UCLA

A concerning outcome of many early interventions is that skills gained over the course of treatment are not maintained after the intervention support ends. Particularly for parents who are the target of early interventions, maintenance of taught strategies may be related to a number of factors, including both parent characteristics and subsequent intervention involvement. This study explored parents' use of three specific categories of strategies taught in an early intervention program (communication strategies, engagement strategies, and time spent in dyadic joint engagement) while interacting with their children with autism over time. Participants included 86 dyads who were randomized to either a parent-mediated joint attention intervention (JASPER) in which the specific strategies were taught, or a comparison parent education intervention (PE). Maintenance of strategies learned in the intervention was examined as a function of parents' level of naturally occurring JASPER fidelity pre-treatment. For parents who were randomized to the JASPER condition, parents who displayed high levels of pre-treatment JASPER skills showed better maintenance of communication fidelity and time spent in dyadic joint engagement with their children from exit to follow-up than parents who displayed low levels of pre-treatment strategies. However, parents' level of pre-treatment JASPER strategies was not related to maintenance of communication strategies, engagement strategies, or time in joint engagement for the parent education condition. Second, for the entire sample, maintenance of parent communication fidelity, engagement fidelity, and time in dyadic joint engagement were examined in relation to participation in adult-directed behavioral interventions after program end. Participation in behavioral interventions after exit from the study was associated with more decrease in time spent in dyadic joint engagement during play from exit to follow-up. Findings highlight the importance of a match between intervention models and existing parent skills.