Family Outcomes of a Community-Based Trial of Project ImPACT

Caregiver-mediated approaches in early intervention can provide impactful support for families of young children with social communication needs. Project ImPACT (PI), a caregiver-mediated naturalistic developmental behavioral intervention, was tested for effectiveness in public early intervention (EI) programs in a randomized waitlist-control community trial across California. Participants included EI service providers (n = 47) and caregiver-child dyads (n = 125; ages 14-32 months). Families received services-as-usual (SAU) or PI following provider training in PI. Multilevel models were used to examine provider coaching, caregiver-child interactions, caregiver PI strategy use, parenting stress, self-efficacy in parenting, and child social communication outcomes across approximately four months of services. Provider use of evidence-based coaching significantly improved after PI training. Caregivers who received PI showed greater gains in some domains of parent-child interaction; PI fidelity scores, stress, and self-efficacy did not differ by condition. Child communication outcomes improved over time in both groups, but differences between conditions were not detected during the study time period. Training community EI providers in PI improved coaching quality and enhanced caregiver-child interaction, demonstrating feasible, scalable use of PI in community settings. Differential child-level effects were not detected, underscoring the need for larger samples and longitudinal follow-up.