Effectiveness of Online-Delivered Project ImPACT for Children With ASD and Their Parents: A Pilot Study During the COVID-19 Pandemic

Fēi Li, Danping Wu, Fang Ren, Lixiao Shen, Minbo Xue, Juehua Yu, Lingli Zhang, Yun Tang, Xin Liu, Minyi Tao, Li Zhou, Liping Jiang, Mingyu Xu, Fei Li, Fēi Li, Danping Wu, Fang Ren, Lixiao Shen, Minbo Xue, Juehua Yu, Lingli Zhang, Yun Tang, Xin Liu, Minyi Tao, Li Zhou, Liping Jiang, Mingyu Xu, Fei Li

Abstract

Objective: During the COVID-19 pandemic, face-to-face intervention services for families of children with autism spectrum disorder (ASD) were limited. This study aimed to evaluate the effectiveness of an 8-week, online-delivered Project ImPACT program for children with ASD and their parents in China during the COVID-19 pandemic.

Methods: A pilot non-randomized study with a waitlist control group was conducted in 68 children with ASD and their parents in the Department of Developmental and Behavioral Pediatrics between April 15, 2020 and March 19, 2021. Participants were allocated to either the intervention (IG) or the waitlist group (WLG) according to their order of recruitment. Parents in the IG immediately received 8 weeks of the online-delivered Project ImPACT program, and the WLG received the same program with a delay when the IG had completed all sessions. Participants in both groups received treatment as usual during the research period.

Results: The online-delivered Project ImPACT program significantly improved the parent-reported social communication skills of children with ASD. Furthermore, parent's involvement in the training program produced a collateral reduction in parenting stress and an increase in perceived competence in the parental role. Parents rated the program acceptable in terms of curriculum schedule, session content, homework assignments, and therapist feedback.

Conclusions: The 8-week, online-delivered Project ImPACT program is a feasible and effective social skill training program for families of children with ASD in China during the COVID-19 pandemic. Due to the methodological limitations, randomized controlled studies with larger sample sizes are suggested to provide more solid evidence.

Keywords: autism spectrum disorder; e-health; parent-mediated intervention; parenting stress; social communication.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2022 Li, Wu, Ren, Shen, Xue, Yu, Zhang, Tang, Liu, Tao, Zhou, Jiang, Xu and Li.

Figures

Figure 1
Figure 1
CONSORT diagram of the study flow. CONSORT, Consolidated Standards of Reporting Trials; ASD, autism spectrum disorder; IG, intervention group; WLG, waitlist group.

