Skip to main content

Preliminary Effectiveness of Project ImPACT: A Parent-Mediated Intervention for Children with Autism Spectrum Disorder Delivered in a Community Program

Abstract

This is a pilot study of the effectiveness of Project ImPACT, a parent-mediated intervention for ASD delivered in a community program. The primary aim was to compare child and parent outcomes between the intervention group and a community comparison for 30 young children with ASD at baseline and 12 weeks. The secondary aim was to identify parent factors associated with changes in child outcomes. Results indicated significant improvement in child communication skills and a strong trend for parent intervention adherence for the intervention group from baseline to 12 weeks. Higher baseline parenting stress was negatively related to child social gains from baseline to 12 weeks. Findings provide further support for delivering parent-mediated interventions in community settings to children with ASD.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

References

  • Abidin, R. R. (1995). Parenting Stress Index (PSI) manual (3rd ed.). Charlottesville: Pediatric Psychology Press.

    Google Scholar 

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders: DSM-IV-TR. Washington, DC: American Psychiatric Association.

    Google Scholar 

  • Baker-Ericzen, M. J., Brookman-Frazee, L., & Stahmer, A. (2005). Stress levels and adaptability in parents of toddlers with and without autism spectrum disorders. Research and Practice for Persons with Severe Disabilities, 30(4), 194–204.

    Article  Google Scholar 

  • Baker-Ericzén, M. J., Stahmer, A. C., & Burns, A. (2007). Child demographics associated with outcomes in a community-based pivotal response training program. Journal of Positive Behavior Interventions, 9(1), 52–60.

    Article  Google Scholar 

  • Berument, S. K., Rutter, M., Lord, C., Pickles, A., & Bailey, A. (1999). Autism screening questionnaire: Diagnostic validity. The British Journal of Psychiatry, 175, 444–451.

    PubMed  Article  Google Scholar 

  • Bishop, D. V. M., & Norbury, C. F. (2002). Exploring the borderlands of autistic disorder and specific language impairment: A study using standardized diagnostic instruments. Journal of Child Psychology and Psychiatry, 43(7), 1–13.

    Article  Google Scholar 

  • Brookman-Frazee, L., Drahota, A., & Stadnick, N. (2012). Training community mental health therapists to deliver a package of evidence-based practice strategies for school-age children with autism spectrum disorders: A pilot study. Journal of Autism and Developmental Disorders, 42(8), 1651–1661.

    PubMed Central  PubMed  Article  Google Scholar 

  • Brookman-Frazee, L. I., Taylor, R., & Garland, A. F. (2010). Characterizing community-based mental health services for children with autism spectrum disorders and disruptive behavior problems. Journal of Autism and Developmental Disorders, 40(10), 1188–1201.

    PubMed Central  PubMed  Article  Google Scholar 

  • Brookman-Frazee, L., Vismara, L., Drahota, A., Stahmer, A., & Openden, D. (2009). Parent training interventions for children with autism spectrum disorders. In J. L. Matson (Ed.), Applied behavior analysis for children with autism spectrum disorders (pp. 237–257). New York, NY: Springer.

    Chapter  Google Scholar 

  • Chandler, S., Charman, T., Baird, G., Simonoff, E., Loucas, T., Meldrum, D., et al. (2007). Validation of the social communication questionnaire in a population cohort of children with autism spectrum disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 46(10), 1324–1332.

    PubMed  Article  Google Scholar 

  • Charman, T., Baird, G., Simonoff, E., Loucas, T., Chandler, S., Meldrum, D., et al. (2007). Efficacy of three screening instruments in the identification of autistic-spectrum disorders. British Journal of Psychiatry, 191, 554–559.

    PubMed  Article  Google Scholar 

  • Chlebowski, C., Robins, D. L., Barton, M. L., & Fein, D. (2013). Large-scale use of the modified checklist for autism in low-risk toddlers. Pediatrics, 131(4), e1121–e1127.

    PubMed Central  PubMed  Article  Google Scholar 

  • Cicchetti, D. V. (1994). Guidelines, criteria, and rule of thumb for evaluating normed and standardized assessment instruments in psychology. Psychological Assessment, 6, 284–290.

