Service Delivery

Telehealth coaching in Project ImPACT indirectly affects children's expressive language ability through parent intervention strategy use and child intentional communication: An RCT.

Ingersoll et al. (2024) · Autism research : official journal of the International Society for Autism Research 2024
★ The Verdict

Weekly Zoom coaching keeps parents using ImPACT strategies, which sparks child intentional communication and later expressive language growth.

✓ Read this if BCBAs running parent-training programs for preschoolers with autism.
✗ Skip if Clinicians who only work with older verbal clients or do not coach parents.

01Research in Context

01

What this study did

Ingersoll et al. (2024) tested Project ImPACT when it is delivered through live Zoom coaching.

Therapists joined families online and coached parents while they played with their child.

The team tracked parent strategy use, child intentional communication, and later expressive language scores.

02

What they found

Nine months later, children spoke more words and longer sentences.

The gains did not come straight from coaching.

They flowed through two steps: first parents used more ImPACT strategies, then children showed more intentional communication, and finally language grew.

03

How this fits with other research

Einfeld et al. (1996) showed the same chain reaction in person. Parents learned PRT at home and family dinners got happier and more talkative.

Kim et al. (2005) found the same link in Korea. When mothers became more responsive, their preschoolers with disabilities talked more.

Sobsey et al. (1983) warned that parent skills can fade after one-time training. Ingersoll et al. (2024) solved this by giving ongoing live feedback each week, keeping strategy use high.

04

Why it matters

You can run Project ImPACT through Zoom and still get strong language gains months later. The trick is to keep coaching parents every week so their strategy use stays strong. If you serve rural families or have long wait-lists, switch to telehealth and schedule weekly live feedback sessions.

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→ Action — try this Monday

Open Zoom during the next parent play session and give live feedback on the child’s turn-taking to keep parent strategy use high.

02At a glance

Intervention
parent training
Design
randomized controlled trial
Sample size
64
Population
autism spectrum disorder
Finding
positive
Magnitude
medium

03Original abstract

Parent-mediated, naturalistic developmental behavioral interventions (NDBIs) are a promising approach for supporting social communication development in young autistic children. This study examined the effect of telehealth delivery of a parent-mediated NDBI, Project ImPACT, on children's expressive language ability using a randomized control trial with intent-to-treat analysis. Sixty-four young autistic children and their primary caregiver were matched on age and developmental quotient and randomly assigned to receive 6 months of therapist-assisted Project ImPACT (i.e., telehealth coaching), self-directed Project ImPACT, or an active control. Parent-child interactions were recorded at intake and immediately post-treatment, and the children's expressive language skills were assessed at intake and a 9-month follow-up using standardized measures. Although there was no total effect of treatment group assignment on child outcomes, a serial mediation analysis revealed that therapist-assisted ImPACT had an indirect effect on children's expressive language ability at follow-up through their parents' use of the intervention strategies and their intentional communication immediately post-treatment. Findings support Project ImPACT's program theory and highlight the importance of coaching in achieving positive outcomes when delivered via telehealth.

Autism research : official journal of the International Society for Autism Research, 2024 · doi:10.1002/aur.3230