87 Pilot testing of BEAR 4 functioning, one parent described that nothing changed. BEAR professionals were more critical on the effect of the training that they provided, but were overall satisfied with the effect of BEAR on family functioning, child upbringing and parental insight in the behaviour of the child. Regarding child behaviour, BEAR trainers report various outcomes: for one child, they deemed the effect of BEAR not judge able, for another child there was no change in the child’s behaviour, one greatly improved and two somewhat improved. Adaptations made after pilot testing The results of pilot testing, feedback collected during a session with participating parents, and discussions at monthly meetings with the intervention team led to some revisions in the original intervention protocol, including a) optimizing (technical) functionalities to the online environment that holds the intervention (BEAR online) and providing b) supervision remotely (via video call) instead of the supervisor accompanying the BEAR professional during the first and last home visits as originally planned. This is speculated to be equally effective, though much more efficient. Furthermore, several adaptations were made to the original research design to optimize the potential for a successful randomized controlled trial. Initially, the Dutch adaptation of the MacArthur Communicative Development Inventory: Toddler (N-CDI) was administered at baseline (T1), endpoint (T2) and follow-up (T3). However, following pilot testing, it was decided that administering the N-CDI only at T1 and T3 would be more practical. This decision was prompted by a) concerns that administering the N-CDI too closely together might introduce errors, such as children potentially being (incorrectly) perceived as regressing in their language production and comprehension, and b) due to parental feedback indicating the questionnaire’s excessive time consumption. Please note that language use will still be assessed during all time points with use of the JERI. Also, a self-made survey that measures satisfaction of parents with healthcare was finalized during pilot testing. Lastly, for the RCT we will increase attention regarding exclusion criteria since two participants dropped out due to insufficient mastery of the Dutch language and severe parental psychopathology. For the revised research design, we refer to our published protocol paper (Snijder et al., 2022). Conclusions Upon initial examination, results suggest that most children and their parents seem to improve on various domains directly after following the BEAR intervention. Most children (n=4) improved on total time spent in joint engagement and three children decreased in severity of ASD symptoms. Regarding parental skills, most parents (n=4) improved in their ability to follow their child’s interests and half of the participants showed improvement on
RkJQdWJsaXNoZXIy MjY0ODMw