    Article  Google Scholar 

  • Constantino, J. N., Davis, S. A., Todd, R. D., Schindler, M. K., Gross, M. M., Brophy, S. L., et al. (2003). Validation of a brief quantitative measure of autistic traits: Comparison of the social responsiveness scale with the Autism Diagnostic Interview-Revised. Journal of Autism and Developmental Disorders, 33, 427–433.

    PubMed  Article  Google Scholar 

  • Constantino, J. N., & Gruber, C. P. (2005). Social Responsiveness Scale (SRS) manual. Los Angeles, CA: Western Psychological Services.

    Google Scholar 

  • Constantino, J. N., Przybeck, T., Friesen, D., & Todd, R. D. (2000). Reciprocal social behavior in children with and without pervasive developmental disorders. Journal of Developmental and Behavioral Pediatrics, 21, 2–11.

    PubMed  Article  Google Scholar 

  • Dawson, G., & Burner, K. (2011). Behavioral interventions in children and adolescents with autism spectrum disorder: A review of recent findings. Current Opinion in Pediatrics, 23, 616–620.

    PubMed  Article  Google Scholar 

  • Dawson, G., Rogers, S., Munson, J., Smith, M., Winter, J., Greenson, J., et al. (2010). Randomized, controlled trial of an intervention for toddlers with autism: The Early Start Denver Model. Pediatrics, 125(1), e17–e23.

    PubMed  Article  Google Scholar 

  • Duncan, J. G., Magnuson, K. A., & Ludwig, G. (2004). The endogeneity problem in developmental studies. Research in Human Development, 1(1 & 2), 59–80.

    Article  Google Scholar 

  • Freeman, N., & Perry, A. (2010). Outcomes of intensive behavioural intervention in the Toronto Preschool Autism Service. Journal on Developmental Disabilities, 16(2), 17–32.

    Google Scholar 

  • Galensky, T. L., Miltenberger, R. J., Stricker, J. M., & Garlinghouse, M. A. (2001). Functional assessment and treatment of mealtime behavior problems. Journal of Positive Behavior Interventions, 3, 211–224.

    Article  Google Scholar 

  • Guralnick, M. J. (2005). Early intervention for children with intellectual disabilities: Current knowledge and future prospects. Journal of Applied Research in Intellectual Disabilities, 18(4), 313–324.

    Article  Google Scholar 

  • Hayes, S. A., & Watson, S. L. (2013). The impact of parenting stress: A meta-analysis of studies comparing the experience of parenting stress in parents of children with and without autism spectrum disorder. Journal of Autism and Developemtnal Disorders, 43, 629–642.

    Article  Google Scholar 

  • Ingersoll, B. (2009). Increasing generalizations through the use of parent-mediated interventions. In W. Christina (Ed.), Real life, real progress: A practical guide for parents and professional on generalization for children with autism spectrum disorders (pp. 173–194). Baltimore: Brookes Publishing Company.

    Google Scholar 

  • Ingersoll, B., & Dvortcsak, A. (2010). Teaching social communication to children with autism: A practitioner’s guide to parent training. New York: The Guilford Press.

    Google Scholar 

  • Ingersoll, B., Dvortcsak, A., Whalen, C., & Sikora, D. (2005). The effects of a developmental, social-pragmatic language intervention on rate of expressive language production in young children with autistic spectrum disorders. Focus on Autism and Other Developmental Disabilites, 20(4), 213–222.

    Article  Google Scholar 

  • Ingersoll, B., & Wainer, A. (2013). Initial efficacy of Project ImPACT: A parent-mediated social communication intervention for young children with ASD. Journal of Autism and Developmental Disorders, 43, 2943–2952.

