<b>For the Dads: Using Practice-Based Coaching to Teach Fathers of Young Children with Autism an Enhanced Milieu Teaching Intervention Via Telehealth</b>
Creators: name: Shannon, Eric Neil
Publisher: name: Purdue University Graduate School
Year: 2024
Subjects: classificationCode: 390411
subject: Special education and disability

description: ABSTRACTIndividuals with autism spectrum disorder (ASD) experience deficits in social communication skills, but the literature suggests that addressing early communication at a young age can result in a myriad of positive outcomes later in life. Early intervention and intensive applied behavior analysis therapy have become commonplace for many, but those supports are costly and may not be accessible to all. Additionally, even for those that do have access, an emphasis is being placed on caregiver-mediated interventions (CMIs) that can be implemented outside of sessions with service providers. Research indicates that CMIs can help children generalize skills to routines and contexts within their natural home environment. CMIs that directly target natural play routines, such as Enhanced Milieu Teaching (EMT), have been repeatedly implemented successfully by caregivers to improve both caregiver implementation outcomes and child expressive communication.Despite the benefits, most CMI interventions for children with ASD have been delivered primarily to mothers, although fathers have reported that they also want access to supports. Barriers that prevent all caregivers from engaging in CMIs are extensive, but additional hurdles exist for fathers, including providers not prioritizing their access to relevant information, inflexible in-person session hours, and provider biases. Many of these barriers can be addressed through the use of modifications and teleahealth service delivery. This study aimed to explore the effectiveness of a father-mediated telehealth EMT intervention delivered via a collaborative practice-based coaching (PBC) partnership. We incorporated modifications to meet the specific needs and desires of fathers, including short weekly coaching sessions over Zoom, flexible scheduling inside and outside of traditional business hours, initial background information on ASD and the principles of operant conditioning, a focus on typical father-child play routines, asynchronous supports to supplement coaching sessions, and video training models of fathers acting as the intervention agent. Two father-child dyads completed the study, which utilized a multiple baseline across behaviors design with four intervention tiers to teach separate EMT implementation strategies. Fathers uploaded two 5-min videos engaging with their child in a chosen play routine each week, and implementation fidelity and child expressive communication were coded. Visual analysis of father data and descriptive analysis of child communication was used to determine the effects of the intervention. Additionally, father well-being and ASD knowledge were assessed via pretest and posttest surveys.Results indicate that fathers can successfully implement the EMT intervention with their children with ASD. As a result of improvements in father implementation, substantial increases in child expressive communication occurred. However, the intervention may not have had an influence on father well-being outcomes, as survey responses improved for one participant but worsened for the other. This study provides evidence that EMT delivered to caregivers–and particularly fathers–via telehealth-based PBC may be ideal to address the needs of children with ASD and their families.