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This mixed-methods study aimed to test the feasibility, acceptability, and fidelity of involving early childhood education (ECE) staff without special education training or prior parent coaching experience in the delivery of an adapted evidence-based parent coaching intervention for young children with autism (Focused Playtime Intervention-Preschool, FPI-P). Ten staff members of a university-affiliated, inclusive ECE program were trained to deliver parent coaching procedures during temporary classroom closures due to the coronavirus disease 2019 (COVID-19) pandemic. Child participants included nine preschool students with ASD aged between 34 and 52 months. While findings highlight several opportunities for improving FPI-P staff training and implementation procedures, results demonstrate (a) the feasibility of involving ECE staff in the delivery of ASD-specific parent coaching to promote social communication, (b) that both parents and preschool staff viewed the experience as beneficial for themselves and the child, and (c) that parents perceived the program to be aligned with family-centered intervention principles.

Cognitive behavioral therapy (CBT) is considered best practice for treating anxiety in youth with autism spectrum disorder (ASD) in clinic settings. However, there is significant need to translate CBT into school settings. This paper presents two case illustrations of students who participated in the Facing Your Fears: School-Based program (FYF-SB), a manualized, group CBT intervention for anxiety in ASD, adapted for delivery in schools by interdisciplinary school providers. Students showed improvement in anxiety across multiple domains following intervention, according to clinical interview and parent- and self-report. These outcomes suggest that anxious youth with ASD can benefit from CBT delivered by interdisciplinary school providers. Importantly, decreases in anxiety symptoms were evident in domains that were not explicitly targeted during intervention. Overall, these case illustrations help frame areas of future research, including examining how treatment gains may generalize across anxiety domains as well as whether corresponding improvement in school functioning occurs.

The Part C Early Intervention system has been a focus of translational efforts in the autism field, as it is an entry point to services during a critical window of early development. Although Early Intervention systems are perceived as a promising setting in which to implement evidence-based practices for autism, implementation efforts seldom account for the unique service delivery model of Early Intervention systems, which emphasize family-centered care. The principles of family-centered care may at times pose tradeoffs to the implementation of manualized evidence-based practices and, thus, are pertinent to consider within implementation research being conducted within these systems. This commentary highlights family-centered care as an important factor of service delivery in Early Intervention systems that deserve greater attention. We lay out how family-centered care provides a framework for evaluating evidence-based practice adaptation in Early Intervention systems, how it may impact the adoption and implementation of evidence-based practices, and directions for future research to evaluate the impact of family-centered care alongside evidence-based practice delivery. Measuring family-centered care as part of research within Early Intervention systems may shift the autism field to a more balanced view of fidelity as both delivering core evidence-based practice components in a manner that closely align with fundamental tenants of Early Intervention systems. Lay Abstract Early Intervention systems provide therapeutic services to families of young children birth to 3 years with developmental delays and are considered a natural access point to services for young children and their families. Research studies in the autism field have been interested in training providers to deliver evidence-based practices in Early Intervention systems to increase access to services for young children with an increased likelihood of being autistic. However, research has often overlooked that Early Intervention systems prioritize family-centered care, an approach to working with families that honors and respects their values and choices and that provides supports to strengthen family functioning. This commentary points out that family-centered care deserves greater attention in research being done in Early Intervention systems. We describe how family-centered care may shape how interventions are delivered, and discuss directions for future research to evaluate the impact of family-centered care alongside intervention delivery.

