Community-Informed Adaptation of a Coparenting Intervention for Parents of Children Recently Diagnosed with Autism Spectrum Disorder

Introduction: It is estimated that 1 in every 68 children meet diagnostic criteria for autism spectrum disorder (ASD), a neurodevelopmental disorder characterized by social communication challenges and restricted or repetitive behaviors or interests. The rapid and significant increase in the prevalence of ASD presents social workers with the challenge of providing evidence-based interventions (EBIs) to meet the unique needs of these children and their families in a timely, cost-effective way. One promising approach for addressing the needs of this growing population is the adaptation of existing evidence-based interventions (EBI’s). Despite calls for research that details the adaptation process of EBIs, however, such work is scarce. To address this gap, we have created the Autism Parent Navigator (APM) program, which combines the core components of an evidence-based intervention (Family Foundations) with an innovative delivery mechanism (parent-to-parent support) to target coparenting relationships shortly after a child has been diagnosed with ASD. The purpose of this paper is to describe the systematic, community-engaged adaptation process used, and draw conclusions for the adaptation of EBI’s in resource-constrained contexts.

Methods: We conducted a systematic adaptation of the Family Foundations program to be delivered to parents of children with ASD in their homes. This process was driven by a partnership between university researchers and a statewide family support organization. We built upon existing adaptation models to execute a six-phase process that included 1) a review of program theory and materials, 2) engaging key stakeholders and forming an implementation team, 3) prototyping program materials, 4) Pre-implementation planning and 5) conducting a pilot study. Detailed field notes, meeting minutes, team communication, and stakeholder interview data were collected and summarized.

Results: Each phase of the adaptation process yielded important lessons learned. The involvement of key stakeholders, including the target population, the implementing organization, and the Family Foundations developer, increased the quality, feasibility and acceptability of the adapted APM program. The formation of an implementation team was critical to balancing fidelity, feasibility and applicability throughout the process. Adaptations were made to program content, delivery mechanism, and training and coaching materials. We provide results from the small pilot concerning fidelity, participant feedback, and preliminary outcomes.

Conclusions: The community-informed adaptation process successfully engaged diverse stakeholders in the development of the adapted program. The strong university/community partnership leveraged vital financial and human resources that enabled the team to execute a rigorous adaptation process in a resource-constrained context. Implications for systematically adapting EBI’s are discussed.