Using qualitative content analysis to understand the active ingredients of a parent-mediated naturalistic developmental behavioral intervention.
Kyle M Frost, Kaylin Russell, Brooke Ingersoll
PMID 33840219WHAT IT FOUND
Caregivers reported that Project ImPACT techniques like following the child's lead increased engagement, but results varied.
Imitating the child and playful obstruction sometimes caused frustration or mixed responses. No single technique consistently produced the expected outcome across all situations.
Key findings
01Caregivers perceived that following the child's lead and imitating the child increased social engagement and interaction duration, though imitating the child often produced mixed responses.
02Techniques like balanced turns, playful obstruction, and teaching play were reported to sometimes cause child frustration rather than the intended communication outcomes.
03The theoretical model was only partially supported; for instance, balanced turns were not perceived to increase child initiations as predicted.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Data came from typed reflection responses, which limited the depth and richness of the information compared to interviews. Caregivers learned techniques in a sequence, so it is impossible to isolate the effect of any single technique from the cumulative effect of previous lessons. The reflection questions included examples of theoretically expected responses, which may have influenced what caregivers reported. This study analyzed perceptions of mechanisms and active ingredients, not the overall efficacy of the intervention on child outcomes.
The easy way to misread this
Do not interpret these findings as evidence that Project ImPACT is ineffective or that specific techniques cause harm. The study reports caregiver perceptions of immediate child responses to individual techniques within a multi-component intervention, not long-term treatment outcomes or causal effects of isolated components.