7/14/2017. Expanding our reach: HRSA CARES research networks. Connie Kasari HRSA CARES Monday July 10, Uniqueness HRSA RN

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1 Expanding ur reach: HRSA CARES research netwrks Cnnie Kasari HRSA CARES Mnday July 10, 2017 Autism Interventin Research Netwrk fr Behaviral Health 1 2 Uniqueness HRSA RN AIR-B Interventin Examples 1 2 Uniqueness HRSA RN 1

2 AIR-B Interventin Examples 1 2 Uniqueness HRSA RN Next Steps Uniqueness f HRSA research netwrks... Mst f the subjects were White and middle class Graham, S; American Psychlgist, Vl 47(5), May 1992, Autism Research tday... Review f evidence based practices >80% studies did nt reprt ethnicity: Of the nes reprting race, 6.5 percent were White West, E et al 2016, Jurnal f Special Educatin 2

3 N shrtage f marketed interventins fr ASD Jint Attentin Symblic Play Engagement Regulatin JASPER Early Start Denver Mdel ESDM Pivtal Respnse Training PRT Flrtime DIR Develpmental Individual difference Relatinship-based RDI Relatinship Develpment Interventin Early Achievements Prj ImPACT PEERS Secret Agent Sciety Discrete Trial Training DTT Verbal Behavir Interventin VB SCERT Scial Cmmunicatin Emtin Regulatin Transactin Supprts Unstuck and O n Target Fcused Playtime Interventin Adapted Respnsive Interventin Jint Attentin Symblic Play Engagement Regulatin JASP Early Start Denver Mdel ESDM Pivtal Respnse Training PRT Flrtime Develpmental Individual difference Relatinship-based DIR Relatinship Develpment Interventin RDI Early Achi Prject ImPACT PEERS Secret Agent Sciety Discrete Trial Trainin DTT Verbal Behavir Mst children with ASD have never been in a research study AND MOST INTERVENTIONS have never been tested in any cntrlled study; The evidence-base des nt reflect mst children in the cmmunity (Weisz, 2004) HRSA AIR-B gals 1. Increase early identificatin, access t effective interventins fr under-resurced, under-represented children with ASD and their families 2. Use cmmunity partnered methds t increase reach, effectiveness and sustainability f interventins AIR-B Interventin Examples 1 2 Uniqueness HRSA RN

4 Tday s interventin landscape LAUSD Students with ASD 2 nd largest schl district; Hispanic 14,000 students with ASD White District as a whle is.. 75% Hispanic; 80% free & reduced lunch; 9% White Black Other Other Black Hispanic Disparities are real.. Public schls shuld be place withut disparities in services 4

5 AIR-B leadership netwrk f academic-cmmunity partnership Fcus n lw resurced cmmunity settings, particularly schls..all children g t schl AIR-B has cmpleted several randmized trials 1. Parent mediated interventin in hmes 2. Schl based interventin fr schl staff Example study 1 Kasari, Lawtn, Shih, Barker, Landa, Lrd, Orlich, King, Wetherby, Sentruk, Pediatrics, 2014 Infrmatin Sharing Hands n Caching Prvided autism specific parent mediated interventin t preschlers in hmes 5

6 Parent Mediated Interventins Child initiated jint engagement Secnds Grup Educatin JASPER Entry Exit Fllw up (Kasari, Lawtn, Shih, Barker et al, Pediatrics, 2014) RCT-Cmparative Efficacy, Multi-site N=112 Parent Mediated Interventin-- Preschlers 112 children (2-5 year lds) Lw resurces (half n services, lw incme) 66% ethnic minrity, 15% nn- English speaking Cmparisn 2 parent interventins In hme interventin r neighbrhd grup 24 sessins ver 12 weeks mnth fllw up JASPER grup Jint engagement Symblic play Initiating JA (Kasari, Lawtn, Shih, Barker, Landa, Lrd, Orlich, King, Wetherby, Sentruk, Pediatrics, 2014) Example study 2: Scial difficulties at schl Interacting, getting alng with peers Develping friendships 6

7 Measuring peer relatinships at schl David () 4.5 Tris (6) Jenny (8) Francisc (7) 7.5 Peter (5) Briana (7) 8 Felika (9) Suzannah (4) Aubyn (7) 5.5 Sam (4) Dindra (2) Cns (4) Ivette (4) 2 Sheryl () S (1) Islate: Cnnie (), Sarah (4) Anthny (4) 5 Amanda (6) Lindsay (4) Paul (2) Based n wrk f Cairns & Cairns Scial netwrks reveal cnsistent findings acrss multiple studies Mst are peripheral t the main scial grups, just lsely attached t thers Sme are ppular Chamberlain, Kasari, Rtheram-Fuller, 2007, JADD; Kasari et al, 2011, JADD; Rtheram-Fuller et al, 2010, JCPP 7

8 Several randmized trials cnducted in schls Example study 2 Michelle Dean Mark Kretzmann Jill Lcke AIR-B Trainees Paraprfessinal mediated interventin during recess Playgrund specific interventin 8

9 Paraprfessinals can imprve child engagement n the playgrund (6 weeks) 0.6 Observed Engaging with Peers at Recess Prprtin f Time Engaged Entry Mid Exit Treat Wait (Kretzmann, Shih & Kasari, 2014) AIR-B Interventin Examples 1 2 Uniqueness HRSA RN Next Steps Can we imprve n deplyment? Increase sustainability? Cmmunity partnered participatry research (Jnes & Wells, 2007) 9

10 Engagement interventin fr lw resurced families f newly diagnsed children with ASD Interventin fr maintaining services between majr schling transitins 10