Telehealth Parent Training in the Early Start Denver Model: Results From a Randomized Controlled Study

2016 ◽  
Vol 33 (2) ◽  
pp. 67-79 ◽  
Author(s):  
Laurie A. Vismara ◽  
Carolyn E. B. McCormick ◽  
Amy L. Wagner ◽  
Katernia Monlux ◽  
Anna Nadhan ◽  
...  

Telehealth training may benefit parents’ use of early intervention for children with autism spectrum disorder (ASD). This study is one of the few randomized trials to compare telehealth parent training in the Early Start Denver Model (P-ESDM) with a community treatment-as-usual, early intervention program. Parents were randomized to 12 weekly 1.5-hr videoconferencing sessions with website access to P-ESDM learning resources or to monthly 1.5-hr videoconferencing sessions with website access to alternative resources to support their intervention. Telehealth training facilitated higher parent fidelity gains and program satisfaction for more of the P-ESDM than the community group at the end of the 12-week training and at follow-up. Children’s social communication skills improved for both groups regardless of parent fidelity. Findings suggest the feasibility of telehealth training with improved parent intervention usage and satisfaction from the program. However, the impact of these effects on children’s development over time is yet to be understood.

2021 ◽  
Author(s):  
◽  
Hannah Waddington

<p>Autism spectrum disorder (ASD) is a pervasive developmental disorder that is characterised by deficits in social communication and restricted and repetitive behaviours, interests and activities. Recent developments in identification techniques mean that many children can be reliably diagnosed with ASD before the age of 2. Early identification creates the opportunity for early intervention. In fact, some research suggests that the earlier a child with ASD receives intervention, the greater the progress he or she is likely to make. Naturalistic developmental behavioural interventions are a relatively recent method of early intervention for children with ASD, which combine elements of previous intervention approaches (behavioural, naturalistic behavioural, and developmental/relationship-focused intervention). One such naturalistic developmental behavioural intervention is the early start Denver model (ESDM), which is designed for children with or at risk for ASD between the ages of 12 and 60 months (5 years). Research suggests that ESDM intervention may improve a range of child outcomes when delivered for at least 15 hours per week over at least 10 months. However, many families may not be able to access or afford such intensive intervention. Therefore, the two studies in this thesis evaluated the effectiveness of two ESDM delivery approaches that required relatively few hours of professional input per week. Specifically, low-intensity therapist delivered ESDM intervention, and ESDM parent training.  Study 1 used a multiple probe across participants design to evaluate the effectiveness of 3 hours per week of home-based ESDM therapy for 12 weeks for improving imitation, communication, and engagement for four young children with ASD. It also examined whether children showed increases in these outcomes with their mothers following the intervention. The results of this study suggest that, following the intervention, all four children increased their imitation skills and their engagement with the therapist. In addition three of the children had more functional utterances and one child increased his use of intentional vocalisations. These results were maintained four weeks after intervention and generalised to a lesser degree to each child’s mother. This suggests that low-intensity therapist delivered ESDM intervention may improve outcomes for children with ASD.  The results of Studies 1 and 2 suggest that both low-intensity therapist delivered ESDM intervention and ESDM parent training may be promising intervention approaches for young children with ASD. This is particularly encouraging as both approaches involved relatively few hours of professional input per week. In theory, this could increase the number of families who are able to access such intervention. More research is needed to identify the most effective low-intensity ESDM intervention method, or combination of methods.</p>


2021 ◽  
Author(s):  
◽  
Hannah Waddington

<p>Autism spectrum disorder (ASD) is a pervasive developmental disorder that is characterised by deficits in social communication and restricted and repetitive behaviours, interests and activities. Recent developments in identification techniques mean that many children can be reliably diagnosed with ASD before the age of 2. Early identification creates the opportunity for early intervention. In fact, some research suggests that the earlier a child with ASD receives intervention, the greater the progress he or she is likely to make. Naturalistic developmental behavioural interventions are a relatively recent method of early intervention for children with ASD, which combine elements of previous intervention approaches (behavioural, naturalistic behavioural, and developmental/relationship-focused intervention). One such naturalistic developmental behavioural intervention is the early start Denver model (ESDM), which is designed for children with or at risk for ASD between the ages of 12 and 60 months (5 years). Research suggests that ESDM intervention may improve a range of child outcomes when delivered for at least 15 hours per week over at least 10 months. However, many families may not be able to access or afford such intensive intervention. Therefore, the two studies in this thesis evaluated the effectiveness of two ESDM delivery approaches that required relatively few hours of professional input per week. Specifically, low-intensity therapist delivered ESDM intervention, and ESDM parent training.  Study 1 used a multiple probe across participants design to evaluate the effectiveness of 3 hours per week of home-based ESDM therapy for 12 weeks for improving imitation, communication, and engagement for four young children with ASD. It also examined whether children showed increases in these outcomes with their mothers following the intervention. The results of this study suggest that, following the intervention, all four children increased their imitation skills and their engagement with the therapist. In addition three of the children had more functional utterances and one child increased his use of intentional vocalisations. These results were maintained four weeks after intervention and generalised to a lesser degree to each child’s mother. This suggests that low-intensity therapist delivered ESDM intervention may improve outcomes for children with ASD.  The results of Studies 1 and 2 suggest that both low-intensity therapist delivered ESDM intervention and ESDM parent training may be promising intervention approaches for young children with ASD. This is particularly encouraging as both approaches involved relatively few hours of professional input per week. In theory, this could increase the number of families who are able to access such intervention. More research is needed to identify the most effective low-intensity ESDM intervention method, or combination of methods.</p>


