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Expanding Training Capacity for the Group-Based Social ABCs Program: Evaluation of Coaching Models and French-Language Implementation in a Pediatric Hospital

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Title: Expanding Training Capacity for the Group-Based Social ABCs Program: Evaluation of Coaching Models and French-Language Implementation in a Pediatric Hospital
Language: English
Authors: Renee Baysarowich (ORCID 0009-0007-1100-7004), Jessica Remedios (ORCID 0009-0004-6121-1984), Kelly King, Martine Brunet, Nicholas Denomey (ORCID 0009-0002-1295-2351), Justyna Litwinska, Taylor Johansen (ORCID 0009-0004-5843-0377), Sarah Raza (ORCID 0000-0002-3666-8585)
Source: Autism: The International Journal of Research and Practice. 2026 30(6):1478-1487.
Availability: SAGE Publications. 2455 Teller Road, Thousand Oaks, CA 91320. Tel: 800-818-7243; Tel: 805-499-9774; Fax: 800-583-2665; e-mail: journals@sagepub.com; Web site: https://sagepub.com
Peer Reviewed: Y
Page Count: 10
Publication Date: 2026
Document Type: Journal Articles
Reports - Research
Education Level: Adult Education
Descriptors: Foreign Countries, French, Autism Spectrum Disorders, Intervention, Toddlers, Coaching (Performance), Group Instruction, Program Implementation, Fidelity, Caregiver Training, Child Caregivers, English, Satisfaction, Hospitals, Interpersonal Communication
Geographic Terms: Canada
DOI: 10.1177/13623613261434573
ISSN: 1362-3613
1461-7005
Abstract: Autism is the fastest growing neurodevelopmental condition in Canada. Caregiver-mediated interventions, such as the Social ABCs, improve early social communication and caregiver empowerment. To enhance accessibility, Social ABCs was adapted into a condensed, group-based model. This study evaluated its implementation and sustainability at a large pediatric hospital, examining child and caregiver outcomes across multiple coach training pathways and French-language delivery. A retrospective chart review included 361 families (children 12-42 months with suspected or confirmed autism) who completed six weekly group sessions and nine individual caregiver coaching sessions between 2020 and 2024. Coaches were trained via expert-led, hybrid, or site-led pathways. Caregiver implementation fidelity improved from 33.6% to 70.0% (p < 0.001), with similar gains in English and French. Child vocal responsivity increased from 5.7% to 43.2% (p < 0.001), and post-intervention caregiver fidelity correlated with child responsivity (r = 0.25, p < 0.001). Fidelity and responsivity outcomes did not differ by training pathway, supporting site-led training. Multiple pathways expanded clinician capacity, increasing children served by ~86% within 2 years. These findings suggest that group-based Social ABCs may improve caregiver and child outcomes, increase service capacity, and enhance accessibility for French‑speaking families, supporting feasibility of multi‑pathway training models for scaling early autism interventions.
Abstractor: As Provided
Entry Date: 2026
Accession Number: EJ1506556
Database: ERIC
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  Value: &lt;anid&gt;AN0193858194;f9d01jun.26;2026May21.02:15;v2.2.500&lt;/anid&gt; &lt;title id=&quot;AN0193858194-1&quot;&gt;Expanding Training Capacity for the Group-Based Social ABCs Program: Evaluation of Coaching Models and French-Language Implementation in a Pediatric Hospital&#160;&lt;/title&gt; &lt;p&gt;Autism is the fastest growing neurodevelopmental condition in Canada. Caregiver-mediated interventions, such as the Social ABCs, improve early social communication and caregiver empowerment. To enhance accessibility, Social ABCs was adapted into a condensed, group-based model. This study evaluated its implementation and sustainability at a large pediatric hospital, examining child and caregiver outcomes across multiple coach training pathways and French-language delivery. A retrospective chart review included 361 families (children 12–42 months with suspected or confirmed autism) who completed six weekly group sessions and nine individual caregiver coaching sessions between 2020 and 2024. Coaches were trained via expert-led, hybrid, or site-led pathways. Caregiver implementation fidelity improved from 33.6% to 70.0% (p &amp;lt; 0.001), with similar gains in English and French. Child vocal responsivity increased from 5.7% to 43.2% (p &amp;lt; 0.001), and post-intervention caregiver fidelity correlated with child responsivity (r = 0.25, p &amp;lt; 0.001). Fidelity and responsivity outcomes did not differ by training pathway, supporting site-led training. Multiple pathways expanded clinician capacity, increasing children served by ~86% within 2 years. These findings suggest that group-based Social ABCs may improve caregiver and child outcomes, increase service capacity, and enhance accessibility for French‑speaking families, supporting feasibility of multi‑pathway training models for scaling early autism interventions. Autism is being identified in more young children in Canada, increasing the need for early supports that families can access in a timely way. The Social ABCs is a caregiver-mediated program that helps caregivers support their child&#39;s early social communication, and it was adapted into a shorter, group-based format to improve accessibility. This study reviewed