Addressing disruptive behaviors within naturalistic developmental behavioral interventions: Clinical decision-making, intervention outcomes, and implications for practice / Elizabeth H. KUSHNER in Autism, 28-6 (June 2024)  

Public ISBD [article]  inAutism > 28-6 (June 2024) . - p.1441-1456 Titre : Addressing disruptive behaviors within naturalistic developmental behavioral interventions: Clinical decision-making, intervention outcomes, and implications for practice Type de document : Texte imprimé et/ou numérique Auteurs : Elizabeth H. KUSHNER, Auteur ; Nicole HENDRIX, Auteur ; Nailah ISLAM, Auteur ; Katherine PICKARD, Auteur Article en page(s) : p.1441-1456 Langues : Anglais (eng) Mots-clés : disruptive behaviors  implementation science  interventions-psychosocial/behavioral Index. décimale : PER Périodiques Résumé : Naturalistic developmental behavioral interventions are an empirically supported intervention approach for young autistic children. Despite the prevalence of disruptive behaviors among autistic children, most manualized caregiver-mediated naturalistic developmental behavioral interventions include limited formal guidance on when and how to manage disruptive behavior. The present study sought to characterize how clinicians address disruptive behaviors within the caregiver-mediated naturalistic developmental behavioral intervention, Project ImPACT, the effect of disruptive behavior on Project ImPACT delivery, and the extent to which disruptive behavior impacts social communication outcomes. Data collection was embedded within outpatient early intervention services and included clinicians' report of adaptations to address behavior within the electronic medical record, child social communication outcomes from 124 children and their caregivers, and interviews with certified Project ImPACT coaches and trainers. Results indicate that close to one-third of Project ImPACT sessions included adaptations made to address behavior and regulation. Furthermore, adaptations made to address disruptive behavior were associated with more adaptations to Project ImPACT overall, although behavior adaptations were not associated with child social communication outcomes. Qualitatively, clinicians described using a flexible approach to integrate content and coaching related to behavior and regulation. The present study indicates several future directions for supporting clinicians in addressing behavior and regulation within the naturalistic developmental behavioral intervention framework. Lay Abstract Naturalistic developmental behavioral interventions are a common and well-researched type of intervention for young autistic children that focus on supporting social communication. These interventions often do not include formal guidelines on how to address disruptive behaviors, even though they are common among autistic children. This study measured how often clinicians delivering a specific naturalistic developmental behavioral intervention, Project ImPACT, adapted how they delivered the program to address disruptive behavior, and how these adaptations related to children?s social communication outcomes at the end of their participation in the intervention. We also spoke with clinicians about how they address disruptive behavior and emotion regulation during their sessions. In this study, clinicians adapted Project ImPACT to address disruptive behaviors in about one-third of all sessions. These adaptations did not affect children?s social communication outcomes. Clinicians discussed how they felt social communication, disruptive behavior, and emotion regulation are linked to one another and that they often try to integrate intervention strategies to address each of these areas. However, they note that a clinicians' approach to addressing disruptive behavior might vary depending on their level of training and experience. These results indicate several future directions for supporting clinicians in addressing behavior and regulation effectively within these types of interventions. En ligne : https://dx.doi.org/10.1177/13623613231203308 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=529 [article] Addressing disruptive behaviors within naturalistic developmental behavioral interventions: Clinical decision-making, intervention outcomes, and implications for practice [Texte imprimé et/ou numérique] / Elizabeth H. KUSHNER, Auteur ; Nicole HENDRIX, Auteur ; Nailah ISLAM, Auteur ; Katherine PICKARD, Auteur . - p.1441-1456. Langues : Anglais (eng) in Autism > 28-6 (June 2024) . - p.1441-1456 Mots-clés : disruptive behaviors  implementation science  interventions-psychosocial/behavioral Index. décimale : PER Périodiques Résumé : Naturalistic developmental behavioral interventions are an empirically supported intervention approach for young autistic children. Despite the prevalence of disruptive behaviors among autistic children, most