Autistic youth frequently experience interfering anxiety, and schools may be an ideal setting to deliver mental health care. A type 1 hybrid-effectiveness, cluster randomized trial was used to examine the effectiveness of school-based Facing Your Fears compared to usual care. Change in provider cognitive behavior therapy knowledge and treatment fidelity (adherence and provider competence) were also examined. Seventy-seven interdisciplinary school providers across 25 elementary/middle schools were trained via a train-the-trainer approach. Eighty-one students, ages 8–14 years, with autism or suspected autism and anxiety participated. Students who received school-based Facing Your Fears displayed significantly greater reductions in anxiety compared to students in usual care according to caregiver and child report (Screen for Anxiety and Related Emotional Disorders). Significant reductions in total anxiety ( p = 0.012), separation ( p = 0.002), and social anxiety ( p = 0.003) subscales occurred, according to parent report. Student self-report indicated significant reductions on the social anxiety subscales ( p = 0.001). Interdisciplinary school providers demonstrated significantly increased cognitive behavior therapy knowledge following training ( p Lay Abstract Autistic youth frequently experience anxiety that can negatively affect them at home, with friends, and at school. Autistic youth have difficulty accessing mental health care, and this is particularly true for youth from traditionally underserved backgrounds. Providing mental health programs in schools may increase access to care for autistic youth with anxiety. The purpose of the study was to train interdisciplinary school providers to deliver school-based Facing Your Fears, a cognitive behavior therapy program for anxiety in autistic youth. Seventy-seven interdisciplinary school providers across 25 elementary/middle schools were trained by their colleagues and members of the research (train-the-trainer approach). Eighty-one students with autism or suspected autism, ages 8–14 years, were randomly assigned to either school-based Facing Your Fears or usual care. Students in school-based Facing Your Fears showed significant reductions in anxiety compared to students in usual care according to caregiver and student report. Other measures involved examining change in provider cognitive behavior therapy knowledge after training and determining how well interdisciplinary school providers were able to deliver school-based Facing Your Fears. Results indicated that interdisciplinary school providers showed significant improvements in cognitive behavior therapy knowledge after training. Interdisciplinary school providers were able to deliver most of school-based Facing Your Fears activities and with good quality. The positive outcomes in this study are encouraging. Training interdisciplinary school providers to deliver school-based Facing Your Fears may increase access to care for anxious autistic students. Future directions and limitations are discussed.

Naturalistic developmental behavioral interventions (NDBIs) are evidence-based interventions for young children with autism spectrum disorder. There has been growing interest in implementing manualized NDBIs within the early intervention (EI) system without a clear understanding of how these programs and the broader strategies encompassed within them are already used by EI providers. This study examined the use of manualized NDBI programs and broader NDBI strategies within an EI system and factors that impacted their use. Eighty-eight EI providers completed a measure of NDBI program and strategy use. Thirty-three providers participated in a supplemental focus group or interview. Overall, providers described using broader NDBI strategies and the need to adapt manualized NDBI programs. Provider-, intervention-, and organization-level factors impacted their use of NDBI programs and strategies.

There is growing research aimed at translating parent-mediated interventions into Part C Early Intervention systems to examine the effectiveness and reach of these models. Although research to date suggests that Early Intervention providers deliver parent-mediated intervention near fidelity, current fidelity reporting practices make delivery difficult to discern. Understanding how parent-mediated interventions are delivered and adapted in a more nuanced manner, including fine-grained intervention delivery and adaptation processes, is important and may increase our understanding of how well these models are aligned within Early Intervention systems. The current study examined the delivery of an evidence-based parent-mediated intervention, Project ImPACT, when delivered by Early Intervention providers and examined their intervention fidelity, the decisions they weighed when delivering Project ImPACT, and reported adaptations to Project ImPACT. Results from 24 providers demonstrated, on average, higher fidelity in response to consultative feedback but notable variability across providers. Preliminary qualitative data highlighted that many events arose within sessions that drove providers to augment their delivery of Project ImPACT. Results suggest the importance of carefully examining how and why providers deliver evidence-based interventions within Early Intervention systems, and the impact of these decisions on fidelity metrics and service outcomes. Lay abstract Parent-mediated interventions are an evidence-based practice for autism in which providers support caregivers in learning and applying strategies that support their child’s development. Research has begun to study whether parent-mediated interventions can be effectively delivered in Part C Early Intervention systems. This research has been promising; however, it has been difficult to determine how Early Intervention providers deliver and adapt parent-mediated interventions to meet the needs of the families they serve. Examining how parent-mediated interventions are delivered and adapted may help us understand whether parent-mediated interventions are a good fit in these systems. The current study examined the delivery of an evidence-based parent-mediated intervention, Project ImPACT, when delivered by providers within an Early Intervention system. Results from 24 Early Intervention providers demonstrated that, on average, providers delivered Project ImPACT with higher quality during their time in training and consultation. However, there was also variability in how providers delivered Project ImPACT, with some delivering the program inconsistently, some increasing their quality throughout consultation, and others having consistently high-quality delivery. In addition, qualitative data demonstrated that a variety of events arose within Project ImPACT sessions that drove providers to adapt the program. Results suggest the importance of carefully examining how and why providers deliver evidence-based interventions within Early Intervention systems.

