Improving Caregiver Engagement inEarly Interventions for Autistic Children Using a Mobile Health Approach

Children under the age of three with autism or a high likelihood of autism are eligible for early intervention (EI) through Part C of the Individuals with Disabilities Education Act (IDEA). Caregiver involvement in goal setting and intervention delivery not only aligns with Part C guidelines but is also mandated by policy. Active participation from caregivers significantly influences intervention adherence and ultimately affects child outcomes. When caregivers struggle with obtaining a diagnosis and early intervention services, low caregiver engagement can further exacerbate these challenges. In fact, the attrition rate for parent-mediated early interventions for autism ranges from 35% to 62%. Therefore, it is crucial to develop effective strategies for supporting caregiver engagement in autism early intervention. This proposal aims to examine the effectiveness of a social-support enhancement program, called Family/Friend Network Support for EI (FANS-EI), designed to improve caregiver engagement in community-based autism EI. This program has been adapted in collaboration with community partners from a text-based program that has successfully increased engagement and patient outcomes in diabetes treatment. Families of toddlers diagnosed with autism or a high likelihood of autism, aged under 30 months, will either receive EI only or FANS-EI plus EI. FANS-EI utilizes a strengths-based approach, leveraging existing family and friend support networks. Supporters, alongside caregivers, will receive information about autism or social communication development, along with text messages from the research team. These messages are designed to foster interactions between supporters and caregivers, providing emotional, informational, and educational support. The project will examine caregiver-perceived social support, self-efficacy, and implementation outcomes. Ultimately, the goal is to enhance caregiver engagement, maximizing the benefits of early interventions for both caregivers and their autistic children. This project would help further the knowledge of improving caregiver engagement in community-partnered research while addressing the persistent challenges in service utilization and child outcomes. Additionally, this project aligns with my training goals, including formal training in clinical trial development and management, community-engaged research, and using mobile health strategies as an implementation tool. This study is well aligned with NIMH’s Objective 3.3, which emphasizes testing interventions for effectiveness in community practice settings, employing new tools (such as mobile health) to engage participants in community settings, and developing and testing approaches to achieve the greatest impact on people’s lives and functioning.