manualized caregiver-mediated naturalistic developmental behavioral interventions include limited formal guidance on when and how to manage disruptive behavior. The present study sought to characterize how clinicians address disruptive behaviors within the caregiver-mediated naturalistic developmental behavioral intervention, Project ImPACT, the effect of disruptive behavior on Project ImPACT delivery, and the extent to which disruptive behavior impacts social communication outcomes. Data collection was embedded within outpatient early intervention services and included clinicians' report of adaptations to address behavior within the electronic medical record, child social communication outcomes from 124 children and their caregivers, and interviews with certified Project ImPACT coaches and trainers. Results indicate that close to one-third of Project ImPACT sessions included adaptations made to address behavior and regulation. Furthermore, adaptations made to address disruptive behavior were associated with more adaptations to Project ImPACT overall, although behavior adaptations were not associated with child social communication outcomes. Qualitatively, clinicians described using a flexible approach to integrate content and coaching related to behavior and regulation. The present study indicates several future directions for supporting clinicians in addressing behavior and regulation within the naturalistic developmental behavioral intervention framework. Lay Abstract Naturalistic developmental behavioral interventions are a common and well-researched type of intervention for young autistic children that focus on supporting social communication. These interventions often do not include formal guidelines on how to address disruptive behaviors, even though they are common among autistic children. This study measured how often clinicians delivering a specific naturalistic developmental behavioral intervention, Project ImPACT, adapted how they delivered the program to address disruptive behavior, and how these adaptations related to children?s social communication outcomes at the end of their participation in the intervention. We also spoke with clinicians about how they address disruptive behavior and emotion regulation during their sessions. In this study, clinicians adapted Project ImPACT to address disruptive behaviors in about one-third of all sessions. These adaptations did not affect children?s social communication outcomes. Clinicians discussed how they felt social communication, disruptive behavior, and emotion regulation are linked to one another and that they often try to integrate intervention strategies to address each of these areas. However, they note that a clinicians' approach to addressing disruptive behavior might vary depending on their level of training and experience. These results indicate several future directions for supporting clinicians in addressing behavior and regulation effectively within these types of interventions. En ligne : https://dx.doi.org/10.1177/13623613231203308 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=529

Early Intervention Provider-Reported NDBI Use and Relationships with Provider- to System-Level Implementation Determinants / Nicole HENDRIX ; Emma CHATSON ; Hannah Davies ; Brooke Demetri ; Yijin Xiang ; Millena Yohannes ; Ainsley Buck ; Shannon Harper ; Jennifer STAPEL-WAX ; Katherine PICKARD in Journal of Autism and Developmental Disorders, 55-1 (January 2025)  

Public ISBD [article]  inJournal of Autism and Developmental Disorders > 55-1 (January 2025) . - p.103-113 Titre : Early Intervention Provider-Reported NDBI Use and Relationships with Provider- to System-Level Implementation Determinants : Journal of Autism and Developmental Disorders Type de document : Texte imprimé et/ou numérique Auteurs : Nicole HENDRIX, Auteur ; Emma CHATSON, Auteur ; Hannah Davies, Auteur ; Brooke Demetri, Auteur ; Yijin Xiang, Auteur ; Millena Yohannes, Auteur ; Ainsley Buck, Auteur ; Shannon Harper, Auteur ; Jennifer STAPEL-WAX, Auteur ; Katherine PICKARD, Auteur Article en page(s) : p.103-113 Langues : Anglais (eng) Index. décimale : PER Périodiques Résumé : An expanding evidence base has advocated for delivery of naturalistic developmental behavioral interventions (NDBIs) within community systems, thus extending the reach of these practices to young autistic children. The current study examined provider-reported use of NBDIs within a Part C Early Intervention (EI) system and the extent to which provider background, attitudes, and perceived organizational support predicted NDBI use. Results from 100 EI providers representing multiple disciplines indicated reported use of NDBI strategies within their practice despite inconsistent reported competency with manualized NDBI programs. Although NDBI strategy use was not predicted by provider experiences or perceived organizational