Defining the central components of an intervention is critical for balancing fidelity with flexible implementation in both research settings and community practice. Implementation scientists distinguish an intervention’s essential components (thought to cause clinical change) and adaptable periphery (recommended, but not necessary). While implementing core components with fidelity may be essential for effectiveness, requiring fidelity to the adaptable periphery may stifle innovation critical for personalizing care and achieving successful community implementation. No systematic method exists for defining essential components a priori. We present the CORE (COmponents & Rationales for Effectiveness) Fidelity Method—a novel method for defining key components of evidence-based interventions—and apply it to a case example of reciprocal imitation teaching, a parent-implemented social communication intervention. The CORE Fidelity Method involves three steps: (1) gathering information from published and unpublished materials; (2) synthesizing information, including empirical and hypothesized causal explanations of component effectiveness; and (3) drafting a CORE model and ensuring its ongoing use in implementation efforts. Benefits of this method include: (1) ensuring alignment between intervention and fidelity materials; (2) clarifying the scope of the adaptable periphery to optimize implementation; and (3) hypothesizing—and later, empirically validating—the intervention’s active ingredients and their associated mechanisms of change. Lay abstract Interventions that support social communication include several “components,” or parts (e.g. strategies for working with children and families, targeting specific skills). Some of these components may be essential for the intervention to work, while others may be recommended or viewed as helpful but not necessary for the intervention to work. “Recommended” components are often described as “adaptable” because they can be changed to improve fit in different settings where interventions are offered or with different individuals. We need to understand which parts of an intervention are essential (and which are adaptable) when translating interventions from research to community settings, but it is challenging to do this before studying an intervention in the community. This article presents the CORE (COmponents & Rationales for Effectiveness) Fidelity Method—a new method for defining the essential components of evidence-based interventions—and applies it to a case example of Reciprocal Imitation Teaching, an intervention that parents are taught to deliver with their young children with social communication delays. The CORE Fidelity Method involves three steps: (1) gathering information from multiple sources; (2) integrating information from previous research and theory; and (3) drafting a CORE model for ongoing use. The benefits of using the CORE Fidelity Method may include: (1) improving consistency in intervention and research materials to help all providers emphasize the most important skills or strategies; (2) clarifying which parts of the intervention can be adapted; and (3) supporting future research that evaluates which intervention components work and how they work.

