Expanding Training Capacity for the Group-Based Social ABCs Program: Evaluation of Coaching Models and French-Language Implementation in a Pediatric Hospital

Abstract

Autism is the fastest growing neurodevelopmental condition in Canada. Caregiver-mediated interventions, such as the Social ABCs, improve early social communication and caregiver empowerment. To enhance accessibility, Social ABCs was adapted into a condensed, group-based model. This study evaluated its implementation and sustainability at a large pediatric hospital, examining child and caregiver outcomes across multiple coach training pathways and French-language delivery. A retrospective chart review included 361 families (children 12–42 months with suspected or confirmed autism) who completed six weekly group sessions and nine individual caregiver coaching sessions between 2020 and 2024. Coaches were trained via expert-led, hybrid, or site-led pathways. Caregiver implementation fidelity improved from 33.6% to 70.0% (p < 0.001), with similar gains in English and French. Child vocal responsivity increased from 5.7% to 43.2% (p < 0.001), and post-intervention caregiver fidelity correlated with child responsivity (r = 0.25, p < 0.001). Fidelity and responsivity outcomes did not differ by training pathway, supporting site-led training. Multiple pathways expanded clinician capacity, increasing children served by ~86% within 2 years. These findings suggest that group-based Social ABCs may improve caregiver and child outcomes, increase service capacity, and enhance accessibility for French‑speaking families, supporting feasibility of multi‑pathway training models for scaling early autism interventions.

Lay Abstract

Autism is being identified in more young children in Canada, increasing the need for early supports that families can access in a timely way. The Social ABCs is a caregiver-mediated program that helps caregivers support their child’s early social communication, and it was adapted into a shorter, group-based format to improve accessibility. This study reviewed clinical records from 361 families of children aged 12–42 months with suspected or confirmed autism who participated in the group-based Social ABCs program at a large pediatric hospital between 2020 and 2024. Caregivers attended group sessions and individual coaching, and clinicians were trained using different approaches, including expert-led and hospital-based training. Results showed that caregivers became more consistent and confident in using the strategies they learned, and children showed meaningful improvements in social communication. These improvements were similar for English- and French-speaking families and did not differ based on how clinicians were trained. Using multiple training pathways also allowed the program to serve many more families. Overall, the group-based Social ABCs improved outcomes for caregivers and children while increasing service capacity and access to early autism supports.