support, provider openness to new interventions predicted the reported use of NDBI strategies. Future directions include mixed methods data collection across and within EI systems to better understand NDBI use and ultimately facilitate NDBI implementation. En ligne : https://doi.org/10.1007/s10803-023-06203-3 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=546 [article] Early Intervention Provider-Reported NDBI Use and Relationships with Provider- to System-Level Implementation Determinants : Journal of Autism and Developmental Disorders [Texte imprimé et/ou numérique] / Nicole HENDRIX, Auteur ; Emma CHATSON, Auteur ; Hannah Davies, Auteur ; Brooke Demetri, Auteur ; Yijin Xiang, Auteur ; Millena Yohannes, Auteur ; Ainsley Buck, Auteur ; Shannon Harper, Auteur ; Jennifer STAPEL-WAX, Auteur ; Katherine PICKARD, Auteur . - p.103-113. Langues : Anglais (eng) in Journal of Autism and Developmental Disorders > 55-1 (January 2025) . - p.103-113 Index. décimale : PER Périodiques Résumé : An expanding evidence base has advocated for delivery of naturalistic developmental behavioral interventions (NDBIs) within community systems, thus extending the reach of these practices to young autistic children. The current study examined provider-reported use of NBDIs within a Part C Early Intervention (EI) system and the extent to which provider background, attitudes, and perceived organizational support predicted NDBI use. Results from 100 EI providers representing multiple disciplines indicated reported use of NDBI strategies within their practice despite inconsistent reported competency with manualized NDBI programs. Although NDBI strategy use was not predicted by provider experiences or perceived organizational support, provider openness to new interventions predicted the reported use of NDBI strategies. Future directions include mixed methods data collection across and within EI systems to better understand NDBI use and ultimately facilitate NDBI implementation. En ligne : https://doi.org/10.1007/s10803-023-06203-3 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=546

Examining provider decisions around the delivery and adaptation of a parent-mediated intervention within an Early Intervention system / Katherine PICKARD in Autism, 27-8 (November 2023)  

Public ISBD [article]  inAutism > 27-8 (November 2023) . - p.2384-2396 Titre : Examining provider decisions around the delivery and adaptation of a parent-mediated intervention within an Early Intervention system Type de document : Texte imprimé et/ou numérique Auteurs : Katherine PICKARD, Auteur ; Nicole HENDRIX, Auteur ; Karen GUERRA, Auteur ; Natalie BRANE, Auteur ; Nailah ISLAM, Auteur Article en page(s) : p.2384-2396 Mots-clés : adaptation  autism spectrum disorders  Early Intervention system  fidelity  implementation  parent-mediated intervention Index. décimale : PER Périodiques Résumé : There is growing research aimed at translating parent-mediated interventions into Part C Early Intervention systems to examine the effectiveness and reach of these models. Although research to date suggests that Early Intervention providers deliver parent-mediated intervention near fidelity, current fidelity reporting practices make delivery difficult to discern. Understanding how parent-mediated interventions are delivered and adapted in a more nuanced manner, including fine-grained intervention delivery and adaptation processes, is important and may increase our understanding of how well these models are aligned within Early Intervention systems. The current study examined the delivery of an evidence-based parent-mediated intervention, Project ImPACT, when delivered by Early Intervention providers and examined their intervention fidelity, the decisions they weighed when delivering Project ImPACT, and reported adaptations to Project ImPACT. Results from 24 providers demonstrated, on average, higher fidelity in response to consultative feedback but notable variability across providers. Preliminary qualitative data highlighted that many events arose within sessions that drove providers to augment their delivery of Project ImPACT. Results suggest the importance of carefully examining how and why providers deliver evidence-based interventions within Early Intervention systems, and the impact of these decisions on fidelity metrics and service outcomes.Lay abstractParent-mediated interventions are an evidence-based practice for autism in which providers support caregivers in learning and applying strategies that support their child?s development. Research has begun to study whether parent-mediated interventions can be effectively delivered in Part C Early Intervention systems. This research has been promising; however, it has been difficult to determine how Early Intervention providers deliver and adapt parent-mediated interventions to meet the needs of the families they serve. Examining how