Overcoming tensions between family-centered care and fidelity within Early Intervention implementation research.
Early Intervention can stay evidence-based and family-friendly if we track fidelity and parent satisfaction side-by-side.
01Research in Context
What this study did
Ledbetter-Cho et al. (2023) wrote a position paper. They looked at Early Intervention for toddlers with autism or developmental delay.
The team asked: why do we only track fidelity and ignore family-centered care? They want both measured in future studies.
What they found
The paper finds a tug-of-war. Strict fidelity rules can clash with what families need or want.
No study numbers are given. The authors argue the field must count both fidelity and family fit.
How this fits with other research
Raulston et al. (2024) answered the call. They show how to tally play actions and engagement in natural homes instead of sterile trials.
Klein et al. (2024) and McKenzie et al. (2015) extend the point. Black families report providers dismiss their views, proving the clash is real and racialized.
Solomon et al. (2007) give a live example. Parent-led PLAY Project boosted child skills and kept parents happy, showing fidelity and family joy can coexist.
Why it matters
You can have both rigor and respect. Add quick parent polls or play tallies to your fidelity sheet. If scores rise but families feel ignored, the program is still failing.
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02At a glance
03Original 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.
Autism : the international journal of research and practice, 2023 · doi:10.1177/13623613221133641