clinical records from 361 families of children aged 12–42 months with suspected or confirmed autism who participated in the group-based Social ABCs program at a large pediatric hospital between 2020 and 2024. Caregivers attended group sessions and individual coaching, and clinicians were trained using different approaches, including expert-led and hospital-based training. Results showed that caregivers became more consistent and confident in using the strategies they learned, and children showed meaningful improvements in social communication. These improvements were similar for English- and French-speaking families and did not differ based on how clinicians were trained. Using multiple training pathways also allowed the program to serve many more families. Overall, the group-based Social ABCs improved outcomes for caregivers and children while increasing service capacity and access to early autism supports.&lt;/p&gt; &lt;p&gt;Keywords: Autism; bilingual accessibility; caregiver-mediated intervention; early intervention; group-based intervention; implementation science; service capacity; social ABCs; social communication; training pathways&lt;/p&gt; &lt;hd id=&quot;AN0193858194-2&quot;&gt;Introduction&lt;/hd&gt; &lt;p&gt;Autism is a neurodevelopmental condition, characterized by differences in social communication and the presence of restrictive, repetitive behaviors and/or interests ([&lt;reflink idref=&quot;bib1&quot; id=&quot;ref1&quot;&gt;1&lt;/reflink&gt;]; [&lt;reflink idref=&quot;bib12&quot; id=&quot;ref2&quot;&gt;12&lt;/reflink&gt;]). Autism remains the fastest growing neurodevelopmental condition in Canada – with approximately 1 in 50 children between the ages of 1 and 17 years diagnosed with autism ([&lt;reflink idref=&quot;bib15&quot; id=&quot;ref3&quot;&gt;15&lt;/reflink&gt;]). This increase in autism prevalence has amplified the need for earlier detection and access to treatment in order to optimize developmental outcomes and, as a result, has become a national healthcare priority ([&lt;reflink idref=&quot;bib2&quot; id=&quot;ref4&quot;&gt;2&lt;/reflink&gt;]; [&lt;reflink idref=&quot;bib6&quot; id=&quot;ref5&quot;&gt;6&lt;/reflink&gt;]; [&lt;reflink idref=&quot;bib14&quot; id=&quot;ref6&quot;&gt;14&lt;/reflink&gt;]; [&lt;reflink idref=&quot;bib16&quot; id=&quot;ref7&quot;&gt;16&lt;/reflink&gt;]; [&lt;reflink idref=&quot;bib17&quot; id=&quot;ref8&quot;&gt;17&lt;/reflink&gt;]; [&lt;reflink idref=&quot;bib18&quot; id=&quot;ref9&quot;&gt;18&lt;/reflink&gt;]). Caregiver-mediated interventions have responded to this need by targeting the early signs and characteristics of autism ([&lt;reflink idref=&quot;bib6&quot; id=&quot;ref10&quot;&gt;6&lt;/reflink&gt;]; [&lt;reflink idref=&quot;bib11&quot; id=&quot;ref11&quot;&gt;11&lt;/reflink&gt;]). The inclusion of caregivers in the delivery of treatment (within the child&#39;s natural environment) has been rigorously studied and demonstrated to positively impact children&#39;s progress and quality of life ([&lt;reflink idref=&quot;bib9&quot; id=&quot;ref12&quot;&gt;9&lt;/reflink&gt;]).&lt;/p&gt; &lt;p&gt;In Ontario, Canada, early intervention services for autistic children are primarily accessed through the Ontario Autism Program (OAP) – a provincially funded system that provides families with financial support and service navigation to obtain evidence-based care. For toddlers, caregiver-mediated programs represent a central service pathway within the OAP, alongside access to developmental, behavioral, and communication-based interventions. As a result, brief, accessible caregiver-mediated models are critical to meeting provincial demand, particularly those that can be delivered efficiently, across diverse settings, and in families&#39; preferred languages. This service context has informed the growing interest in scalable, caregiver-mediated Naturalistic Developmental Behavioral Interventions (NDBI) such as the Social ABCs.&lt;/p&gt; &lt;p&gt;The Social ABCs is an example of a targeted, caregiver-mediated intervention for toddlers aged 12–36 months (with clinical application up to 42 months) with suspected or confirmed autism. It was developed in response to the need for evidence-based, feasible, and sustainable early interventions for toddlers with emerging autism and is a manualized, caregiver-mediated program grounded in NDBI principles ([&lt;reflink idref=&quot;bib5&quot; id=&quot;ref13&quot;&gt;5&lt;/reflink&gt;]). The standard program – co-developed at SickKids Hospital (Toronto, Ontario) and the IWK Health Centre (Halifax, Nova Scotia) – involves individual (1:1), in-home didactic teaching and live coaching over a period of 12 weeks ([&lt;reflink idref=&quot;bib6&quot; id=&quot;ref14&quot;&gt;6&lt;/reflink&gt;], [&lt;reflink idref=&quot;bib5&quot; id=&quot;ref15&quot;&gt;5&lt;/reflink&gt;]). Operating within a developmental framework, the Social ABCs targets functional (directed) vocal communication and positive affect-sharing ([&lt;reflink idref=&quot;bib6&quot; id=&quot;ref16&quot;&gt;6&lt;/reflink&gt;]). Parents are coached to integrate the program&#39;s strategies into their everyday play and caregiving routines with their toddler. As evidenced in a large community implementation trial and a cross-site randomized controlled trial, the Social ABCs has been shown to be an effective intervention for improving early social