Cognitive behavioral therapy for youth with autism spectrum disorder and anxiety is effective, but disparities exist in accessing these programs. Training school providers to deliver cognitive behavioral therapy may help to address these disparities. However, little is known about how cognitive behavioral therapy programs are implemented by interdisciplinary school providers and the broader impact of these programs. This study aimed to address this gap and was part of a larger trial that examined the effectiveness of Facing Your Fears–School-Based across 25 public schools. Study aims were to understand the impact of Facing Your Fears–School-Based and factors that impacted implementation. Thirty providers participated in exit interviews guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework. Primary themes included (1) the fit of Facing Your Fears–School-Based for diverse students; (2) the effects of Facing Your Fears–School-Based on students’ school participation; and (3) planned Facing Your Fears–School-Based maintenance. Participants also highlighted the program’s accessibility for non-mental health providers and reported adapting Facing Your Fears–School-Based in response to student needs. Results suggest that Facing Your Fears–School-Based may have a broader impact on students and highlight the importance of task sharing to overcome mental health staff shortages within public schools. Programs that can be implemented flexibly are also critical given variability in school structures and student needs. Lay abstract Cognitive behavioral therapy helps to treat anxiety symptoms in autistic youth, but it is difficult for families to access cognitive behavioral therapy in the community. Training school providers to deliver cognitive behavioral therapy may help autistic youth and their families to access these programs. Unfortunately, we do not know how cognitive behavioral therapy programs can be delivered by school providers and how these programs help the autistic students who access them. This study addressed this gap and was part of a larger study that looked at the effectiveness of Facing Your Fears–School-Based in 25 public schools. The study goals were to understand whether Facing Your Fears–School-Based helped students and the factors that made it easy or difficult to deliver Facing Your Fears–School-Based in schools. Thirty providers participated in interviews guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework. Participants shared information that fell into several major categories that included (1) delivering Facing Your Fears–School-Based to many different students; (2) the positive impact of Facing Your Fears–School-Based on students’ school participation; and (3) plans to continue using Facing Your Fears–School-Based. School providers also shared that Facing Your Fears–School-Based was easy to use for non-mental health providers and reported adapting Facing Your Fears–School-Based to meet student needs. The results of this study suggest that Facing Your Fears–School-Based may help autistic students and highlight the importance of using mental health programs in schools that are flexible, able to be adapted, and that are able to be used by many different types of school providers.

Anxiety disorders are among the most common co-occurring psychiatric conditions for youth with ASD (van Steensel et al. in Clin Child Fam Psychol Rev 14:302–317, 2011). Although modified cognitive behavioral therapies (CBT) have yielded significant reductions in anxiety, substantial disparities in access to mental health services exist for youth from diverse and low-income families. Schools represent a consistent resource for underserved communities; thus, there is a critical need to adapt and implement CBT programs in school settings. Engaging stakeholders in the initial phase of adaptation is essential to support adoption and sustainability of best practice interventions in schools. The primary purpose of the study was to adapt group CBT (Facing Your Fears (FYF); Reaven et al. in Facing your fears: group therapy for managing anxiety in children with high-functioning autism spectrum disorders, Paul Brookes Publishing, Baltimore, 2011) via iterative processes with key stakeholders to create a feasible, effective, and sustainable school-based program to manage anxiety in underserved students with ASD. Two rounds of parent and professional focus groups were conducted across three school districts (total 14 groups), using qualitative content analysis methodology. Details regarding the delivery of FYF, selection of students, training considerations for staff, and identifying meaningful outcomes were obtained in anticipation of an implementation trial of FYF.

Anxiety disorders occur at higher rates in youth with ASD than in neurotypical youth. Although the efficacy of CBT for anxiety in children with ASD is widely supported, factors that influence treatment outcomes are not well understood. This study examined the role of maternal anxiety in treatment outcomes for youth with ASD. Youth with ASD and anxiety (ages 8 to 14), along with their mothers (n = 87), participated in a group CBT intervention. Results indicated that maternal anxiety did not improve over the course of treatment. However, findings suggest that high levels of maternal anxiety at pre-treatment predicted higher levels of youth anxiety post-treatment. Importantly, the relationship between parent anxiety and youth outcomes was moderated by child age. The findings of the present study may provide initial insight into the role that maternal anxiety plays in treatment outcomes for children with ASD and co-occurring anxiety, particularly when considering child age.

