and higher-income families compared to middle-income ones. In addition, families that spoke only English at home received less consistent coaching than those who spoke other languages. These findings highlight the complex relationship between family background and how early intervention services are delivered, suggesting a need for further research.</p>","PeriodicalId":8724,"journal":{"name":"Autism","volume":" ","pages":"1898-1906"},"PeriodicalIF":5.2000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12159352/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Autism","FirstCategoryId":"102","ListUrlMain":"https://doi.org/10.1177/13623613251317780","RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/2/11 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"PSYCHOLOGY, DEVELOPMENTAL","Score":null,"Total":0}
引用次数: 0
Abstract
There is a great demand for quality early intervention services for autistic children and their families. Caregiver-mediated interventions are critical components of evidence-based early intervention. However, their implementation in publicly funded systems is often done with poor fidelity. Qualitative evidence suggests that family characteristics impact clinicians' use of caregiver-mediated intervention coaching strategies. We estimated associations between family characteristics and clinicians' use of a caregiver-mediated intervention in a publicly funded early intervention system, leveraging data from a pilot randomized trial. Data were collected from 12 clinicians and 34 families. We used multiple linear regression models to estimate associations. The association between household income and clinicians' overall coaching fidelity demonstrated a quadratic trend (b= -10.4, standard error = 4.1, p < 0.05) with low fidelity for low- and high-income families relative to middle-income families. Use of in vivo feedback, one component of coaching, was similarly associated with income (b= -0.5, standard error = 0.2, p < 0.05). Clinicians' coaching fidelity was lower among families in exclusively English-speaking homes than for families who speak other languages (b = 18.4, standard error = 8.8, p < 0.05). Results suggest that associations between family characteristics and clinician behavior may be more nuanced than previously understood.Lay abstractThere is a high demand for quality early intervention services for autistic children and their families. A key part of effective early intervention is teaching caregivers how to support their child's development through caregiver-mediated interventions. However, in publicly funded programs, these strategies are often not followed correctly. Some studies suggest that family characteristics may influence how well clinicians apply these coaching methods. In this study, we explored the connection between family factors, like household income and language spoken at home, and the way clinicians coached families. We found that clinicians used coaching strategies less consistently with both lower- and higher-income families compared to middle-income ones. In addition, families that spoke only English at home received less consistent coaching than those who spoke other languages. These findings highlight the complex relationship between family background and how early intervention services are delivered, suggesting a need for further research.
期刊介绍:
Autism is a major, peer-reviewed, international journal, published 8 times a year, publishing research of direct and practical relevance to help improve the quality of life for individuals with autism or autism-related disorders. It is interdisciplinary in nature, focusing on research in many areas, including: intervention; diagnosis; training; education; translational issues related to neuroscience, medical and genetic issues of practical import; psychological processes; evaluation of particular therapies; quality of life; family needs; and epidemiological research. Autism provides a major international forum for peer-reviewed research of direct and practical relevance to improving the quality of life for individuals with autism or autism-related disorders. The journal''s success and popularity reflect the recent worldwide growth in the research and understanding of autistic spectrum disorders, and the consequent impact on the provision of treatment and care. Autism is interdisciplinary in nature, focusing on evaluative research in all areas, including: intervention, diagnosis, training, education, neuroscience, psychological processes, evaluation of particular therapies, quality of life issues, family issues and family services, medical and genetic issues, epidemiological research.