communication in autistic toddlers ([&lt;reflink idref=&quot;bib4&quot; id=&quot;ref17&quot;&gt;4&lt;/reflink&gt;]; [&lt;reflink idref=&quot;bib6&quot; id=&quot;ref18&quot;&gt;6&lt;/reflink&gt;], [&lt;reflink idref=&quot;bib5&quot; id=&quot;ref19&quot;&gt;5&lt;/reflink&gt;]; [&lt;reflink idref=&quot;bib7&quot; id=&quot;ref20&quot;&gt;7&lt;/reflink&gt;]). Specifically, toddlers demonstrated significant gains in vocal responsivity to caregiver prompts, vocal initiations, shared smiling, and social orienting. The intervention has also yielded positive developmental and mental health outcomes for the caregiver-child dyad, including increased positive affect-sharing in toddlers and parental empowerment – by bolstering the caregivers&#39; skills and confidence in supporting their child&#39;s development ([&lt;reflink idref=&quot;bib6&quot; id=&quot;ref21&quot;&gt;6&lt;/reflink&gt;], [&lt;reflink idref=&quot;bib5&quot; id=&quot;ref22&quot;&gt;5&lt;/reflink&gt;]). Caregivers have also reported enjoying the Social ABCs training and maintaining the skills gained during the program ([&lt;reflink idref=&quot;bib7&quot; id=&quot;ref23&quot;&gt;7&lt;/reflink&gt;]).&lt;/p&gt; &lt;p&gt;Despite promising evidence of the positive effects of the Social ABCs on child and caregiver outcomes, there remains a need for intervention programs that are resource-efficient and brief in duration. In many publicly funded systems, the standard 12-week, 1:1 in-home model requires substantial clinician time, travel, and scheduling coordination, limiting the number of families that can be served; delivering core content repeatedly in individual formats rather than through shared didactic sessions further constrains workforce capacity and contributes to extended wait times for early autism services. To increase access, serve more families in the community, and optimize resource use, the Social ABCs has been adapted as a condensed, hybrid, group-based model. Served over a period of 6 weeks (as opposed to 12 weeks in the original model), the adapted model maintains session objectives and preserves all targeted skills, core content, parent materials, and evaluation of fidelity and child responsivity. The primary difference is the delivery format: six weekly virtual small-group didactic sessions (of 5–8 caregivers) and nine live 1:1 coaching sessions – delivered either in-person or virtually (hybrid format). Findings from a large pilot study of the group-based model revealed toddlers making significant gains in vocal responding, word inventory, and reduced autism symptoms ([&lt;reflink idref=&quot;bib7&quot; id=&quot;ref24&quot;&gt;7&lt;/reflink&gt;]). Moreover, caregivers were able to achieve fidelity of strategy implementation and reported a reduction in parenting stress (albeit greater in the in-person delivery format).&lt;/p&gt; &lt;p&gt;Building on the successes of the group-based Social ABCs, the present study aimed to explore the accessibility and sustainability of the intervention in two ways. First, we sought to scale up the group-based Social ABCs intervention by accelerating the growth of coaching capacity through an expanded training infrastructure, which included multiple coach training pathways – ranging from expert team-led to fully site-led models. Central to this approach is the incorporation of &lt;emph&gt;on-site coach trainers&lt;/emph&gt;, who are responsible for training Social ABCs coaches who, in turn, train caregivers ([&lt;reflink idref=&quot;bib7&quot; id=&quot;ref25&quot;&gt;7&lt;/reflink&gt;]; [&lt;reflink idref=&quot;bib8&quot; id=&quot;ref26&quot;&gt;8&lt;/reflink&gt;]). This approach leverages existing workforce resources to support the rapid and sustainable expansion of the intervention. Second, we explored how the group-based Social ABCs can be adapted and implemented within French-speaking communities, reflecting the bilingual service context and substantial French-speaking population in our region. Literature has indicated inequities in accessing linguistically appropriate interventions, including few caregiver-mediated programs available to French-speaking families in Canada with an autistic child ([&lt;reflink idref=&quot;bib10&quot; id=&quot;ref27&quot;&gt;10&lt;/reflink&gt;]). As such, there is an urgent need to improve equitable access to evidence-based interventions, as well as provide tailored support to culturally and linguistically diverse communities.&lt;/p&gt; &lt;hd id=&quot;AN0193858194-3&quot;&gt;Objectives&lt;/hd&gt; &lt;p&gt;The present study explored the implementation of the group-based Social ABCs, with a focus on expanding coaching capacity. Objectives included exploring potential differences in child and caregiver outcomes across different Social ABCs coach training pathways – coaches trained by the expert team, coaches trained by &lt;emph&gt;on-site coach trainers&lt;/emph&gt; with expert team support, and coaches trained solely by &lt;emph&gt;on-site coach trainers&lt;/emph&gt; – as well as differences in outcomes related to French service delivery of the intervention. Child and caregiver outcomes included observed changes in child vocal responsivity, caregiver implementation fidelity, and caregiver satisfaction. Sustainability was further assessed by examining clinician capacity, service flow, and strategies for building organizational capacity to sustain the program.