Autism ◽  
2019 ◽  
Vol 24 (2) ◽  
pp. 484-498 ◽  
Author(s):  
Hannah Waddington ◽  
Larah van der Meer ◽  
Jeff Sigafoos ◽  
Andrew Whitehouse

Contemporary parent-implemented early intervention programs for children with autism spectrum disorder usually incorporate a range of techniques with different theoretical underpinnings. While research suggests that parents often learn to implement interventions with an acceptable degree of overall fidelity, there is limited research into parent use of individual intervention techniques. This study included five mothers of young children with autism spectrum disorder who participated in a 12-week parent training program based on the Early Start Denver Model. Ten-minute play samples were coded for the mothers’ use of 18 specific Early Start Denver Model techniques before, during, and 1 month after the training program. The correlation between the mothers’ use of each Early Start Denver Model technique and their child’s level of engagement and expressive language was also calculated. Results suggest that all mothers increased the number of techniques that they were using from baseline to parent training. Some Early Start Denver Model techniques were moderately or strongly correlated with both child engagement and expressive language. There was considerable variation in outcomes across all mother–child dyads. These preliminary results have implications for how parents are trained/coached to implement interventions for young children with autism spectrum disorder. Lay abstract Parents of young children with autism are often taught to deliver interventions which involve several different types of strategies. Research suggests that parents can usually learn to deliver these interventions but not much is known about their use of each specific intervention strategy. This study included five mothers of young children with autism who participated in a 12-week parent training program based on the Early Start Denver Model. We measured their use of 18 different ESDM strategies before, during, and 1 month after the training program. We found that parents increased the number of strategies that they used during the training program. There were differences between mothers in terms of the ESDM strategies that they used the most during the training. We also found that some of the strategies were more closely related to children’s levels of engagement and language than others. This suggests that parent training should be adapted to suit each parent’s needs.


ISRN Nursing ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Paul Ratanasiripong ◽  
Nop Ratanasiripong ◽  
Duangrat Kathalae

Purpose. It has been well documented that nursing students across the world experience stress and anxiety throughout their education and training. The purpose of this randomized controlled study is to investigate the impact of biofeedback intervention program on nursing students' levels of stress and anxiety during their first clinical training. Methods. Participants consisted of 60 second-year baccalaureate nursing students. The 30 participants in the biofeedback group received training on how to use the biofeedback device to assist in stress and anxiety management for 5 weeks while the 30 in the control group did not receive any training. Findings. Results indicated that the biofeedback group was able to maintain the stress level while the control group had a significant increase in the stress level over the 5-week period of clinical training. Additionally, the biofeedback group had a significant reduction in anxiety, while the control group had a moderate increase in anxiety. Conclusions. The better the nursing students can manage their stress and anxiety, the more successful they can be in their clinical training. Ultimately, the more psychologically healthy the nursing students are, the more likely they will flourish and graduate to become productive and contributing members of the nursing profession.


2017 ◽  
Vol 39 (3) ◽  
pp. 415-425 ◽  
Author(s):  
Sarah N. Douglas ◽  
Rebecca Kammes ◽  
Erica Nordquist

Parent training is an essential part of quality programming for children with autism spectrum disorder (ASD). However, limited research exists exploring online training approaches to support parents of children with both ASD and complex communication needs (CCN; e.g., limited verbal ability), despite the many benefits that online training might have for these parents and the overall sustainability and scalability of such approaches. This study utilized a single-subject multiple probe design with three parents and their children to explore the impact of online parent training for parents and their children with ASD and CCN. Training included online interactive components to teach parents a communication strategy, as well as live practice sessions during which parents implemented the strategy, had an opportunity to ask questions, and engaged in self-reflection. Results indicated that training increased communication opportunities and responses provided by parents, and communication by the child. Limitations and future research directions are discussed.


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