References

    1. Francesmonneris A, Pincus H, First M. Diagnostic and Statistical Manual of Mental Disorders: DSM-V. Arlington: American Psychiatric Association; (2013).
    1. Maenner MJ, Shaw KA, Baio J, Washington A, Patrick M, DiRienzo M, et al. . Prevalence of autism spectrum disorder among children aged 8 years - Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2016. MMWR Surveill Summ. (2020) 69:1–12. 10.15585/mmwr.ss6904a1
    1. Cheung PPP, Brown T, Yu ML, Siu AMH. The effectiveness of a school-based social cognitive intervention on the social participation of Chinese children with autism. J Autism Dev Disord. (2021) 51:1894–908. 10.1007/s10803-020-04683-1
    1. Duvall S, Armstrong K, Shahabuddin A, Grantz C, Fein D, Lord C. A road map for identifying autism spectrum disorder: recognizing and evaluating characteristics that should raise red or “pink” flags to guide accurate differential diagnosis. Clin Neuropsychol. (2021) 16:1–36. 10.1080/13854046.2021.1921276
    1. Hoefman R, Payakachat N, Exel J, Kuhlthau K, Kovacs E, Pyne J, et al. . Caring for a child with autism spectrum disorder and parents' quality of life: application of the carerQol. J Autism Dev Disord. (2014) 44:1933–45. 10.1007/s10803-014-2066-1
    1. Maglione MA, Gans D, Das L, Timbie J, Kasari C, Res-Behav HAI. Nonmedical interventions for children with ASD: recommended guidelines and further research needs. Pediatrics. (2012) 130:S169–S78. 10.1542/peds.2012-0900O
    1. Elder JH, Brasher S, Alexander B. Identifying the barriers to early diagnosis and treatment in underserved individuals with autism spectrum disorders (ASD) and their families: a qualitative study. Issues Ment Health Nurs. (2016) 37:412–20. 10.3109/01612840.2016.1153174
    1. Koly KN, Martin-Herz SP, Islam MS, Sharmin N, Blencowe H, Naheed A. Parent mediated intervention programmes for children and adolescents with neurodevelopmental disorders in South Asia: a systematic review. PLoS ONE. (2021) 16:e0247432-e. 10.1371/journal.pone.0247432
    1. Wetherby AM, Guthrie W, Woods J, Schatschneider C, Holland RD, Morgan L, et al. . Parent-implemented social intervention for toddlers with autism: an RCT. Pediatrics. (2014) 134:1084–93. 10.1542/peds.2014-0757
    1. Nevill RE, Lecavalier L, Stratis EA. Meta-analysis of parent-mediated interventions for young children with autism spectrum disorder. Autism. (2018) 22:84–98. 10.1177/1362361316677838
    1. Althoff CE, Dammann CP, Hope SJ, Ausderau KK. Parent-mediated interventions for children with autism spectrum disorder: a systematic review. Am J Occup Ther. (2019) 73:1–13. 10.5014/ajot.2019.030015
    1. Corona LL, Janicki C, Milgramm A, Christodulu KV. Brief report: reductions in parenting stress in the context of PEERS-a social skills intervention for adolescents with autism spectrum disorder. J Autism Dev Disord. (2019) 49:5073–7. 10.1007/s10803-019-04201-y
    1. Wainer AL. Increasing the Dissemination of an Evidence-based ASD Intervention via a Telehealth Parent Training Program. East Lansing, MI: Michigan State University; (2014).
    1. Bearss K, Burrell TL, Challa SA, Postorino V, Gillespie SE, Crooks C, et al. . Feasibility of parent training via telehealth for children with autism spectrum disorder and disruptive behavior: a demonstration pilot. J Autism Dev Disord. (2018) 48:1020–30. 10.1007/s10803-017-3363-2
    1. Nocker YLD, Toolan CK. Using telehealth to provide interventions for children with ASD: a systematic review. Rev J Autism Dev Disord. (2021) 13:1–31. 10.1007/s40489-021-00278-3
    1. Teles S, Ferreira A, Seeher K, Fréel S, Paúl C. Online training and support program (iSupport) for informal dementia caregivers: protocol for an intervention study in Portugal. BMC Geriatr. (2020) 20:10. 10.1186/s12877-019-1364-z
    1. Moshe I, Terhorst Y, Philippi P, Domhardt M, Cuijpers P, Cristea I, et al. . Digital interventions for the treatment of depression: a meta-analytic review. Psychol Bull. (2021) 147:749–86. 10.1037/bul0000334
    1. Alfuraydan M, Croxall J, Hurt L, Kerr M, Brophy S. Use of telehealth for facilitating the diagnostic assessment of Autism Spectrum Disorder (ASD): a scoping review. PLoS ONE. (2020) 15:e0236415. 10.1371/journal.pone.0236415
    1. Parsons D, Cordier R, Vaz S, Lee HC. Parent-mediated intervention training delivered remotely for children with autism spectrum disorder living outside of urban areas: systematic review. J Med Internet Res. (2017) 19:e198. 10.2196/jmir.6651