&lt;/p&gt; &lt;hd id=&quot;AN0193858194-4&quot;&gt;Methods&lt;/hd&gt; &lt;p&gt;&lt;/p&gt; &lt;hd id=&quot;AN0193858194-5&quot;&gt;Setting&lt;/hd&gt; &lt;p&gt;As a global leader in pediatric health care and research, the Children&#39;s Hospital of Eastern Ontario (CHEO) is a pediatric hospital serving the Eastern Ontario region in Canada and is committed to partnering with Anglophone and Francophone families, children, and youth to provide care. In partnership with the Social ABCs expert and program-development team (at Holland Bloorview Kids Rehabilitation Hospital; hereafter referred to as the &quot;expert team&quot;), an adapted version of the group-based Social ABCs was developed.&lt;/p&gt; &lt;hd id=&quot;AN0193858194-6&quot;&gt;French-Language Adaptation&lt;/hd&gt; &lt;p&gt;French-language implementation involved systematic translation of all core Social ABCs materials, including the parent manual, didactic slide content, handouts, and fidelity coding templates. Translation was conducted by bilingual clinicians familiar with the intervention model to ensure conceptual, rather than literal, equivalence. Delivery was provided by bilingual (English–French) coaches who completed the same certification requirements and fidelity benchmarks as English-language coaches. Importantly, the core intervention components, coaching structure, session objectives, and fidelity criteria were preserved across language conditions to maintain alignment with the established Social ABCs model. Adaptation focused on linguistic accessibility and contextualization of examples used during didactic teaching and live coaching (e.g. tailoring play routines and caregiver examples to align with family practices), rather than modification of the intervention&#39;s core components.&lt;/p&gt; &lt;hd id=&quot;AN0193858194-7&quot;&gt;Eligibility&lt;/hd&gt; &lt;p&gt;&lt;/p&gt; &lt;hd id=&quot;AN0193858194-8&quot;&gt;Participants&lt;/hd&gt; &lt;p&gt;Eligibility was determined by CHEO&#39;s intake and clinical teams based on specific criteria, including a confirmed diagnosis of autism by a qualified professional (i.e. pediatrician or psychologist) and registration in the OAP (provides funding and support to autistic children and youth and their families to access evidence-based services in Ontario, Canada). Children on the autism diagnostic waitlist were also eligible if social communication concerns had been identified by clinicians and/or family members and confirmed via robust chart review. Children were between 12 and 42 months of age at the time of enrolment. Families were able to continue accessing other supports (e.g. physiotherapy or occupational therapy) while participating in the Social ABCs program; however, families were asked not to engage in applied behavior analytic services targeting communication or speech-language services beyond bi-weekly consultation during the intervention period.&lt;/p&gt; &lt;hd id=&quot;AN0193858194-9&quot;&gt;Sample Description&lt;/hd&gt; &lt;p&gt;A total of 406 families were enrolled in the clinically provided group-based Social ABCs program at CHEO. Of the total, 361 families completed the program, with 329 families participating in the English program delivery, and 32 families participating in the French program delivery. Forty-five families withdrew from the program due to scheduling conflicts, complications from the COVID-19 pandemic, or decision to change programing to another clinical service. Families were given the opportunity to participate in the program at CHEO (31.3%), at home in-person (61.8%), or at home virtually (6.9%). As there were no significant differences across program delivery method, the results will not discuss this further.&lt;/p&gt; &lt;p&gt;A total of 361 caregivers (316 mothers, 41 fathers, 4 grandmothers) and their toddlers (70.6% male; mean age = 35.05 months) completed the group-based Social ABCs. 311 toddlers had a confirmed clinical diagnosis of autism, whereas 50 toddlers did not have an autism diagnosis by program onset. Of the toddlers with suspected autism, 80% received an autism diagnosis by program completion. Table 1 highlights family demographics and participant characteristics.&lt;/p&gt; &lt;p&gt;Table 1. Participant and Family Characteristics.&lt;/p&gt; &lt;p&gt;Graph&lt;/p&gt; &lt;p&gt; &lt;ephtml&gt; &amp;lt;table&amp;gt;&amp;lt;colgroup&amp;gt;&amp;lt;col align=&quot;left&quot; /&amp;gt;&amp;lt;col align=&quot;char&quot; char=&quot;.&quot; /&amp;gt;&amp;lt;/colgroup&amp;gt;&amp;lt;thead&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;th align=&quot;left&quot;&amp;gt;Variable&amp;lt;/th&amp;gt;&amp;lt;th align=&quot;left&quot;&amp;gt;&amp;lt;italic&amp;gt;N&amp;lt;/italic&amp;gt; (%)&amp;lt;/th&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;/thead&amp;gt;&amp;lt;tbody&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Toddler age&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Mean (&amp;lt;italic&amp;gt;SD&amp;lt;/italic&amp;gt;): 35.1 months (5.80) Range: 17&amp;amp;#8211;54 months&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Toddler sex&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Male: 255 (70.6%) Female: 106 (29.4%)&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Toddler diagnostic status&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Confirmed diagnosis: 311 (86.1%) No confirmed