IDEA Part C Programs... Pathways Parent Training Program is a practice to research model developed specifically to fit the service delivery model and guiding principles of publicly funded Individuals with Disabilities Education Act (IDEA) Part C intervention programs.

Publicly funded Individuals with Disabilities Education Act (IDEA) Part C programs across the nation are facing serious issues in their attempt to meet compliance of the law. Intervention, by law, must be based on explicit principles, validated practices, and best available research. Most believe that for Autism Spectrum Disorders (ASD) this means ABA-based interventions. IDEA Part C programs are also charged with providing these services in the child’s natural environment.

On September 14, 2015, the U.S. Department of Health and Human Services and the U.S. De- partment of Education released a joint Policy Statement on Inclusion of Children with Disabilities in Early Childhood Programs. The statement, based on both relevant research and the law, states “Families are children’s first and most important teachers and advocates”. It goes on to state that appropriate early intervention services for any infant or toddler with a disability are to be provided in natural environments including the home. Unless these early childhood programs are able to provide an efficacious intervention that fits within their service model, they must face being out of compliance in one area or the other.

The Pathways Parent Training Program has an innovative approach that sets it apart from other autism treatment models. The Pathways Parent Training Program was developed to fit the service delivery model and guiding principles of Texas’ publicly funded IDEA Part C ECI. This differs from traditional NDBI and ABA models that are typically applied in homes, clinics or classrooms, one-to-one with a therapist, for 20 to 40 hours/week. It also deviates considerably from what is being used in many IDEA Part C programs. Programs are not able to provide the intensity of services needed for producing favorable outcomes in children with autism. To increase the intensity of services, some IDEA Part C providers use a combination of various autism treatments (with or without an evidence base) or work to provide a higher intensity of general developmental services. Other IDEA Part C providers attempt to deliver autism-specific programming using a combination of treatments in a non-systematic way or they must send the children to ABA-based treatment centers, a practice which is costly, limited, and likely unsustainable.

Best practice for toddler-aged children with autism involves parents being coached to incorporate specific behavioral and developmental strategies into daily routines and family activities. By utilizing daily routines and activities, parents are able to embed intervention strategies throughout the child’s day to promote participation and learning in an authentic setting and, thus, provide the recommended intensity of services necessary for significant change. Pathways Parent Training Program was specifically designed to be compatible with these key principles, as reflected in the Texas Part C ECI guidelines:

(a) the role of the service providers is to work with and support families;

(b) families are active participants in all aspects of services;

(c) services are provided in convenient naturalistic environments, such as the home;

(d) the child learns new skills best during authentic activities;

(e) the density of the service providers’ time is limited, often to only one visit a week.

A study published in Autism—International Journal of Research and Practice and funded by the State of Texas found the Pathways Parent Training Program model to be effective for developing the early foundational social communication skills of eye contact, social engagement, and verbal reciprocity in toddlers enrolled in an IDEA part C program. In addition, parents perceived the intervention as beneficial, easy to learn, and easy to incorporate into daily life.

Pathways Parent Training Program was developed based on highly researched behavioral and developmental sciences—teaching parents to use behavioral strategies to target developmentally appropriate early social communication skills. The Pathways parent training model includes all the features of a Naturalistic Developmental Behavioral Intervention, but unlike most other programs that are research to practice models—Pathways Parent Training Program is a practice to research model.

Created from within an authentic setting, Pathways Parent Training Program was specifically designed to be compatible with the Key Principles for Providing Early Intervention Services in Natural Environments, which guide publicly funded early childhood intervention programs. A recent brief from The Office of the Assistant Secretary for Planning and Evaluation—US Department of Health and Human Services indicates that "contextual fit" is important to the effective adoption of evidence-based interventions. To be effective, there must be a match between an intervention and the service system—the agency, interventionists and families.

Autism affects one in 68 children. The ability to identify these children before the age of 3 has created a significant lack of capacity within IDEA Part C programs across the nation to provide effective autism intervention. Programs are actively seeking ways to provide research based, autism specific intervention, for these toddlers suspected of or having autism, within their current service delivery system.

Existing IDEA Part C programs already have a very effective service delivery infrastructure in place, making implementation of the Pathways Parent Training Program feasible. These programs employ many highly qualified and credentialed personnel, such as speech pathologists, occupational therapists, mental health specialists, and child development specialists who, with training, will be able to build capacity to serve this rapidly growing population in a relatively short time.

The Pathways team has developed a training model designed to provide widespread intensive instruction to Early Childhood Interventionists that will enable them to effectively train parents in the Pathways Parent Training Program model.

The training model consists of a combination of web-based and hands-on training. After an initial face to face introduction, planning and overview, each interventionist to be trained will complete a series of on-line instructional modules to provide a foundation of knowledge and understanding. Once completed, the interventionist will attend four days of intensive step-by-step instruction, teaching the Pathways NDBI model. Monthly follow up support is provided with a combination of hands-on and web-based meetings. A second phase of support includes more intensive ongoing training for select providers to become agency support personnel.