Predictors of Parent Engagement in Part C Early Intervention for Autism: The Role of Single Parenthood and Initial Motivation

Abstract

Parent engagement in early intervention supports child progress but is variable in community settings and understudied in autism populations. Prior studies have examined attendance and homework completion rather than parent participation engagement—active, independent, and responsive contribution to treatment—and it is unclear how these distinct engagement measures are related. This study examined how observationally-coded parent participation engagement during early intervention sessions, between-session practice, and attendance were interrelated in addition to the influence of sociodemographic (marital status, minoritized racial/ethnic identity, and education) and psychological characteristics (stress, self-efficacy, and motivation) on engagement. The sample included 164 parents of toddlers (16–34 months) with an autism diagnosis or early autism indicators (i.e. social communication delays) receiving services through the publicly funded Part C Early Intervention system in the United States, which serves children under 36 months with developmental delays and disabilities. Observed parent participation engagement, parent-reported between-session practice, and attendance were not significantly correlated. Only marital status significantly predicted observed parent participation engagement, such that single parents exhibited lower parent participation engagement. Low motivation predicted lower parent-reported between-session practice. No parent characteristics predicted session attendance. Results suggest that early intervention providers should consider multiple aspects of parent engagement that are influenced by different parent characteristics when assessing and promoting engagement to support child progress.

Lay Abstract

Parent engagement in early intervention for autism supports child progress but often varies in the community. Most research studies of parents’ engagement in intervention have examined attendance and homework completion rather than active and independent contribution to treatment during intervention sessions (e.g. participating in practice activities, sharing perspectives about at-home practice). In addition, little research has examined parent engagement in early intervention for autism, which may be higher compared to broader child psychotherapy since parents typically report high satisfaction with early intervention. To address these gaps, we examined how active engagement observed and scored by trained researchers in video-recorded early intervention sessions, parent report of how often they practice intervention strategies at home, and session attendance were related to each other. We also examined how parents’ personal (marital status, racial/ethnic identity, and education) and psychological characteristics (stress, self-efficacy, and motivation) influenced their active engagement, at-home practice, and attendance. Our sample included 164 parents of toddlers with an autism diagnosis or showing early signs of autism participating in the United States publicly funded early intervention system. We found that active engagement, at-home practice, and attendance were not related. While most parent characteristics did not influence active engagement, single parents showed lower engagement during intervention sessions. In addition, parents who reported lower motivation to change their parenting behavior reported less at-home practice. No parent characteristics influenced their session attendance. Our results suggest that active engagement, at-home practice, and attendance may represent different aspects of parent engagement. To assess and increase parent engagement in community early intervention for autism, clinicians should consider multiple signs of engagement and the influence of various parent characteristics.