diagnosis yet: 50 (13.9%) Missing: 0 (0%)&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Program delivery method&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;At CHEO: 113 (31.3%) At home in-person: 223 (61.8%) At home virtually: 25 (6.9%)&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Program delivery group&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;English: 329 (91.1%) French: 32 (8.9%)&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Caregiver coached&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Mother: 316 (87.5%) Father: 41 (11.4%) Grandmother: 4 (1.1%)&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;/tbody&amp;gt;&amp;lt;/table&amp;gt; &lt;/ephtml&gt; &lt;/p&gt; &lt;hd id=&quot;AN0193858194-10&quot;&gt;On-Site Coach Trainers&lt;/hd&gt; &lt;p&gt;CHEO clinicians who previously received Social ABCs training and worked with families enrolled in the Social ABCs program were sent an expression of interest to participate in the Social ABCs &lt;emph&gt;on-site coach trainer&lt;/emph&gt; program. &lt;emph&gt;On-site coach trainers&lt;/emph&gt; were responsible for the clinical supervision of the Social ABCs coaches, as well as the planning, administration, and delivery of the adapted group-based Social ABCs. &lt;emph&gt;On-site coach trainers&lt;/emph&gt; were required to undergo comprehensive training; possess a bachelor&#39;s and/or master&#39;s degree in psychology (or related field); have 7 years of direct clinical Applied Behavior Analysis or Intensive Behavioral Intervention experience with children, as well as supervisory experience; and be bilingual (English and French). Two clinicians were selected to participate in the &lt;emph&gt;on-site coach trainer&lt;/emph&gt; program, each possessing a minimum of 12 months of experience as a Social ABCs coach.&lt;/p&gt; &lt;hd id=&quot;AN0193858194-11&quot;&gt;Social ABCs Coaches&lt;/hd&gt; &lt;p&gt;Eleven coaches received the group-based Social ABCs training from the expert team, &lt;emph&gt;on-site coach trainers&lt;/emph&gt; with expert team support, or solely from the &lt;emph&gt;on-site coach trainers&lt;/emph&gt;. Training included participation in a weeklong intensive training workshop, implementation practice, parent coaching with a minimum of six families to practice the intervention strategies, and co-facilitation of weekly didactics. Implementation practice required the Social ABCs coach to work hands-on with a child and utilize specific Social ABCs techniques to elicit directed vocalizations and engage in positive emotion sharing. Fidelity of implementation was measured by assessing a 10-minute video (1-minute interval coding) for nine techniques. Techniques included child choice, child attention, clear opportunity, contingent reinforcement, reinforcement of child attempts, shared control, pace, recast, and positive emotion sharing. Fidelity of implementation was met when the coach received a score of ≥80%.&lt;/p&gt; &lt;p&gt;Coaching skills practice was assessed in three phases and required the Social ABCs coach to work directly with the parent-caregiver dyad. That is, during Phase 1 (co-facilitation), coaching skills were modeled and practiced with direct supervision and review from the expert team and/or &lt;emph&gt;on-site coach trainer&lt;/emph&gt;, followed by Phase 2 (coaching with intense supervision), where 50% direct supervision occurred until parent coaching fidelity was achieved. Phase 3 required continued monitoring of coaching skills by &lt;emph&gt;on-site trainers&lt;/emph&gt; through regular supervision meetings and observation of coaching. Fidelity of coaching skills was measured by assessing a 10-minute video (2-minute interval coding) for five coaching principles. This included specific positive feedback to the caregiver, clear and concise coaching, active setup including step-by-step coaching and supporting the caregiver to correctly use strategies, moving from suggestive to directive coaching, and prompt-response contingency. Global coaching skills were also assessed during the video coding, which included coaching of appropriate Social ABCs targets, providing rationale to caregiver and/or describing the observed impact on child, providing positive global feedback to the caregiver, supporting parent-initiated interactions with child, promoting caregivers&#39; positive affect and proximity with child, and coaching in a way that is positive and responsive to the parent&#39;s learning needs and style. Coaching fidelity was met when the Social ABCs coach received a score of ≥80% across three families. To maintain certification, staff were required to submit a coaching video annually demonstrating continued fidelity, which was reviewed by a member of the expert team. &lt;emph&gt;On-site coach&lt;/emph&gt; trainers were permitted to independently train coaches only after meeting certification criteria for the &lt;emph&gt;on-site coach trainer&lt;/emph&gt; role, as determined by the expert team.&lt;/p&gt; &lt;p&gt;Finally, weekly didactics involved co-facilitated sessions with the expert team and/or &lt;emph&gt;on-site coach trainer&lt;/emph&gt; using the Social ABCs parent manual. Eight modules were explored, including the ABCs of Learning, Enhancing Communication, Sharing Positive Emotion, Motivation and Arousal, Play and The Social ABCs, Daily Care-giving Activities, Managing Behavioral Challenges, and Taking Care of Yourself.