Parent Training for Latinx Autistic Toddlers: Development and Preliminary Testing

拉丁裔自闭症幼儿家长培训：发展和初步测试

• 批准号: 10644658
• 负责人: Katharine Elizabeth Zuckerman
• 金额: $ 26.49万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-01 至 2026-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10644658
• 关键词: Acceleration; Adult; Age; Albania; Autism Diagnosis; Behavior; Caregivers; Caring; Cellular Phone; Child; Child Behavior; Child Care; Child Development; Child Rearing; Communication; Communities; Development; Developmental Delay Disorders; Diagnosis; Diagnostic; Disparity; Early Intervention; Educational Intervention; Educational Materials; Educational process of instructing; Extended Family; Family; Feedback; Goals; Intervention; Knowledge; Language; Latinx; Latinx population; Learning; Life; Linguistics; Low income; Measures; Mediating; Mediator; National origin; Outcome; Parent-Child Relations; Parents; Preparation; Provider; Reporting; Research; Resources; Self Efficacy; Services; Severities; Socioeconomic Status; Strategic Planning; Stress; Symptoms; Tablets; Telephone; Testing; Toddler; Training; Translating; Transportation; Underserved Population; United States National Institutes of Health; Wait Time; Waiting Lists; Woman; Work; access disparities; applied behavior analysis; arm; autism spectrum disorder; autistic; autistic children; bilingualism; coping; cost; design; disparity reduction; empowerment; evidence base; experience; follow up assessment; handheld mobile device; intervention program; low socioeconomic status; mHealth; online version; pediatrician; peer; personalized intervention; pilot test; prevent; primary care provider; primary outcome; programs; prototype; public health insurance; rate of change; reproductive; rural area; screening; secondary outcome; skills; social communication; social stigma; stressor; suspected autism; uptake; usability; willingness

PROJECT SUMMARY Latinx children with diagnosed or suspected autism have especially long wait times for diagnoses and intervention, up to a year or even more. This delayed access to intervention is likely to prevent children from reaching their full potential in skills and adaptive functioning. A comprehensive, online mobile device-based, free intervention that can be used by parents while on these wait lists may optimize their child's development. We have developed such a program, the Online Parent Training in Early Intervention (OPT-In-Early) program. It teaches parents the fundamental principles of both applied behavior analysis and naturalistic interventions, uses non-technical language, video demonstrations, guidance in selecting appropriate skills to teach, embedding teaching into daily routines, and reducing interfering behaviors. It is a self-paced, individualized platform giving parents strategies to strengthen the parent-child relationship, to teach basic skills, such as simple communication, to reduce interfering behaviors, and to establish helpful routines. In pilot the RCT, parents (half of whom were self-identified as Latinx) rated the program very highly and showed positive changes in behavior and knowledge. The goal of the current project is to develop, and pilot test a bilingual Spanish/English culturally tailored version of OPT-In-Early for Latinx families in the US. First, we will obtain detailed, iterative feedback from bilingual Latinx parents with an autistic child regarding OPT-In-Early. We will use this feedback to culturally adapt the program content and format. Next, we will modify the adapted program via user testing with Spanish- speaking parents. Finally, we will test the bilingual version in a six-month pilot RCT, in preparation for a fully- powered R01 trial. We will use a wait-list control design: the Intervention Now arm will be given the online program and the Intervention Later arm (controls) will be given educational material about autism. All children will receive a baseline and 6-month follow-up assessment, which will measure parent fidelity in using the intervention principles (the primary outcome), child social communication, level of autism symptoms, impact of autism symptoms, and degree of developmental delays. At the conclusion of this research, we will have developed an evidence-based, comprehensive, freely available, parent-delivered intervention that can be used by US Latinx families on their mobile devices as they await diagnosis and intervention. This will increase parent efficacy and reduce their stress, accelerate children's skills, reduce interfering behavior, and enhance PCPs' willingness to implement universal autism screening.

项目摘要 有诊断或怀疑自闭症的拉丁裔儿童的等待时间特别漫长，进行诊断和 干预，长达一年甚至更长时间。这种延迟获得干预可能会阻止儿童 发挥其技能和自适应功能的全部潜力。一个全面的，在线移动设备， 在这些等待名单中，父母可以使用的免费干预可能会优化孩子的成长。 我们已经制定了这样的计划，即早期干预（选择性）计划的在线父母培训。 它教父母应用行为分析和自然主义干预措施的基本原理， 使用非技术语言，视频演示，指导来选择适当的教学技能 将教学嵌入日常工作中，并减少干扰行为。这是一个自节奏的个性化的 平台为父母提供加强亲子关系的策略，教基本技能，例如 简单的沟通，减少干扰行为并建立有用的例程。在飞行员中，RCT， 父母（一半的自我识别为拉丁裔）对该计划的评价很高，并且表现为积极 行为和知识的变化。 当前项目的目的是开发和试点测试双语的西班牙语/英语文化量身定制的 在美国的拉丁裔家庭的选择版本。首先，我们将从 双语拉丁父母有一个自闭症孩子的选择。我们将在文化上使用此反馈 调整程序内容和格式。接下来，我们将通过西班牙语通过用户测试来修改改编程序 - 说话父母。最后，我们将在六个月的飞行员RCT中测试双语版本，以准备一项完全 电力R01试验。我们将使用等待名单的控制设计：现在的干预措施将获得在线 计划和后来的干预措施（对照）将获得有关自闭症的教育材料。所有孩子 将获得基线和6个月的随访评估，这将衡量使用该父母的保真度 干预原则（主要结果），儿童社交交流，自闭症症状水平，影响 自闭症症状和发育延迟程度。 在这项研究结束时，我们将开发一个基于证据的，全面的，自由的 美国拉丁裔家庭可以在其移动设备上使用，可用的父母交付干预措施 等待诊断和干预。这将增加父母的功效并减轻压力，加速他们的压力 儿童的技能，减少干扰行为，并增强PCP实施普遍自闭症的意愿 筛选。