Telehealth coaching in Project ImPACT indirectly affects children's expressive language ability through parent intervention strategy use and child intentional communication: An RCT

Abstract

AbstractParent‐mediated, naturalistic developmental behavioral interventions (NDBIs) are a promising approach for supporting social communication development in young autistic children. This study examined the effect of telehealth delivery of a parent‐mediated NDBI, Project ImPACT, on children's expressive language ability using a randomized control trial with intent‐to‐treat analysis. Sixty‐four young autistic children and their primary caregiver were matched on age and developmental quotient and randomly assigned to receive 6 months of therapist‐assisted Project ImPACT (i.e., telehealth coaching), self‐directed Project ImPACT, or an active control. Parent–child interactions were recorded at intake and immediately post‐treatment, and the children's expressive language skills were assessed at intake and a 9‐month follow‐up using standardized measures. Although there was no total effect of treatment group assignment on child outcomes, a serial mediation analysis revealed that therapist‐assisted ImPACT had an indirect effect on children's expressive language ability at follow‐up through their parents' use of the intervention strategies and their intentional communication immediately post‐treatment. Findings support Project ImPACT's program theory and highlight the importance of coaching in achieving positive outcomes when delivered via telehealth.