&lt;/p&gt; &lt;hd id=&quot;AN0193858194-12&quot;&gt;Procedure&lt;/hd&gt; &lt;p&gt;The study is a retrospective chart review, where child and caregiver clinical data were analyzed using a single-group, pre-post design. Research ethics board (REB) approval was obtained from the Children&#39;s Hospital of Eastern Ontario Research Institute REB (CHEOREB#24/116X).&lt;/p&gt; &lt;hd id=&quot;AN0193858194-13&quot;&gt;Group-Based Social ABCs&lt;/hd&gt; &lt;p&gt;The group-based Social ABCs was delivered in 6-week cycles, from October 2020 to October 2024. A total of 361 families completed the program over 4 years. Each week, caregivers participated in one group virtual didactic session (90 minutes in length), which covered content from one to two modules from the Social ABCs parent manual. The child-caregiver dyad also participated in one to two individualized coaching sessions per week that took place at home, at CHEO, or virtually depending on parent preference and/or geographical location. These individualized sessions were consistently scheduled between the weekly group didactic sessions to allow caregivers to apply newly introduced strategies in real time with their child and receive individualized feedback and support. This integration of group-based learning with ongoing one-to-one coaching was designed to promote knowledge acquisition, individualized application of principles, and fidelity of strategy implementation.&lt;/p&gt; &lt;p&gt;Parents received a total of nine individual coaching sessions (each 60 minutes in length), which focused on accurate use of the Social ABCs strategies using a positive coaching model. Individual coaching sessions tapered from two visits per week in Weeks 1 to 3 to one visit per week for the remainder of the program. If a family missed a group session, the coach reviewed the missed material during the next one-on-one session or scheduled a virtual appointment to cover it. One-on-one sessions were rescheduled within the timeframe of the group program as needed. A follow-up phone call was conducted with the caregiver at 2 weeks post the group session. Attendance was tracked as part of routine clinical documentation; for this analysis, only families who completed all required sessions and submitted video recordings for fidelity scoring were included.&lt;/p&gt; &lt;hd id=&quot;AN0193858194-14&quot;&gt;Data Collection&lt;/hd&gt; &lt;p&gt;Video-recorded data from all families participating in the group-based Social ABCs was collected per clinical protocols. Ten-minute, caregiver-child free play interactions were collected before starting the group-based Social ABCs (baseline) and following the program (post-intervention). Final videos were collected during Session 9, which was the last session for all families. Data on implementation fidelity and client flow among the Social ABCs coaches was also collected both during the training process and annually, as part of the ongoing quality-assurance process within the program.&lt;/p&gt; &lt;hd id=&quot;AN0193858194-15&quot;&gt;Video Coding&lt;/hd&gt; &lt;p&gt;In line with previous studies ([&lt;reflink idref=&quot;bib4&quot; id=&quot;ref28&quot;&gt;4&lt;/reflink&gt;]; [&lt;reflink idref=&quot;bib6&quot; id=&quot;ref29&quot;&gt;6&lt;/reflink&gt;], [&lt;reflink idref=&quot;bib3&quot; id=&quot;ref30&quot;&gt;3&lt;/reflink&gt;]), 10-minute, parent-child free play interactions were video coded at baseline and post intervention. Parents were instructed to play with their child as they typically play, and no coaching occurred during these sessions. Coding examined caregiver implementation fidelity, where the correct use of 10 antecedent and consequence strategies were scored during 1-minute intervals. In addition, child vocal responsivity was recorded continuously as the mean percent of vocal responses directed to the caregiver in response to caregiver-provided language opportunities. Video coding was conducted by trained staff, with inter-rater reliability (IRR) established in collaboration with the expert team. When &lt;emph&gt;on-site coach trainers&lt;/emph&gt; were supervised by the expert team, all videos were scored together (CHEO trainers with the expert team). IRR was initially established by independently scoring at least three videos and confirming ≥90% inter-observer agreement between CHEO trainers and expert raters. Once IRR was met, CHEO trainers continued to check IRR for approximately 30% of videos for each group.&lt;/p&gt; &lt;hd id=&quot;AN0193858194-16&quot;&gt;Parent Survey – Caregiver Satisfaction&lt;/hd&gt; &lt;p&gt;Following the 6-week group-based Social ABCs program, caregivers were invited to complete an eight-item survey to assess their satisfaction with various aspects of the program. Questions were rated on a 5-point Likert-type scale (i.e. 1: &quot;&lt;emph&gt;completely disagree/unsatisfied/uncomfortable&lt;/emph&gt;&quot; to 5: &quot;&lt;emph&gt;completely agree/satisfied/comfortable&lt;/emph&gt;&quot;). Questions pertained to the helpfulness of the program&#39;s didactic content; satisfaction with the program, support received from Social ABCs coaches, and incorporation into daily routines; comfort level related to implementing Social ABCs strategies at home and supporting other family members to use the strategies; improved understanding of child&#39;s motivation and emotion; and recommendation of the program to other families.