79 Pilot testing of BEAR 4 To capture the flow of parent-child interactions, the “fluency and connectedness” item of the JERI was assessed. This item rated the balance between partners, their connection to each other and their play, and the fluency of the interaction. (Adamson & Suma, 2020). The item was rated on a 7-point Likert scale (1 = no interaction, 4 = interaction lacking smoothness and largely dominated by one partner, 7 = fluid, balanced, and sustained interaction). During pilot testing, the first author (MSn) was trained by one of the developers of the JERI until high accuracy was obtained on all items. For the RCT, students and research assistants will be trained in administering the JERI by MSn. BOSCC. Change in social-communicative development was examined through administering the Brief Observation of Social Communication Change (BOSCC; Grzadzinski et al., 2016). The BOSCC was rated based on the same 12-minute parent-child dyadic interaction as the primary outcome measure. The BOSCC consists of 15 coding items associated with key features of ASD, such as making eye contact, unusual sensory interests and the frequency and function of social overtures and were rated from 0 to 5 points. The difference in total score between measurement moments is indicative for change in behavior in the socialcommunicative domain, with a lower score meaning less severe ASD symptoms. MS and IO trained in administering the BOSCC together in order to be research reliable. Coders were deemed fully trained when they were within 1-point for ≥80% of items on a segment and total change scores per segment were within 3 points for three consecutive video’s. Evaluation of acceptability To assess the acceptability of both the intervention and research protocol the Rating Scale Satisfaction and Effect questionnaire (in Dutch: Beoordelingsschaal Tevredenheid en Effect ([BESTE], de Meyer et al., 2004) was administered immediately following treatment. The BESTE consists of two versions, one for assessing parental satisfaction and another for evaluating professional satisfaction with the intervention. Validity and reliability have been established (de Meyer et al., 2004). Additionally, monthly meetings with the intervention team were held in order to track and evaluate the acceptability and feasibility of the intervention protocol. After the pilot had ended, a feedback session was organized with participating parents. Participants During pilot testing, six children (5 boys, 1 girl) and their parents (6 mothers, 1 father) participated. Initially, eight children and their parents were enrolled in this study, but two participants withdrew after two and three sessions respectively. Dropout was attributed to
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