    PubMed  Article  Google Scholar 

  • Interagency Autism Coordinating Committee. (2011). 2011 IACC Strategic Plan for Autism Spectrum Disorder Research. Retrieved from the Department of Health and Human Services Interagency Autism Coordinating Committee website, http://iacc.hhs.gov/strategic-plan/2011/index.shtml

  • Kleinman, J. M., Robins, D. L., Ventola, P. E., Pandey, J., Boorstein, H. C., Esser, E. L., et al. (2008). The modified checklist for autism in toddlers: A follow-up study investigating the early detection of autism spectrum disorders. Journal of Autism and Developmental Disorders, 38(5), 827–839.

    PubMed Central  PubMed  Article  Google Scholar 

  • Koegel, L. K., Vernon, T. W., Koegel, R. L., Koegel, B. L., & Paullin, A. W. (2012). Improving social engagement and initiations between children with autism spectrum disorder and their peers in inclusive settings. Journal of Positive Behavior Interventions, 14, 220–227.

    PubMed Central  PubMed  Article  Google Scholar 

  • Lord, C., & Bishop, S. (2010). Autism spectrum disorders: Diagnosis, prevalence, and services for children and families. Social Policy Report, 24(1), 3–21.

    Google Scholar 

  • National Research Council. (2001). Educating children with autism. Washington, DC: National Academy Press, Division of Behavioral and Social Sciences and Education, Committee on Educational Interventions for Children with Autism.

    Google Scholar 

  • National Standards Report. (2009). The national standards project—Addressing the need for evidence-based practice guidelines for autism spectrum disorders. Randolph: National Autism Center.

    Google Scholar 

  • Oono, I. P., McConachie, H., & Honey, E. J. (2012). Parent-mediated early intervention for young children with autism spectrum disorders (ASD). Cochrane Database of Systematic Reviews, 4, 1–11.

    Google Scholar 

  • Osborne, L. A., McHugh, L., Saunders, J., & Reed, P. (2008). Parenting stress reduces the effectiveness of early teaching interventions for autistic spectrum disorders. Journal of Autism and Developmental Disorders, 38(6), 1092–1103.

    PubMed  Article  Google Scholar 

  • Perry, A., Cummings, A., Geier, J. D., Freeman, N. L., Hughes, S., LaRose, L., et al. (2008). Effectiveness of intensive behavioral intervention in a large, community-based program. Research in Autism Spectrum Disorders, 2(4), 621–642.

    Article  Google Scholar 

  • Plienis, A. J., Robbins, F. R., & Dunlap, G. (1988). Parent adjustment and family stress as factors in behavioral parent training for young autistic children. Journal of the Multihandicapped Person, 1(1), 31–52.

    Article  Google Scholar 

  • Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.

    Article  Google Scholar 

  • Robbins, F. R., Dunlap, G., & Plienis, A. J. (1991). Family characteristics, family training, and the progress of young children with autism. Journal of Early Intervention, 15(2), 173–184.

    Article  Google Scholar 

  • Robins, D. L. (2008). Screening for autism spectrum disorders in primary care settings. Autism, 12(5), 537–556.

    PubMed  Article  Google Scholar 

  • Robins, D. L., Fein, D., & Barton, M. (1999). The Modified Checklist for Autism in Toddlers (M-CHAT). Storrs, CT: Self-published

  • Robins, D. L., Fein, D., Barton, M. L., & Green, J. A. (2001). The modified checklist for autism in toddlers: An initial study investigating the early detection of autism and pervasive developmental disorders. Journal of Autism and Developmental Disorders, 31(2), 131–144.

    PubMed  Article  Google Scholar 

  • Rogers, S. J., & Dawson, G. (2009). Early Start Denver model for young children with autism: Promoting language, learning, and engagement. New York: The Guilford Press.

    Google Scholar 

  • Rogers, S. J., Estes, A., Lord, C., Vismara, L., Winter, J., Fitzpatrick, A., et al. (2012). Effects of a brief Early Start Denver Model (ESDM)-based parent intervention on toddlers at risk for autism spectrum disorders: A randomized controlled trial. Journal of the American Academy of Child and Adolescent Psychiatry, 51(10), 1052–1065.

    PubMed Central  PubMed  Article  Google Scholar 

  • Rogers, S. J., & Vismara, L. A. (2008). Evidence-based comprehensive treatments for early autism. Journal of Clinical Child and Adolescent Psychology, 37(1), 8–38.

