Project ImPACT for Toddlers: Pilot outcomes of a community adaptation of an intervention for autism risk.
Aubyn C Stahmer, Sarah R Rieth, Kelsey S Dickson and 4 others
PMID 31565955WHAT IT FOUND
Parents coached by trained providers interacted more supportively with their toddlers, but the children's communication scores did not improve significantly more than usual care.
Low-intensity parent coaching changed how parents played, yet the study was too small to prove it helped the children.
Key findings
01Parents in the intervention group showed significantly greater improvements in supportive parenting behaviors (affection, responsiveness, encouragement, teaching) compared to usual care.
02There were no statistically significant differences between groups for children's social communication or adaptive skills, though effect sizes favored the intervention group.
03Providers trained in the intervention used significantly more coaching strategies than untrained providers, and their coaching was associated with better parent fidelity.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study was a pilot with a very small sample size (28 dyads), resulting in low statistical power. Families were not randomly assigned to groups; assignment depended on whether their provider happened to be trained, which may have introduced selection bias. The PI T group had significantly more boys than the usual care group, which could affect outcomes. The intervention was low intensity (average 2.5 hours per week for PI T vs 2 hours for UC), which may not be sufficient to produce significant changes in child outcomes. Differences in child outcomes were not statistically significant, and the authors relied on effect sizes to suggest promise, which is less reliable in small samples.
Declared interests
The study was supported by N.I.H. funding. The authors state that the intervention was adapted with community partners, but do not report specific commercial conflicts of interest for the authors themselves in the provided text.
The easy way to misread this
Do not conclude that this intervention significantly improves child communication skills. The study was underpowered and did not find statistically significant differences in child outcomes between the groups; the positive findings were limited to changes in parent behavior.