Family-Centered Implementation of Parent Training for Emotion Regulation in Autistic Toddlers within the Part C Early Intervention System

/ABSTRACT: The objective of this K23 career development grant is to help the applicant acquire the skills needed for an independent research career as an innovative implementation scientist focused on increasing equitable access to autism-specialized supports aligned with individual family needs within the context of complex service systems. It will achieve this by building on the candidate’s background in clinical science, developmental psychopathology, and intervention research with mentorship in health equity, intervention adaptation, mechanisms and system-level factors of implementation, and professional development. The IDEA Part C Early Intervention (EI) system is ideally situated to provide family- centered intervention to children from birth to three years. Autism spectrum disorder (ASD) is highly prevalent among children served by Part C. However, Part C EI providers receive little systematic training in areas of impairment related to ASD, including emotion dysregulation (e.g., meltdowns, aggression). These types of challenging behavior are a prominent aspect of ASD in toddlerhood, but are often misdiagnosed and over- pathologized in children of color, especially Black children. This proposed K23 will address these gaps in EI provider training and in family access to autism-specialized services by implementing a highly evidence-based practice (Parent Training) in Part C with toddlers with autism (Aim 1) as well as mechanistically understanding whether family and provider readiness (Aim 2), and system level characteristics (Aim 3) may enhance future high-quality Parent Training within Part C. With primary mentorship from Sarabeth Broder-Fingert, MD MPH, and Jane Roberts, PhD, and co-mentorship from Donna Coffman, PhD and a consultant team, the applicant will pursue training in: (1) implementation methods that foster healthcare equity; (2) adapting interventions for sustainable use within systems; (3) mechanisms of effectiveness and implementation (e.g., causal modeling, adaptive treatment design); (4) system-level implementation factors (e.g., cost effectiveness, policy); and (5) building a strong, grant-funded research program. Training in these areas will enhance and be enhanced by the completion of research aims: Aim 1, Assess the feasibility, acceptability, cultural responsiveness, and preliminary effectiveness of Parent Training versus EI practice as usual; Aim 2, Examine whether EIs’ and caregivers’ readiness to implement Parent Training strategies predicts their fidelity to and intent to use Parent Training; and Aim 3, Prepare for implementation at scale by identifying implementation supports for Parent Training within the Part C context. This proposal is aligned with the NIMH’s strategic objective 4.2.B., “Building models to scale-up evidence-based practices for use in public and private primary care, specialty care, and non-traditional settings.” Completing the substantive training and research goals within this K23 proposal will position the applicant as an independent researcher who conducts hybrid effectiveness-implementation trials of supports for both social communication and emotion regulation in public healthcare systems. Project Number: 1K23MH137383-01A1 | Fiscal Year: 2025 | NIH Institute/Center: National Institute of Mental Health (NIMH) | Principal Investigator: Sarah Edmunds | Institution: UNIVERSITY OF SOUTH CAROLINA AT COLUMBIA, COLUMBIA, SC | Award Amount: $163,534 | Activity Code: K23 | Study Section: Effectiveness of Mental Health Interventions Study Section[EMHI] View on NIH RePORTER: https://reporter.nih.gov/project-details/11137885