    PubMed Central  PubMed  Article  Google Scholar 

  • Rutter, M., Bailey, A., & Lord, C. (2003). Social Communication Questionnaire. Los Angeles, CA: Western Psychological Services.

    Google Scholar 

  • Smith, I. M., Koegel, K., Koegel, L. K., Openden, D. A., Fossum, K. L., & Bryson, S. E. (2010). Effectiveness of a novel community-based early intervention model for children with autistic spectrum disorder. American Journal on Intellectual and Developmental Disabilities, 115(6), 504–523.

    PubMed  Article  Google Scholar 

  • Sparrow, S. S., Cicchetti, D. V., & Balla, D. A. (2005). Vineland Adaptive Behavior Scales (2nd ed.). Circle Pines, MN: AGS Publishing.

    Google Scholar 

  • Stahmer, A. C., Collings, N. M., & Palinkas, L. A. (2005). Early intervention practices for children with autism: Descriptions from community providers. Focus on Autism and Other Developmental Disabilites, 20(2), 66–79.

    Article  Google Scholar 

  • Stahmer, A. C., & Gist, K. (2001). The effects of an accelerated parent education program on technique mastery and child outcome. Journal of Positive Behavior Interventions, 3(2), 75–82.

    Article  Google Scholar 

  • Stahmer, A. C., Schreimban, L., & Cunningham, A. B. (2011). Toward a technology of treatment individualization for young children with autism spectrum disorders. Brain Research, 1380, 229–239.

    PubMed Central  PubMed  Article  Google Scholar 

  • Valenti, M., Cerbo, R., Masedu, F., De Caris, M., & Sorge, G. (2010). Intensive intervention for children and adolescents with autism in a community setting in Italy: A single-group longitudinal study. Child and Adolescent Psychiatry and Mental Health, 4, 23.

    PubMed Central  PubMed  Article  Google Scholar 

  • Vismara, L. A., Young, G. S., & Rogers, S. J. (2013). Community dissemination of the Early Start Denver Model: Implications for science and practice. Topics in Early Childhood Special Education, 32(4), 223–233.

    Article  Google Scholar 

  • Vismara, L. A., Young, G. S., Stahmer, A. C., Griffith, E. M., & Rogers, S. J. (2009). Dissemination of evidence-based practice: Can we train therapists from a distance? Journal of Autism and Developmental Disorders, 39(12), 1636–1651.

    PubMed Central  PubMed  Article  Google Scholar 

  • Wainer, A. L., & Ingersoll, B. R. (2013). Disseminating ASD interventions: A pilot study of a distance learning program for parents and professionals. Journal of Autism and Developmental Disorders, 43, 11–24.

    PubMed  Article  Google Scholar 

  • Wallace, K. S., & Rogers, S. J. (2010). Intervening in infancy: Implications for autism spectrum disorders. Journal of Child Psychology and Psychiatry, 51(12), 1300–1320.

    PubMed  Article  Google Scholar 

  • Yoder, P., & Stone, W. L. (2006). A randomized comparison of the effect of two prelinguistic communication intervention on the acquisition of spoken communication in preschoolers with ASD. Journal of Speech, Language, and Hearing Research, 49, 698–711.

    PubMed  Article  Google Scholar 

Download references

Acknowledgments

The authors would like to acknowledge funding from Autism Speaks (7060; PI: Stadnick), the National Institute of Mental Health (R01MH094317-03; PI: Brookman-Frazee). This manuscript was prepared from the doctoral dissertation of the first author.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Nicole A. Stadnick.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Stadnick, N.A., Stahmer, A. & Brookman-Frazee, L. Preliminary Effectiveness of Project ImPACT: A Parent-Mediated Intervention for Children with Autism Spectrum Disorder Delivered in a Community Program. J Autism Dev Disord 45, 2092–2104 (2015). https://doi.org/10.1007/s10803-015-2376-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10803-015-2376-y

Keywords

  • ASD
  • Community-based services
  • Implementation
  • Parent-mediated interventions