    1. Ingersoll B, Dvortcsak A. Teaching Social Communication to Children With Autism. New York, NY: Guilford Press; (2010).
    1. Ingersoll B, Dvortcsak A. Teaching Social Communication to Children with Autism & Other Developmental Delay:The Project ImPACT Manual for Parents. New York, NY: Guilford Press; (2019).
    1. Ingersoll BR, Wainer AL. Initial efficacy of Project ImPACT: a parent-mediated social communication intervention for young children with ASD. J Autism Dev Disord. (2013) 43:2943–52. 10.1007/s10803-013-1840-9
    1. Ingersoll BR, Wainer AL. Pilot study of a school-based parent training program for preschoolers with ASD. Autism. (2013) 17:434–48. 10.1177/1362361311427155
    1. Stadnick NA, Stahmer A, Brookman-Frazee L. Preliminary effectiveness of Project ImPACT: a parent-mediated intervention for children with autism spectrum disorder delivered in a community program. J Autism Dev Disord. (2015) 45:2092–104. 10.1007/s10803-015-2376-y
    1. Pickard KE, Wainer AL, Bailey KM, Ingersoll BR. A mixed-method evaluation of the feasibility and acceptability of a telehealth-based parent-mediated intervention for children with autism spectrum disorder. Autism. (2016) 20:845–55. 10.1177/1362361315614496
    1. Ingersoll BR, Wainer AL, Berger NI, Pickard KE, Bonter N. Comparison of a self-directed and therapist-assisted telehealth parent-mediated intervention for children with ASD: a pilot RCT. J Autism Dev Disord. (2016) 46:2275–84. 10.1007/s10803-016-2755-z
    1. Schopler E, Reichler RJ, Renner BR. The Childhood Autism Rating Scale (CARS). Los Angeles, CA: Western Psychological Services; (1988).
    1. Lord C, Risi S, Lambrecht L, Cook EH, Jr, Leventhal BL, DiLavore PC, et al. . The autism diagnostic observation schedule-generic: a standard measure of social and communication deficits associated with the spectrum of autism. J Autism Dev Disord. (2000) 30:205–23. 10.1037/t17256-000
    1. Constantino JN, Gruber CP. The Social Responsiveness Scale (SRS) Manual. Los Angeles, CA: Western Psychological Services; (2005).
    1. Magiati I, Moss J, Yates R, Charman T, Howlin P. Is the autism treatment evaluation checklist a useful tool for monitoring progress in children with autism spectrum disorders? J Intellect Disabil Res. (2011) 55:302–12. 10.1111/j.1365-2788.2010.01359.x
    1. Abidin R. Parenting Stress Index: Professional Manual. Odessa, FL: Psychological Assessment Resources Inc. (1995).
    1. Gibaud-Wallston J. Self-esteem and situational stress: factors related to sense of competence in new parents. Diss Abstr Int. (1977) 39:379–86.
    1. Ngai FW, Chan WC, Holroyd E. Translation and validation of a Chinese version of the parenting sense of competence scale in Chinese mothers. Nurs Res. (2007) 56:348–54. 10.1097/01.NNR.0000289499.99542.94
    1. Xianwei P. The meaning, calculation and interpretation of effect size in quantitative sutdy. Psychol Explor. (2016) 36:64–9. 10.3969/j.issn.1003-5184.2016.01.012
    1. Siller M, Sigman M. Modeling longitudinal change in the language abilities of children with autism: parent behaviors and child characteristics as predictors of change. Dev Psychol. (2008) 44:1691–704. 10.1037/a0013771
    1. Oono IP, Honey EJ, Mcconachie H. Parent-mediated early intervention for young children with autism spectrum disorders (ASD). Cochrane Database Syst Rev. (2013) 4:CD009774. 10.1002/14651858.CD009774.pub2
    1. Barroso NE, Mendez L, Graziano PA, Bagner DM. Parenting stress through the lens of different clinical groups: a systematic review & meta-analysis. J Abnorm Child Psychol. (2018) 46:449–61. 10.1007/s10802-017-0313-6
    1. Schnabel A, Youssef GJ, Hallford DJ, Hartley EJ, McGillivray JA, Stewart M, et al. . Psychopathology in parents of children with autism spectrum disorder: a systematic review and meta-analysis of prevalence. Autism. (2020) 24:26–40. 10.1177/1362361319844636
    1. Smart LK. Parenting Self-Efficacy in Parents of Children with Autism Spectrum Disorders. Provo, UT: Brigham Young University; (2016).
    1. McDevitt SE. While quarantined: an online parent education and training model for families of children with autism in China. Res Dev Disabil. (2021) 109:103851. 10.1016/j.ridd.2020.103851

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