Parent utilization of ImPACT intervention strategies is a mediator of proximal then distal social communication outcomes in younger siblings of children with ASD.
Paul J Yoder, Wendy L Stone, Sarah R Edmunds
PMID 32811160WHAT IT FOUND
The training did not directly improve children's social communication or expressive language.
It was associated with later improvement through parents using ImPACT strategies after training, then better motor imitation or intentional communication.
Key findings
01The training did not directly improve children's communication outcomes.
02Parents in the ImPACT group used more ImPACT strategies after training than control parents.
03Children's later expressive language and social communication were associated with parents' strategy use and then with motor imitation or intentional communication.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study did not measure how often or how long parents used ImPACT strategies during everyday routines outside the assessment sessions. The dose of intervention is unclear. The sample was mostly Non-Hispanic White and well educated. This restricts generalisability. The main child outcomes were not significantly improved overall. Positive findings were indirect, and some categorical analyses were exploratory. The researchers did not adjust for testing many mediation models. The intervention included staff coaching and parent-delivered therapy. The effect of any single component cannot be separated. Randomised groups differed at baseline on a motor imitation measure. The analysis controlled for this.
Declared interests
The supplied publication types list NIH extramural research support. No conflicts of interest declaration appears in the supplied text.
The easy way to misread this
Do not conclude that ImPACT coaching alone directly improves younger siblings' social communication or language. The main child outcomes were not significantly improved. The positive findings were only seen through parents' strategy use and then child motor imitation or intentional communication. Some categorical analyses were exploratory. The intervention also included 24 in-home coaching sessions over 12 weeks plus a request for at least 1 hour of parent-delivered therapy per day, 5 days per week. The effect of any single component cannot be separated.