Short report: Associations of family characteristics and clinicians' use of caregiver coaching in early intervention.
Alyssa M Hernandez, Diondra Straiton, David S Mandell and 4 others
PMID 39931868WHAT IT FOUND
Clinicians' coaching fidelity varied with family income and language.
Fidelity was lower for the poorest and wealthiest families compared to middle-income households. Unexpectedly, clinicians showed higher fidelity with English-only speaking families than those speaking other languages.
Key findings
01Coaching fidelity was lower and more variable for households with income at or below $20K and above $60K compared to families with household incomes between $20K and $40K and between $40K and $60K.
02Clinicians’ Project ImPACT coaching adherence was lower when coaching caregivers in households where English was the only language spoken.
03On average, coaching fidelity was low.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The sample size was very small (12 clinicians, 34 families), limiting statistical power and generalizability. This was an exploratory secondary analysis, not a primary test of these hypotheses. Family characteristic variables were not selected a priori, which may have affected how income ranges were defined and analyzed. The study was conducted during the COVID-19 pandemic via video conferencing, which may not reflect in-person practice dynamics.
Declared interests
One author is a Project ImPACT trainer who receives funding for training providers. Another author is a co-developer of Project ImPACT who receives royalties from curriculum sales and fees for training, though she donates profits to research. The study was funded by a grant from the Eagles Autism Foundation.
The easy way to misread this
Do not interpret the association between family language and fidelity as evidence that coaching is more effective for non-English speaking families. The study is exploratory with a very small sample, and the direction of the finding (higher fidelity with non-English speakers) contradicts typical barriers reported in literature, suggesting complex mechanisms or sample-specific artifacts rather than a causal effect of language on coaching quality.