Background Parent-mediated early interventions (EI) for children with autism spectrum disorder (ASD) can result in significant improvements in children's cognitive ability, social functioning, behavior, and adaptive skills, as well as improvements in parental self-efficacy and treatment engagement. The common component to efficacious parent-mediated early interventions for ASD is clinician use of parent coaching and occurs when a clinician actively teaches the parent techniques to improve their child's functioning. Available evidence suggests that community-based EI clinicians rarely coach parents when working with families of these children, although specific barriers to coaching are unknown. This consistent finding points to the need to develop strategies to improve the use of parent coaching in community EI programs. The purpose of this community-partnered study is to iteratively develop and pilot test a toolkit of implementation strategies designed to increase EI clinicians' use of parent coaching. Methods This study has four related phases. Phase 1: examine how EI clinicians trained in Project ImPACT, an evidence-based parent-mediated intervention, coach parents of children with ASD. Phase 2: identify barriers and facilitators to clinician implementation of parent coaching by administering validated questionnaires to, and conducting semi-structured interviews with, clinicians, parents, and agency leaders. Phase 3: partner with a community advisory board to iteratively develop a toolkit of implementation strategies that addresses identified barriers and capitalizes on facilitators to improve clinician implementation of evidence-based parent coaching. Phase 4: pilot test the feasibility and effectiveness of the implementation strategy toolkit in improving EI clinicians' use of parent coaching with nine EI clinicians and parent-child dyads using a multiple-baseline-across-participants single-case design. Discussion Completion of these activities will lead to an in-depth understanding of EI clinicians' implementation of parent coaching in usual practice following training in an evidence-based parent-mediated intervention, barriers to their implementation of parent coaching, a toolkit of implementation strategies developed through an iterative community-partnered process, and preliminary evidence regarding the potential for this toolkit to improve EI clinicians' implementation of parent coaching. These pilot data will offer important direction for a larger evaluation of strategies to improve the use of parent coaching for young children with ASD.

中文翻译：

---

早期干预中的家长授权和指导：可行性研究的研究方案。

背景 对自闭症谱系障碍 (ASD) 儿童的父母介导的早期干预 (EI) 可以显着改善儿童的认知能力、社会功能、行为和适应技能，并提高父母的自我效能感和治疗参与度。有效的父母介导的 ASD 早期干预的共同组成部分是临床医生使用父母辅导，并且当临床医生积极教授父母技术以改善其孩子的功能时发生。现有证据表明，以社区为基础的 EI 临床医生在与这些孩子的家庭一起工作时很少指导父母，尽管指导的具体障碍尚不清楚。这一一致的发现表明需要制定策略来改善社区 EI 项目中家长辅导的使用。这项社区合作研究的目的是迭代开发和试点测试旨在增加 EI 临床医生使用家长指导的实施策略工具包。方法 本研究有四个相关阶段。第 1 阶段：检查 EI 临床医生如何在 Project ImPACT 中进行培训，这是一种基于证据的父母介导的干预措施，指导患有 ASD 儿童的父母。第 2 阶段：通过对临床医生、家长和机构负责人进行经过验证的问卷调查并进行半结构化访谈，确定临床医生实施家长辅导的障碍和促进因素。第 3 阶段：与社区咨询委员会合作，反复开发实施策略工具包，以解决已确定的障碍并利用促进者改善临床医生实施循证家长指导。第 4 阶段：试点测试实施策略工具包在改进 EI 临床医生使用家长指导方面的可行性和有效性，与 9 名 EI 临床医生和亲子二元组一起使用多基线跨参与者单案例设计。讨论 完成这些活动将有助于深入了解 EI 临床医生在接受基于证据的父母介导干预培训后在日常实践中实施家长指导的情况、实施家长指导的障碍、制定的实施策略工具包通过一个迭代的社区合作过程，以及初步证据表明该工具包有可能改善 EI 临床医生对家长指导的实施。