Test of an Innovative, Scalable Support Program for Parents with a Young Child Recently Diagnosed with Autism Spectrum Disorder

针对最近被诊断患有自闭症谱系障碍的幼儿的父母测试创新的、可扩展的支持计划

• 批准号: 10197178
• 负责人: MARK Ethan FEINBERG
• 金额: $ 66.99万
• 依托单位: PENNSYLVANIA STATE UNIVERSITY, THE
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-06-17 至 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10197178
• 关键词: Address; Aggressive behavior; Anxiety; Behavioral; Birth; Characteristics; Child; Child Behavior; Child Rearing; Conflict (Psychology); Country; Data; Diagnosis; Disease; Early Intervention; Environment; Family; Family Relationship; Family Violence; Financial Hardship; Foundations; Health Services Accessibility; Healthcare; Home; Home visitation; Individual; Intervention; Life; Mediating; Medical; Mental Depression; Mental Health; Mentors; Modeling; Monitor; Outcome; Parents; Pathway interactions; Patient Recruitments; Problem behavior; Procedures; Process; Quality of life; Randomized; Reporting; Schools; Self Efficacy; Services; Social Work; South Carolina; Strategic Planning; Stress; Structure; Syndrome; Testing; Training; Voice; Work; autism spectrum disorder; autistic children; cohort; cost; cost effective; design; evidence base; family support; flexibility; follow-up; health care service; high risk population; improved; innovation; parental influence; peer coaching; peer support; preventive intervention; primary outcome; programs; randomized trial; recruit; secondary outcome; skills; stressor; treatment program

Abstract Improving the family environment, service access, and behavioral adjustment of children with Autism Spectrum Disorder (ASD) has high relevance both for the children and their families as well as for health care and service payors. Family environment is a critical influence on ASD children’s adjustment: Poor parent adjustment increases behavior problems in ASD children, reduces parents’ capacity to access and adhere to critical services, and dampens or eliminates the benefits of early intervention. However, due to the stressors of navigating ASD-related and medical services, as well as managing child behavior challenges, parents of children with ASD report low levels of individual and couple adjustment. Parents report high levels of depression and anxiety, and low levels of parental efficacy and couple relationship quality compared to parents of typically developing children. To address the dual needs of parents for support in navigating ASD services and maintaining positive family functioning, we propose to test Autism Parent Navigators (APN), an innovative in-home, peer support model for parents with a young child recently diagnosed with ASD. APN was designed to be feasible and scalable by relying on parent peer mentors to conduct sessions. Extensive pilot work over the past 3 years has generated evidence of feasibility, acceptability, and impact. This pilot work has allowed us to fine-tune the parent mentor training, participant recruitment, delivery, and fidelity monitoring procedures. Aim 1. To assess the efficacy of APN in a randomized trial with 180 families. Aim 2. To test the mediating pathways through which APN impacts outcomes: We will test whether impact on proximal targets (ASD-related appraisals; coparenting; parent self-efficacy about accessing services; and peer mentor support) influence parent mental health, parenting, and treatment engagement, and if these in turn influence child outcomes. Aim 3. To assess whether baseline parent characteristics (financial stress, mental health, relationship conflict), child characteristics, or program processes (fidelity, parent engagement) moderate outcomes.

抽象的 改善儿童的家庭环境、服务获取和行为调节 自闭症谱系障碍 (ASD) 与儿童及其家庭具有高度相关性 以及医疗保健和服务支付者，家庭环境对自闭症谱系障碍具有重要影响。 孩子的适应能力：父母适应能力差会增加自闭症儿童的行为问题， 父母获得和坚持关键服务的能力，并削弱或消除 然而，由于自闭症谱系障碍（ASD）相关的压力因素和早期干预的好处。 医疗服务，以及管理儿童行为挑战，自闭症儿童的父母 父母报告个人和夫妻适应水平较低。 和焦虑，以及与其他人相比，父母效能和夫妻关系质量水平较低 满足发育中儿童父母的双重需求。 导航 ASD 服务并维持积极的家庭功能，我们建议测试自闭症 Parent Navigators (APN)，一种创新的家庭同伴支持模式，为有孩子的父母提供服务 APN 的设计是可行且可扩展的，依赖于最近被诊断出患有 ASD 的孩子。 家长同伴导师在过去 3 年开展了广泛的试点工作。 这项试点工作使我们能够提供可行性、可接受性和影响力的证据。 微调家长导师培训、参与者招募、交付和忠诚度监控 程序。 目标 1. 在一项针对 180 个家庭的随机试验中评估 APN 的功效。 目标 2. 进行测试。 APN 影响结果的中介途径：我们将测试是否对 近端目标（自闭症谱系障碍相关评估；共同养育；家长关于获取信息的自我效能 服务；和同伴导师支持）影响父母的心理健康、养育和治疗 目标 3. 评估基线是否有效。 父母特征（经济压力、心理健康、关系冲突）、孩子特征、 或计划流程（忠诚度、家长参与）调节结果。