Objectives The theory of planned behavior (TPB) suggests that attitudes, subjective norms, and perceived behavioral control influence intentions to perform a behavior, and that intentions predict behavior. The present studies examined whether the TPB is applicable to community providers’ use of a parent-mediated intervention for children with autism spectrum disorder (ASD) following introductory training and whether TPB constructs can be modified with training. Results Study 1 demonstrated that community providers’ intentions to use the intervention post-training predicted their use of the intervention 6 months later [X2(1) = 8.03, p = .005]. Study 2 found that provider education (β = .23, t = 2.27, p = .025), attitudes (β = .21, t = 2.09, p = .039), and perceived behavioral control (β = .21, t = 2.15, p = .035) were all unique predictors of intentions. There was a significant increase in providers’ ratings of subjective norms (Z = − 2.46, p = .014) and perceived behavioral control (Z = − 7.36, p

Parent-mediated interventions for young children with autism spectrum disorder (ASD) are highly under-utilized in community settings. A challenge to the dissemination of these programs is that provider training protocols must teach both the intervention techniques, and the parent coaching strategies. The current study assesses the feasibility an innovative multimodal training protocol to teach community-based intervention providers Project ImPACT (Improving Parents as Communication Teachers). A total of 30 providers (90% female; 76% Caucasian, 13.3% Multiracial/Other, 3.3% Hispanic/Latino, and 3.3% Asian/Pacific Islander) participated in Phase 1, and 15 of these participants (80% female; 60% Caucasian, 33.3% multiracial, and 6.6% Hispanic/Latino) participated in Phase 2. In Phase 1, providers completed questionnaires and videotaped interactions before and after a web-based tutorial and interactive workshop focused on intervention techniques. In Phase 2, providers completed questionnaires and videotaped interactions before and after a second interactive workshop focused on parent coaching. Results from Phase 1 indicate that the addition of the workshop resulted in higher ratings of training satisfaction (p

Individuals with autism spectrum disorder (ASD) tend to experience difficulties with emotion regulation (ER). Treatments designed to address ER difficulties in individuals with ASD are emerging. The authors review cognitive-behavioral therapy (CBT) and mindfulness-based treatments that have focused on ER difficulties in youth and young adults with ASD. In general, these treatments addressing ER skills have included awareness of emotions/psychoeducation about emotions, frustration tolerance, and ER skills, as well as practice and use of these skills during group therapy that sometimes includes caregivers. The results from these interventions are encouraging for individuals with high-functioning ASD because ER skills tend to improve following treatment. The inclusion of ER in other ASD treatments is discussed.

This conceptual paper reviews the need for a family-focused service delivery model within the autism spectrum disorder (ASD) field and suggests that the Double ABCX Model of Stress and Adaptation is a way to address this need. Within the ASD field, there is an absence of service delivery models that are able to address the needs of the family as a unit, rather than the individual child with ASD. This gap is striking given the reciprocal relationship between parent and child outcomes within the ASD field. To support our argument that the Double ABCX model could be used to integrate parent and child-focused interventions within the ASD field, this paper starts by reviewing the mental health outcomes often associated with having a child with ASD. We next provide a historical overview of the Double ABCX model and review a body of ASD intervention literature within the context of the Double ABCX model framework. Doing so shows that a number of child and parent focused interventions within the ASD field can be fit within the Double ABCX framework. However, a handful of methodological and sampling limitations prevent the Double ABCX model from being fully supported as a model that could be applied in a variety of settings. Taken together, this review highlights that the Double ABCX model is a promising strategy to integrate child and parent-focused interventions within the ASD field, but highlights that specific areas of future research are needed in order to build continued support for this argument.

Results of randomized controlled trials have demonstrated significant reductions in anxiety symptoms following cognitive behavior therapy participation. Although promising, the extent to which previous research has included families from low socioeconomic status or racially/ethnically diverse backgrounds is unknown. Aims of this study are as follows: (1) What is the race, ethnicity, and educational attainment of youth with autism spectrum disorder and their families who have participated in research examining the efficacy of cognitive behavior therapy for anxiety? and (2) How do the demographics of these participants compare to that of the United States census? A total of 14 studies were reviewed that included 473 participants. Chi-square analyses indicated that there are significant differences between the race/ethnicity of youth with autism spectrum disorder participating in cognitive behavior therapy research for anxiety and that of youth in the United States. Standard residuals indicated significant overrepresentation of White youth and significant underrepresentation of Black and Latino youth in cognitive behavior therapy research (all p-values

