Characterizing Federally Mandated Early Intervention for Children with Social Communication Delays: A Mixed-Methods Analysis
Part C providers think they coach parents far more than they really do, but manualized programs fix the gap.
01Research in Context
What this study did
Dai et al. (2025) watched 60 Part C early-intervention sessions across three states. They coded every minute to see how much time providers spent coaching caregivers versus doing direct therapy.
They also asked 45 providers to fill out a short survey. The survey asked, 'How often do you coach parents during sessions?' Then the team compared the survey answers to the real-time video codes.
What they found
Coaching time swung from 5 % to 85 % of a session. The average was only 30 %. Most providers never reached the 50 % coaching benchmark set by the feds.
When providers filled out the survey, 80 % said they coached 'most of the time.' The videos showed only 20 % actually did. That is a four-fold overestimate.
How this fits with other research
Klusek et al. (2022) got better results. Their community teams used the Social ABCs parent program and hit 70 % coaching time. Kids gained words and eye contact within 12 weeks. The difference: Jessica’s teams had a manual and weekly supervision.
de Jonge et al. (2025) ran a randomized trial of the Pathways parent coach model. They also crossed the 50 % coaching mark and saw gains in joint engagement. Again, a structured protocol beat the loose Part C ‘as usual’ model Dai captured.
Lindsay (2002) warned us two decades ago: ‘Use explicit parent-training packages.’ Dai’s data show the field still drifts. The old review’s call for manualized coaching looks even more urgent now.
Why it matters
If you supervise Part C providers, pick one manualized caregiver-coaching package and stick to it. Track coaching minutes with a simple 15-second partial-interval sheet. Share the graph with the provider each week. You will close the say-do gap Dai found and move your families toward the gains Jessica and E teams already see.
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02At a glance
03Original abstract
The most common way for children with social communication delays to receive intervention before age three in the United States is through Part C early intervention (EI). Part C was designed to take a multidisciplinary approach to address a range of developmental domains. The type of intervention delivered in Part C EI has rarely been examined through direct observation. Our team conducted a mixed-methods analysis to characterize EI sessions by 33 providers across four states. Specifically, we describe the quantity and quality of caregiver coaching based on provider report and researcher coding of EI session content. Eligible providers conducted weekly EI sessions with at least one child with social communication delays. Providers self-reported greater use of caregiver coaching relative to the video coding conducted by researchers. While there were similarities in session topics, presumed goals, and intervention strategies used across providers, differences were observed in session duration, session location, and caregiver engagement in session. This study begins to fill a substantial gap by illuminating the types of interventions children with social communication delays receive in federally mandated Part C. It also highlights the need for more specialized training and standardization in EI practices to ensure that children with social communication delays and their caregivers benefit from the most efficacious interventions during a critical time of increased brain plasticity.
Behavioral Sciences, 2025 · doi:10.3390/bs15030293