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 患有诊断或疑似自闭症的拉丁裔儿童等待诊断的时间特别长， 干预，长达一年甚至更长时间。这种延迟获得干预的情况可能会阻止儿童 在技能和适应性功能方面充分发挥潜力。一个全面的、基于在线移动的设备的、 在这些等待名单上的父母可以使用的免费干预可能会优化他们孩子的发展。 我们已经开发了这样一个项目，即早期干预在线家长培训（OPT-In-Early）项目。 它教导父母应用行为分析和自然干预的基本原则， 使用非技术语言，视频演示，指导选择适当的技能来教授， 将教学融入日常生活，减少干扰行为。这是一个自定进度，个性化 为父母提供加强亲子关系的策略，教授基本技能，如 简单的沟通，以减少干扰行为，并建立有用的例程。在随机对照试验中， 父母（其中一半自认为是拉丁裔）评价该计划非常高，并表现出积极的 行为和知识的变化。 目前项目的目标是开发和试点测试一个西班牙语/英语双语文化定制 美国拉丁裔家庭的OPT-In-Early版本。首先，我们将从以下方面获得详细的反复反馈： 双语拉丁裔父母与自闭症儿童关于OPT-In-Early.我们将利用这些反馈， 调整节目内容和格式。接下来，我们将通过西班牙语的用户测试来修改改编后的程序- 说话的父母最后，我们将在为期六个月的试验性RCT中测试双语版本，为全面- 动力R 01试验。我们将使用等待列表控制设计：立即干预手臂将被给予在线 计划组和后期干预组（对照组）将获得有关自闭症的教育材料。所有儿童 将接受基线和6个月的随访评估，这将衡量父母在使用 干预原则（主要结局），儿童社会交往，孤独症症状水平， 自闭症症状和发育迟缓的程度 在这项研究的结论，我们将制定一个循证的，全面的，自由的 美国拉丁裔家庭可以在他们的移动的设备上使用， 等待诊断和干预。这将提高父母的效能，减少他们的压力，加速他们的成长。 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