Research within the autism spectrum disorder field has emphasized the role of socioeconomic status in shaping parents’ ability to access services for their child with autism spectrum disorder. However, research has yet to explore the possible mechanisms underlying this relationship. This study sought to address this research gap by examining the following questions: (1) Does parents’ service knowledge mediate the relationship between parent socioeconomic status and parents’ autism spectrum disorder service use? (2) What are parents’ reported service needs and service barriers, and do these needs vary across higher and lower socioeconomic status groups? Quantitative results from 244 parents of a child with autism spectrum disorder indicate that parents’ autism spectrum disorder service knowledge partially mediates the relationship between parent socioeconomic status and parents’ autism spectrum disorder service use. Qualitative findings helped to clarify this relationship by suggesting that both high and low socioeconomic status parents are aware of their child’s basic autism spectrum disorder needs. However, low socioeconomic status parents more often report needing more information about services and more in-home services and emphasize that a number of structural barriers impede their ability to meet their child’s autism spectrum disorder needs. On the other hand, high socioeconomic status parents more often report a need for “higher quality services,” possibly reflecting their better recognition of best practice guidelines. These results highlight the need for a multi-pronged approach to tackling unmet service needs within the autism spectrum disorder field.

This brief paper examined the community services delivered to youth with autism spectrum disorder (ASD) in a Southern Californian city as a way to better understand ASD service provision and service attitudes. Specific goals of the study were to identify the services being delivered within the area, and how the use, perceived evidence and value attached to these services mapped onto recent systematic ASD service reviews. Forty-six providers completed the ASD Strategies and Interventions Survey (ASD-SIS), which consisted of 21 treatment strategies and 22 interventions packages commonly used with children with ASD. Participants: 1) indicated each treatment strategy and intervention package they use; and 2) rated the perceived evidence and value of each treatment strategy and intervention package they endorsed using. Results demonstrated that a variety of treatment strategies and intervention packages, both with and without an established evidence base, were reportedly being delivered to youth with ASD through community-based agencies. Additionally, a large number of providers reported not knowing the evidence of many treatment strategies and intervention packages. Finally, although no relationship was found between evidence base and use, perceived evidence, and value for treatment strategies, providers reported significantly higher use, perceived evidence and value for established intervention packages. Results demonstrate the need to more effectively disseminate strategies that can support providers in selecting services to deliver to youth with ASD, and underscore the need to better understand the community service landscape on a larger scale.

Within the autism spectrum disorder field, rates of attrition in parent-mediated interventions have highlighted the need to engage families around improving the delivery of these services. The primary goal of this study was to approximate the impact of adaptations to an evidence-based, parent-mediated intervention, Project ImPACT (Improving Parents as Communication Teachers), that had been made in collaboration with families in a Medicaid system. A total of 103 parents of a child with autism spectrum disorder were randomized to watch a presentation of either the original or adapted Project ImPACT program. After watching the presentation, participants rated (1) demographic information, (2) perceived structural barriers, (3) Project ImPACT attributes, and (4) intent to use the program. Results from hierarchical linear regression models demonstrated that program type alone predicted parents’ ratings of perceived structural barriers. Additionally, both program type and the interaction of program type and annual household income were unique predictors of parents’ ratings of program attributes and intent to use. Qualitatively, although many parents reflected positively on both Project ImPACT programs, parents who viewed the adapted program appeared more likely to report positive program attributes. Results suggest the importance of engaging families in improving the fit of parent-mediated interventions for use within a variety of community settings.

Despite research that has documented the types of services that are being used by parents of children with autism spectrum disorder (ASD), researchers have yet to determine how intervention-related knowledge spreads to parents. In the current study, we sought to clarify the impact of parent social networks on intervention use in 244 parents of a child with ASD by examining the following: (a) Do social-network variables predict the use of evidence-based practices (EBPs) or non-EBPs? (b) Do social-network variables predict parent satisfaction with service use? and (c) Who are the referral sources of EBPs and non-EBPs? Results indicated that social-network variables predict parents’ EBP use and non-EBP use beyond income, education, and child ASD symptom severity. In addition, recommendations to EBPs and non-EBPs came from distinct referral sources. The results have implications for both the active provision of basic social-network support and psychoeducation at the onset of ASD diagnosis and the use of social networks to more effectively disseminate best-practice information on a larger scale.

