Optimization of Fidelity Procedures for Pivotal Response Training in Autism

自闭症关键反应训练保真度程序的优化

• 批准号: 8900338
• 负责人: LAUREN BROOKMAN-FRAZEE
• 金额: $ 29.3万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-01 至 2017-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8900338
• 关键词: Address; Affect; Area; Autistic Disorder; Behavior; Behavior Therapy; Behavioral; Characteristics; Child; Child Behavior; Child Mental Health; Clinical; Code; Communities; Community Services; Data; Data Analyses; Development; Diagnosis; Discipline; Disease; Education; Effectiveness; Environment; Evaluation; Feedback; Funding; Goals; Health Personnel; Individual; Intervention; Investigation; Knowledge; Measures; Mental Health; Mental Health Services; Methods; Modeling; Modification; National Research Council; Outcome; Parents; Population; Procedures; Process; Prospective Studies; Provider; Research; Research Personnel; Sampling; Specific qualifier value; Supervision; Techniques; Testing; Time; Trainers Training; Training; Validation; citizen science; community setting; implementation science; improved; instrument; prospective; response; skills; teacher; therapy development; tool; usability

DESCRIPTION (provided by applicant): To improve the overall quality and effectiveness of mental health intervention, it is essential to identify empirically supported behavioral treatments (ESBTs) and assure the accessibility and usability of these treatments for providers in community settings. Fidelity of implementation (FI), or the degree to which an intervention is implemented as was intended, provides necessary information for training and maintaining providers' effectiveness. However, the tools and procedures used to measure FI and provide feedback to providers must be effective and efficient. Through archival data analysis and prospective assessment of individual treatment components, we aim to develop and assess an FI instrument and assessment procedures for an ESBT for children with autism. Autism is a key area of concern in the field of child mental health; Pivotal Response Training (PRT) is a naturalistic ESBT for this population (Humphries, 2003; National Standards Project, 2009). PRT is routinely used in community settings with limited data regarding treatment integrity or effectiveness (Stahmer, Collings & Palinkas, 2005). PRT fidelity of implementation (FI) measures were developed for use in research settings and have received minimal validation and adaptation for use by community therapists. The specific components of PRT have not been independently evaluated to determine how FI relates to child outcome, and the effect of ancillary factors such as therapist discipline, setting, education, affect, and the treatment environment on treatment integrity and child outcome have not been examined. The overall goal of this project is to inform strategies for enhancing fidelity of PRT in community service settings Toward this goal, there will be six specific aims: 1) Evaluate relationships between FI of PRT and within-session child skills and behavior via archival data analysis. 2) Evaluate relationships between provider characteristics and FI of PRT components via archival data analysis. 3) Individually test possible modifications to components of PRT using deconstructive evaluation. 4) Develop and evaluate a PRT FI instrument and assessment procedures in partnership with community providers. 5) Evaluate effectiveness of a PRT FI instrument and assessment procedures including (a) examining improvements to training and supervision methods using the instrument and (b) analyzing possible moderating variables affecting FI of PRT and child outcome in a prospective study. 6) Prospectively assess the relationship between provider implementation of PRT and child skills and behavior. The proposed scientific model will generate data and important products supporting ESBT use in the autism services community. This research will also serve as a general model for evaluation and improvement of FI knowledge and practice for the mental health services community and implementation science.

描述（由申请人提供）：为了提高心理健康干预的总体质量和有效性，必须确定经验支持的行为治疗 （ESBT）并确保在社区环境中为提供者提供这些治疗方法的可及性和可用性。实施的保真度（FI）或按预期实施干预的程度，为培训和维护提供者的有效性提供了必要的信息。但是，用于测量FI并向提供商提供反馈的工具和程序必须有效。通过档案数据分析和对个体治疗组件的预期评估，我们旨在为自闭症儿童的ESBT开发和评估FI工具和评估程序。自闭症是儿童心理健康领域中关注的关键领域。关键反应培训（PRT）是该人群的自然主义ESBT（Humphries，2003；国家标准项目，2009年）。 PRT通常在社区环境中使用，该环境的数据有限，该数据有限，有关治疗完整性或有效性的数据（Stahmer，Collings＆Palinkas，2005年）。实施（FI）措施的PRT保真度是用于研究环境中使用的，并获得了最少的验证和适应性，以供社区治疗师使用。尚未对PRT的特定组成部分进行独立评估，以确定FI与儿童结局的关系，以及诸如治疗师纪律，环境，教育，影响以及治疗环境对治疗完整性和儿童结局等辅助因素的影响。该项目的总体目标是为在社区服务环境中提高PRT的忠诚策略，将有六个具体的目的：1）通过档案数据分析评估PRT与会议内的儿童技能和行为之间的关系。 2）通过档案数据分析评估PRT组件的提供商特征与FI之间的关系。 3）使用解构性评估单独测试可能修改PRT的组件。 4）与社区提供者合作制定和评估PRT FI工具和评估程序。 5）评估PRT FI仪器和评估程序的有效性，包括（a）使用该工具检查培训和监督方法的改进，以及（b）在一项前瞻性研究中分析影响PRT和儿童结果的调节变量。 6）前瞻性评估提供者实施PRT与儿童技能和行为之间的关系。拟议的科学模型将生成支持自闭症服务社区中ESBT使用的重要产品。这项研究还将成为评估和改善精神卫生服务社区和实施科学的FI知识和实践的通用模型。