Over 7 million children in the U.S. receive support for a developmental delay or disability
(DD). For caregivers of these children, behavior issues that often accompany their child's
condition create high levels of stress leading to increased mental and physical health issues
and impacts on caregiver-child interactions and family functioning. Although evidence-based
practices exist to help caregivers with their child's behavioral development, access to these
services is often limited by rigid delivery models requiring in-person visits that can delay
support and further increase the burden on families. These barriers are disproportionately
higher for families of color and for those in low resource situations: an effect that has
been exacerbated by reductions in services due to coronavirus disease 2019 (COVID-19). The
overall objective of this project is to develop and implement a telehealth delivery model of
rapid-response, evidence-based behavioral support to be provided in conjunction with an
existing family navigation program (Undivided) serving parents of children with DD to create
a commercially marketable product that will reduce barriers to services in local communities
across the country.
This project will test the feasibility and acceptability of the Family Advice Text and
Telephone (FASTT) support service for caregivers of young children. This Phase 1 application
will enable a collaborative process to adapt evidence-based behavioral support to the
specific needs of families of children ages birth to 12 with DD and integrate that support
within the existing family navigation service. The rationale for the work is that providing
effective, personalized support through the widely accessible mediums of text and telephone
will get caregivers the help they need when and where they have time to access it and close
in time to the behavioral issues they need help with, thus reducing caregiver stress and
increasing their sense of competence and positive interactions with their child. Aim 1
determines the feasibility of delivering evidence-based behavioral support to caregivers of
children with disabilities using on-demand text messaging. Aim 2 gauges the acceptability of
the text-based support service to caregivers. Aim 3 assesses the extent to which text-based
support reduces caregiver stress, improves caregiver sense of competence, and builds more
positive perceptions of their child's behavior and their relationship with their child.