Service use disparities have been noted to impede under-resourced families' ability to access high-quality services for their child with autism spectrum disorder (ASD). These disparities are particularly relevant for parent-mediated interventions and may suggest a lack of fit between these interventions and the needs of under-resourced community settings. This study used Roger's Diffusion of Innovations theory to guide community partnerships aimed at understanding the perceived compatibility, complexity, and relative advantage of using an evidence-based, parent-mediated intervention (Project ImPACT) within a Medicaid system. Three focus groups were conducted with 16 Medicaid-eligible parents, and three focus groups were conducted with 16 ASD providers operating within a Medicaid system. Across all groups, parents and providers reported general interest in using Project ImPACT. However, primary themes emerged regarding the need to (a) reduce the complexity of written materials; (b) allow for a more flexible program delivery; (c) ensure a strong parent-therapist alliance; (d) involve the extended family; and (e) help families practice the intervention within their preexisting routines. Results are discussed as they relate to the design and fit of evidence-based, parent-mediated interventions for under-resourced community settings.

This pilot RCT compared the effect of a self-directed and therapist-assisted telehealth-based parent-mediated intervention for young children with ASD. Families were randomly assigned to a self-directed or therapist-assisted program. Parents in both groups improved their intervention fidelity, self-efficacy, stress, and positive perceptions of their child; however, the therapist-assisted group had greater gains in parent fidelity and positive perceptions of child. Children in both groups improved on language measures, with a trend towards greater gains during a parent-child interaction for the therapist-assisted group. Only the children in the therapist-assisted group improved in social skills. Both models show promise for delivering parent-mediated intervention; however, therapist assistance provided an added benefit for some outcomes. A full-scale comparative efficacy trial is warranted.

Research within the autism spectrum disorder field has called for the use of service delivery models that are able to more efficiently disseminate evidence-based practices into community settings. This study employed telehealth methods in order to deliver an Internet-based, parent training intervention for autism spectrum disorder, ImPACT Online. This study used mixed-methods analysis to create a more thorough understanding of parent experiences likely to influence the adoption and implementation of the program in community settings. Specific research questions included (1) What are parents’ perceptions of the online program? (2) How does ImPACT Online compare to other services that parents are accessing for their children? And (3) Do parents’ experience in, and perceptions of, the program differ based on whether they received a therapist-assisted version of the program? Results from 28 parents of a child with autism spectrum disorder indicate that parents saw improvements in their child’s social communication skills and their own competence during the course of the program, regardless of whether they received therapist assistance. However, qualitative interviews indicate that parents who received therapist assistance were more likely endorse the acceptability and observability of the program. These findings support the potential for Internet-based service delivery to more efficiently disseminate evidence-based parent training interventions for autism spectrum disorder.

Across three studies, we investigated whether 4-year-olds would trust a previously reliable informant when learning novel morphological forms. In Experiment 1, children (N= 16) were presented with two informants: one who correctly named familiar objects and another who named them incorrectly. Children were invited to turn to these informants when learning novel labels and morphological forms. The majority of children chose the previously correct labeller when learning novel label and morphology. In Experiment 2, children (N= 16) were presented with an informant who used familiar plurals correctly and one who used them incorrectly. Children chose the previously correct morphologist when learning novel labels and past tense forms. Thus, children track both semantic and morphological accuracy. In Experiment 3, some children (N= 16) were presented with two informants who differed in naming accuracy, whereas others (N= 16) were presented with two informants who differed in morphological accuracy. To forestall any risk of experimenter cuing, one experimenter blind to the training children had received, tested children with novel labels and morphology. The results replicated those of Experiments 1 and 2. Implications for how children's trust in an informant might play a role in their acquisition of morphological forms are discussed.