&lt;/p&gt; &lt;hd id=&quot;AN0193858194-17&quot;&gt;Statistical Analyses&lt;/hd&gt; &lt;p&gt;All analyses were conducted using IBM-SPSS Statistics (Version 21). To examine differences in caregiver implementation fidelity across Social ABCs coach training pathways, a one-way ANOVA was conducted comparing coaches trained directly by the expert team, coaches trained by &lt;emph&gt;on-site coach trainers&lt;/emph&gt; with expert support, and coaches trained solely by &lt;emph&gt;on-site coach trainers&lt;/emph&gt;. Paired-samples &lt;emph&gt;t&lt;/emph&gt;-tests were used to assess pre- to post-intervention changes in caregiver implementation fidelity and child vocal responsivity. Pearson correlations were also performed to explore associations among key variables.&lt;/p&gt; &lt;hd id=&quot;AN0193858194-18&quot;&gt;Results&lt;/hd&gt; &lt;p&gt;&lt;/p&gt; &lt;hd id=&quot;AN0193858194-19&quot;&gt;Social ABCs Training, Implementation, and Capacity Building&lt;/hd&gt; &lt;p&gt;&lt;/p&gt; &lt;hd id=&quot;AN0193858194-20&quot;&gt;Social ABCs Coaches&lt;/hd&gt; &lt;p&gt;Eleven Social ABCs coaches were trained. This included two coaches trained by the expert team, six coaches trained by &lt;emph&gt;on-site coach trainers&lt;/emph&gt; with expert team support, and three coaches trained solely from the &lt;emph&gt;on-site coach trainers.&lt;/emph&gt; Social ABCs coaches completed an average of 89.09 hours (&lt;emph&gt;SD&lt;/emph&gt; = 43.27) of training, ranging from 35.00 to 165.00 hours. It was ensured that coaches achieved ≥80% fidelity in both implementation and coaching prior to being certified. Two Social ABCs coaches withdrew from the training due to leaving the CHEO department. Social ABCs coaches trained a total of 361 caregivers on the group-based Social ABCs.&lt;/p&gt; &lt;hd id=&quot;AN0193858194-21&quot;&gt;Training Pathways&lt;/hd&gt; &lt;p&gt;There were no significant differences in caregiver implementation fidelity across the three coach training pathways (&lt;emph&gt;F&lt;/emph&gt;(&lt;reflink idref=&quot;bib2&quot; id=&quot;ref31&quot;&gt;2&lt;/reflink&gt;,&lt;reflink idref=&quot;bib300&quot; id=&quot;ref32&quot;&gt;300&lt;/reflink&gt;) = 1.95, &lt;emph&gt;p =&lt;/emph&gt; 0.14). Mean caregiver implementation fidelity scores were comparable across expert-trained coaches (&lt;emph&gt;M&lt;/emph&gt; = 72.17%, &lt;emph&gt;SD&lt;/emph&gt; = 11.45), coaches trained by &lt;emph&gt;on-site coach trainers&lt;/emph&gt; with expert team support (&lt;emph&gt;M&lt;/emph&gt; = 68.34%, &lt;emph&gt;SD&lt;/emph&gt; = 13.17), and coaches trained solely by &lt;emph&gt;on-site coach trainers&lt;/emph&gt; (&lt;emph&gt;M&lt;/emph&gt; = 69.73%, &lt;emph&gt;SD&lt;/emph&gt; = 16.12). Similarly, with respect to child vocal responsivity, there were no significant differences across the three coach training pathways (&lt;emph&gt;F&lt;/emph&gt;(&lt;reflink idref=&quot;bib2&quot; id=&quot;ref33&quot;&gt;2&lt;/reflink&gt;,&lt;reflink idref=&quot;bib235&quot; id=&quot;ref34&quot;&gt;235&lt;/reflink&gt;) = 0.78, &lt;emph&gt;p =&lt;/emph&gt; 0.46). Mean child vocal responsivity scores were comparable across expert-trained coaches (&lt;emph&gt;M&lt;/emph&gt; = 46.02%, &lt;emph&gt;SD&lt;/emph&gt; = 0.28), coaches trained by &lt;emph&gt;on-site coach trainers&lt;/emph&gt; with expert team support (&lt;emph&gt;M&lt;/emph&gt; = 59.72%, &lt;emph&gt;SD&lt;/emph&gt; = 1.48), and coaches trained solely by &lt;emph&gt;on-site coach trainers&lt;/emph&gt; (&lt;emph&gt;M&lt;/emph&gt; = 65.83%, &lt;emph&gt;SD&lt;/emph&gt; = 1.47).&lt;/p&gt; &lt;hd id=&quot;AN0193858194-22&quot;&gt;Clinician Capacity and Service Flow&lt;/hd&gt; &lt;p&gt;To understand the sustainability of the group-based Social ABCs across varying coach training pathways, we examined clinician capacity and service flow at CHEO. Specifically, the number of Social ABCs coaches trained and the number of families served by the program were documented from October 2020 to October 2024. Implementation of the training pathways significantly increased service capacity, increasing the average number of children seen by approximately 86.05% over the period of 2 years.&lt;/p&gt; &lt;hd id=&quot;AN0193858194-23&quot;&gt;Treatment Effects&lt;/hd&gt; &lt;p&gt;&lt;/p&gt; &lt;hd id=&quot;AN0193858194-24&quot;&gt;Caregiver Implementation Fidelity&lt;/hd&gt; &lt;p&gt;There was a significant increase in caregiver implementation fidelity from baseline to post-intervention (&lt;emph&gt;M&lt;/emph&gt; = 33.56%, &lt;emph&gt;SD&lt;/emph&gt; = 12.40 vs &lt;emph&gt;M&lt;/emph&gt; = 70.01%, &lt;emph&gt;SD&lt;/emph&gt; = 11.82; &lt;emph&gt;t&lt;/emph&gt;(&lt;reflink idref=&quot;bib226&quot; id=&quot;ref35&quot;&gt;226&lt;/reflink&gt;) = -31.51, &lt;emph&gt;p&lt;/emph&gt; ≤ 0.001). When stratified by language program delivery, caregiver fidelity also increased from baseline to post-intervention in both English (&lt;emph&gt;M&lt;/emph&gt; = 34.25%, &lt;emph&gt;SD&lt;/emph&gt; = 12.02 vs &lt;emph&gt;M&lt;/emph&gt; = 70.30%, &lt;emph&gt;SD&lt;/emph&gt; = 11.83; &lt;emph&gt;t&lt;/emph&gt;(&lt;reflink idref=&quot;bib210&quot; id=&quot;ref36&quot;&gt;210&lt;/reflink&gt;) = -30.46, &lt;emph&gt;p ≤&lt;/emph&gt; 0.001) and French program delivery groups (&lt;emph&gt;M&lt;/emph&gt; = 28.12%, &lt;emph&gt;SD&lt;/emph&gt; = 12.94 vs &lt;emph&gt;M&lt;/emph&gt; = 67.84%, &lt;emph&gt;SD&lt;/emph&gt; = 10.97; &lt;emph&gt;t&lt;/emph&gt;(&lt;reflink idref=&quot;bib18&quot; id=&quot;ref37&quot;&gt;18&lt;/reflink&gt;) = -10.12, &lt;emph&gt;p ≤&lt;/emph&gt; 0001). Moreover, there were no significant differences in caregiver fidelity between English and French groups (&lt;emph&gt;F&lt;/emph&gt;(&lt;reflink idref=&quot;bib1&quot; id=&quot;ref38&quot;&gt;1&lt;/reflink&gt;,&lt;reflink idref=&quot;bib228&quot; id=&quot;ref39&quot;&gt;228&lt;/reflink&gt;) = 0.80, &lt;emph&gt;p =&lt;/emph&gt; 0.37) – indicating feasibility of program delivery among linguistically diverse communities. Caregiver implementation fidelity outcomes are summarized in Table 2.