The Development and Implementation of an Early Intervention Program for Underserved Families of Children with Autism Spectrum Disorder.

摘要

This dissertation focuses on the design and implementation of an early intervention protocol—the Early Social Interaction-Community Outreach Project (ESI-CO)—for families with limited education and limited income. The project was modified from an existing parent-mediated intervention, the Early Social Interaction Project (Wetherby & Woods, 2006), to increase participation from a population that historically has been underserved, and to place greater emphasis on the influences of family environment and experiences of caregivers of children with ASD. Specific aims of the project were to 1) apply empirically supported methods for promoting treatment attendance, adherence, and retention in the specified population; and 2) provide preliminary outcome data that includes descriptive, quantitative, and qualitative analyses of the experiences of participating families. Participants were 14 families from the Southeast Michigan region. Families received 24 in-home treatment sessions over the course of 5 months with an additional 3 months of resource support. Data were collected and analyzed using a mixed- methods approach. A single-subject multiple baseline design was used to measure caregivers’ acquisition of strategies to facilitate their child’s social engagement and communication, while additional data were collected qualitatively to assess caregivers’ satisfaction with the intervention. Eight families completed the intervention, yielding an attrition rate of 38%. This rate was higher than most other reported autism interventions, but lower than what is typically reported in research with low-income populations. Data are presented on the first four families to complete the intervention. Caregivers demonstrated acquisition of treatment strategies with generalization of skills to activities and families were assisted in identifying and enrolling in community autism resources. Overall, caregivers reported positive experiences with the intervention. The ESI-CO study yields promising results in promoting positive change in families from underserved populations. Future directions will include the recruitment of a larger sample and modifications to the research and intervention design to afford the examination of mediating and moderating factors affecting caregiver and child outcome. Results from the project will contribute to the development of treatment services that are accessible and appropriate for families from diverse socioeconomic backgrounds.