parent-mediated interventions are delivered and adapted may help us understand whether parent-mediated interventions are a good fit in these systems. The current study examined the delivery of an evidence-based parent-mediated intervention, Project ImPACT, when delivered by providers within an Early Intervention system. Results from 24 Early Intervention providers demonstrated that, on average, providers delivered Project ImPACT with higher quality during their time in training and consultation. However, there was also variability in how providers delivered Project ImPACT, with some delivering the program inconsistently, some increasing their quality throughout consultation, and others having consistently high-quality delivery. In addition, qualitative data demonstrated that a variety of events arose within Project ImPACT sessions that drove providers to adapt the program. Results suggest the importance of carefully examining how and why providers deliver evidence-based interventions within Early Intervention systems. En ligne : http://dx.doi.org/10.1177/13623613231162149 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=513 [article] Examining provider decisions around the delivery and adaptation of a parent-mediated intervention within an Early Intervention system [Texte imprimé et/ou numérique] / Katherine PICKARD, Auteur ; Nicole HENDRIX, Auteur ; Karen GUERRA, Auteur ; Natalie BRANE, Auteur ; Nailah ISLAM, Auteur . - p.2384-2396. in Autism > 27-8 (November 2023) . - p.2384-2396 Mots-clés : adaptation  autism spectrum disorders  Early Intervention system  fidelity  implementation  parent-mediated intervention Index. décimale : PER Périodiques Résumé : There is growing research aimed at translating parent-mediated interventions into Part C Early Intervention systems to examine the effectiveness and reach of these models. Although research to date suggests that Early Intervention providers deliver parent-mediated intervention near fidelity, current fidelity reporting practices make delivery difficult to discern. Understanding how parent-mediated interventions are delivered and adapted in a more nuanced manner, including fine-grained intervention delivery and adaptation processes, is important and may increase our understanding of how well these models are aligned within Early Intervention systems. The current study examined the delivery of an evidence-based parent-mediated intervention, Project ImPACT, when delivered by Early Intervention providers and examined their intervention fidelity, the decisions they weighed when delivering Project ImPACT, and reported adaptations to Project ImPACT. Results from 24 providers demonstrated, on average, higher fidelity in response to consultative feedback but notable variability across providers. Preliminary qualitative data highlighted that many events arose within sessions that drove providers to augment their delivery of Project ImPACT. Results suggest the importance of carefully examining how and why providers deliver evidence-based interventions within Early Intervention systems, and the impact of these decisions on fidelity metrics and service outcomes.Lay abstractParent-mediated interventions are an evidence-based practice for autism in which providers support caregivers in learning and applying strategies that support their child?s development. Research has begun to study whether parent-mediated interventions can be effectively delivered in Part C Early Intervention systems. This research has been promising; however, it has been difficult to determine how Early Intervention providers deliver and adapt parent-mediated interventions to meet the needs of the families they serve. Examining how parent-mediated interventions are delivered and adapted may help us understand whether parent-mediated interventions are a good fit in these systems. The current study examined the delivery of an evidence-based parent-mediated intervention, Project ImPACT, when delivered by providers within an Early Intervention system. Results from 24 Early Intervention providers demonstrated that, on average, providers delivered Project ImPACT with higher quality during their time in training and consultation. However, there was also variability in how providers delivered Project ImPACT, with some delivering the program inconsistently, some increasing their quality throughout consultation, and others having consistently high-quality delivery. In addition, qualitative data demonstrated that a variety of events arose within Project ImPACT sessions that drove providers to adapt the program. Results suggest the importance of carefully examining how and why providers deliver evidence-based interventions within Early Intervention systems. En ligne : http://dx.doi.org/10.1177/13623613231162149 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=513

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