Leveraging technology to make parent training more accessible: Randomized trial of in-person versus online executive function training for parents of autistic children.

LAY ABSTRACT: This study compared the first online parent training program for executive function intervention for autism to in-person parent training on the same content. Participants were parents of autistic children, who were between 8 and 12 years of age and did not have intellectual disability. Parents were randomized to the in-person (n = 51) or online (n = 46) training conditions. Both trainings were developed with stakeholder (parents and autistic people) guidance. In this trial, most parents reported that they liked both trainings and that they were able to implement what they learned with their children. Parents in both groups spent equivalent amounts of time (about 8 hours) with the training materials, but while 94% of parents in the in-person training attended both parent trainings, only 59% of parents in the online group completed all 10 online modules. Parents reported that it was difficult to stay motivated to complete the online trainings over the 10-week trial. Parent and child outcomes did not differ significantly between the groups. Overall, parents reported that the trainings resulted in a reduction in their own parenting strain and improvements in their child's flexibility, emotional control, and global executive function, but not planning and organization. These findings indicated brief in-person and online training can help parents learn to support and improve their autistic children's executive function abilities, reducing their own experience of parenting strain. The finding that the online training was equivalent to the in-person trainings is important because it is accessible to parents who encounter barriers to in-person care.

Exploring Provider Use of a Digital Implementation Support System for School Mental Health: A Pilot Study.

This pilot study explored provider use of an online system, Centervention, to support the delivery of empirically supported school-based mental health interventions (ESIs); and associations between components of this system [resources, training, technical assistance (TA), feedback loops], implementation indicators, and student outcomes. Multilevel modeling data were collected from 39 providers implementing ESIs with 758 students. Training, TA, and progress monitoring predicted ESI adherence, and perceived value of resources and TA influenced student responsiveness. Greater adherence was predictive of better socio-emotional outcomes. Interviews with 15 providers illuminated how they used these four Centervention support strategies. Implications for digital implementation support research are discussed.

Improving Children's Mental Health with a Digital Social Skills Development Game: A Randomized Controlled Efficacy Trial of Adventures aboard the S.S. GRIN.

OBJECTIVE: The purpose of this study was to investigate whether a computer-based game to improve social skills and mental health in children with social skills deficits would be efficacious. The program, Adventures aboard the S.S. GRIN, translates a proven in-person intervention into a nine-episode interactive online adventure game that provides opportunity for knowledge acquisition and skill practice. MATERIALS AND METHODS: Participants (children aged 7-11 years with social skills challenges) were randomly assigned to immediate treatment group (n = 33) or waitlist control group (n = 36). Children in the immediate treatment condition completed the game at home over the course of 9 weeks. Before playing the game and again within 1 week of game completion, children completed surveys about social literacy, social anxiety, bullying, social self-efficacy, and social satisfaction. RESULTS: Children who played Adventures improved significantly more from pretest to posttest than children who did not play the game in social literacy, social anxiety, bullying victimization, and social satisfaction. CONCLUSION: Online interactive games can be effective in improving mental health for children who struggle with social skills. For children who can access them, serious games have the potential to increase the reach of effective programs by overcoming the logistical and implementation barriers (such as cost, travel, and accessibility) that limit traditionally delivered mental health interventions.

Intent to sustain use of a mental health innovation by school providers: What matters most?

Despite innovations being routinely introduced in schools to support the mental health of students, few are successfully maintained over time. This study explores the role of innovation characteristics, individual attitudes and skills, and organizational factors in school providers' decisions to continue use of Centervention, a technology-based tool that supports implementation of evidence-based mental health interventions (EBIs). Data were collected from 44 providers through online surveys following use of Centervention over a one-year period. When considered with individual and organizational factors, experience with Centervention (usability, usefulness, and satisfaction) was found to be the most influential predictor of intent to sustain use. Results reinforce the importance of (1) differentiating between factors that predict initial adoption vs. those that enable sustainability and (2) tailoring sustainability decision models to the nature of the innovation. They also support the need to incorporate strategies to enhance provider experience during implementation of an innovation.