Test of an Innovative, Scalable Support Program for Parents with a Young Child Recently Diagnosed with Autism Spectrum Disorder

针对最近被诊断患有自闭症谱系障碍的幼儿的父母测试创新的、可扩展的支持计划

• 批准号: 10573205
• 负责人: MARK Ethan FEINBERG
• 金额: $ 67万
• 依托单位: PENNSYLVANIA STATE UNIVERSITY, THE
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-06-17 至 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10573205
• 关键词: Address; Aggressive behavior; Anxiety; Autism Diagnosis; Behavioral; Birth; Characteristics; Child; Child Behavior; Child Rearing; Conflict (Psychology); Country; Data; Diagnosis; Disease; Early Intervention; Environment; Family; Family Relationship; Family Violence; Financial Hardship; Foundations; Health Services; Health Services Accessibility; Healthcare; Home; Home visitation; Individual; Intervention; Life; Manuals; Mediating; Medical; Mental Depression; Mental Health; Mentors; Modeling; Monitor; Outcome; Parents; Pathway interactions; Patient Recruitments; Problem behavior; Procedures; Process; Quality of life; Randomized; Reporting; Schools; Self Efficacy; Services; Social Work; South Carolina; Strategic Planning; Stress; Structure; Syndrome; Testing; Training; Voice; Work; autism spectrum disorder; autistic children; cohort; cost; cost effective; design; efficacy evaluation; evidence base; family support; flexibility; follow-up; high risk population; improved; innovation; parental influence; peer coaching; peer support; preventive intervention; primary outcome; programs; randomized trial; recruit; secondary outcome; skills; stressor; treatment program

Abstract Improving the family environment, service access, and behavioral adjustment of children with Autism Spectrum Disorder (ASD) has high relevance both for the children and their families as well as for health care and service payors. Family environment is a critical influence on ASD children’s adjustment: Poor parent adjustment increases behavior problems in ASD children, reduces parents’ capacity to access and adhere to critical services, and dampens or eliminates the benefits of early intervention. However, due to the stressors of navigating ASD-related and medical services, as well as managing child behavior challenges, parents of children with ASD report low levels of individual and couple adjustment. Parents report high levels of depression and anxiety, and low levels of parental efficacy and couple relationship quality compared to parents of typically developing children. To address the dual needs of parents for support in navigating ASD services and maintaining positive family functioning, we propose to test Autism Parent Navigators (APN), an innovative in-home, peer support model for parents with a young child recently diagnosed with ASD. APN was designed to be feasible and scalable by relying on parent peer mentors to conduct sessions. Extensive pilot work over the past 3 years has generated evidence of feasibility, acceptability, and impact. This pilot work has allowed us to fine-tune the parent mentor training, participant recruitment, delivery, and fidelity monitoring procedures. Aim 1. To assess the efficacy of APN in a randomized trial with 180 families. Aim 2. To test the mediating pathways through which APN impacts outcomes: We will test whether impact on proximal targets (ASD-related appraisals; coparenting; parent self-efficacy about accessing services; and peer mentor support) influence parent mental health, parenting, and treatment engagement, and if these in turn influence child outcomes. Aim 3. To assess whether baseline parent characteristics (financial stress, mental health, relationship conflict), child characteristics, or program processes (fidelity, parent engagement) moderate outcomes.

抽象的 改善儿童的家庭环境，服务访问和行为调整 自闭症谱系障碍（ASD）对儿童及其家人都具有很高的相关性 以及医疗保健和服务付款人。家庭环境是对ASD的关键影响 儿童调整：父母调整不佳会增加ASD儿童的行为问题， 降低父母获得和遵守关键服务的能力，并削弱或消除 早期干预的好处。但是，由于导航与ASD相关的压力源和 医疗服务以及管理儿童行为挑战，ASD儿童的父母 报告较低的个人和夫妇调整。父母报告高水平的抑郁症 与动画，父母效率低的水平和夫妻关系质量相比 典型成长子女的父母。解决父母双重需求以支持 导航ASD服务并保持积极的家庭功能，我们建议测试自闭症 家长导航员（APN），一种创新的家庭，同伴支持模型，适合父母的年轻人 最近被诊断出患有ASD的孩子。 APN的设计是可行的和可扩展的 家长同伴导师进行会议。过去三年中，大量的飞行员工作已有 产生了可行性，可接受性和影响的证据。这项飞行员的工作使我们能够 微调父母的心理培训，参与者招聘，交付和保真度监测 程序。 目的1。在与180个家庭的随机试验中评估APN的效率。目标2。测试 APN影响结果的中介途径：我们将测试是否影响 近端目标（与ASD相关的评估；共同降低；父母在访问 服务；和同伴的心理支持）影响父母的心理健康，育儿和治疗 参与，如果这些反过来影响儿童的结果。目标3。评估基线是否 父母特征（财务压力，心理健康，关系冲突），儿童特征， 或计划过程（保真度，父母参与）中等结果。