An important principle of evidenced-based practice (EBP) is using interventions with strong empirical support for their effectiveness, commonly known as evidence-based interventions (EBIs). Evidence of an intervention’s effectiveness is strongest when supported by treatment integrity data. Treatment integrity refers to the degree to which an intervention is implemented as intended by the original design. The assessment’s purpose is to provide researchers and practitioners with data about the implementation process to enable valid conclusions to be drawn about an intervention’s effectiveness.The present study focused on the treatment integrity assessment of Project ImPACT (Improving Parents as Communication Teachers; Ingersoll & Dvortcsak, 2010), a parent training program that aims to improve parents’ competence in teaching social communication skills to children diagnosed with autism spectrum disorder (ASD). The parent coaching portion of the training program was the focus of this study. Treatment integrity assessment occurred at two stages: The coaching delivery and the treatment delivery.This study used videos of coaching sessions from two randomized controlled trial (RCT) studies that examined the effectiveness of delivering Project ImPACT via telehealth with and without parent coaching. Dane and Schneider’s (1998) treatment integrity conceptual framework was used to guide the assessment. For the coaching delivery, the assessment focused on the therapists’ adherence to the coaching procedure, provision of feedback, and quality of coaching delivery, and the parents’ responsiveness during the coaching session. For the treatment delivery, the assessment focused on the parents’ adherence to the intervention strategies and quality of the treatment delivery. Descriptive statistics provided a general overview of the therapists’ coaching performance and the parents’ teaching performance. Multilevel regression analysis determined which components of the coaching delivery best predicted how parents used the intervention techniques and structured the play session for their child during the coaching sessions.Overall, the therapists consistently completed the essential steps of the coaching process. They frequently provided comprehensive feedback, attention, and reassurance. They did not provide as many opportunities for the parents to engage in collaborative problem-solving or to reflect on their implementation progress. In turn, the parents fully participated in the coaching session and demonstrated sufficient capacity to implement the intervention techniques and structure a meaningful play session for their child.Results from a multilevel regression analysis indicated that none of the treatment integrity components of the coaching delivery significantly predicted the parents’ treatment adherence. The quality of coaching delivery did, however, significantly predict the parents’ structure of the play segment, albeit in a negative direction. The study’s results, along with its limitations, provided a platform for continuing the conversation about treatment integrity assessment in intervention studies. In particular, the study concluded with new questions about the conceptualization and operationalization of different parent coaching aspects for parent-implemented interventions. Seeking to understand the concept and improve the measurement of these parent coaching aspects can lead to a more accurate identification of the active ingredients of parent coaching in ASD parent-implemented interventions.
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