&lt;/p&gt; &lt;p&gt;Table 2. Summary of Caregiver Fidelity and Child Vocal Responsivity Outcomes.&lt;/p&gt; &lt;p&gt;Graph&lt;/p&gt; &lt;p&gt; &lt;ephtml&gt; &amp;lt;table&amp;gt;&amp;lt;colgroup&amp;gt;&amp;lt;col align=&quot;left&quot; /&amp;gt;&amp;lt;col align=&quot;char&quot; char=&quot;.&quot; /&amp;gt;&amp;lt;col align=&quot;char&quot; char=&quot;.&quot; /&amp;gt;&amp;lt;col align=&quot;char&quot; char=&quot;.&quot; /&amp;gt;&amp;lt;col align=&quot;char&quot; char=&quot;.&quot; /&amp;gt;&amp;lt;col align=&quot;char&quot; char=&quot;.&quot; /&amp;gt;&amp;lt;/colgroup&amp;gt;&amp;lt;thead&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;th align=&quot;left&quot;&amp;gt;Outcome&amp;lt;/th&amp;gt;&amp;lt;th align=&quot;left&quot;&amp;gt;Group&amp;lt;/th&amp;gt;&amp;lt;th align=&quot;left&quot;&amp;gt;Baseline, &amp;lt;italic&amp;gt;M&amp;lt;/italic&amp;gt; (&amp;lt;italic&amp;gt;SD&amp;lt;/italic&amp;gt;)&amp;lt;/th&amp;gt;&amp;lt;th align=&quot;left&quot;&amp;gt;Post-intervention, &amp;lt;italic&amp;gt;M&amp;lt;/italic&amp;gt; (&amp;lt;italic&amp;gt;SD&amp;lt;/italic&amp;gt;)&amp;lt;/th&amp;gt;&amp;lt;th align=&quot;left&quot;&amp;gt;Test statistic&amp;lt;/th&amp;gt;&amp;lt;th align=&quot;left&quot;&amp;gt;&amp;lt;italic&amp;gt;p&amp;lt;/italic&amp;gt;-value&amp;lt;/th&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;/thead&amp;gt;&amp;lt;tbody&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td rowspan=&quot;3&quot;&amp;gt;Caregiver Implementation Fidelity (%)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Overall&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;33.56 (12.40)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;70.01 (11.82)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;lt;italic&amp;gt;t&amp;lt;/italic&amp;gt;(226) = -31.51&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8804;0.001&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;English&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;34.25 (12.02)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;70.30 (11.83)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;lt;italic&amp;gt;t&amp;lt;/italic&amp;gt;(210) = -30.46&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8804;0.001&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;French&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;28.12 (12.94)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;67.84 (10.97)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;lt;italic&amp;gt;t&amp;lt;/italic&amp;gt;(18) = -10.12&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8804;0.001&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td rowspan=&quot;3&quot;&amp;gt;Child Vocal Responsivity (%)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Overall&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;5.73 (16.04)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;43.19 (24.87)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;lt;italic&amp;gt;t&amp;lt;/italic&amp;gt;(227) = -21.20&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8804;0.001&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;English&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;5.73 (16.25)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;42.47 (23.88)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;lt;italic&amp;gt;t&amp;lt;/italic&amp;gt;(208) = -20.72&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8804;0.001&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;French&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;5.68 (13.86)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;51.12 (33.74)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;lt;italic&amp;gt;t&amp;lt;/italic&amp;gt;(18) = -5.46&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8804;0.001&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;/tbody&amp;gt;&amp;lt;/table&amp;gt; &lt;/ephtml&gt; &lt;/p&gt; &lt;hd id=&quot;AN0193858194-25&quot;&gt;Child Vocal Responsivity&lt;/hd&gt; &lt;p&gt;There were significant increases in child vocal responsivity from baseline to post-intervention (&lt;emph&gt;M&lt;/emph&gt; = 5.73%, &lt;emph&gt;SD&lt;/emph&gt; = 16.04 vs &lt;emph&gt;M&lt;/emph&gt; = 43.19%, &lt;emph&gt;SD&lt;/emph&gt; = 24.87; &lt;emph&gt;t&lt;/emph&gt;(&lt;reflink idref=&quot;bib227&quot; id=&quot;ref40&quot;&gt;227&lt;/reflink&gt;) = -21.20, &lt;emph&gt;p&lt;/emph&gt; ≤ 0.001). When stratified by language program delivery, child vocal responsivity increased from baseline to post-intervention in both the English (&lt;emph&gt;M&lt;/emph&gt; = 5.73%, &lt;emph&gt;SD&lt;/emph&gt; = 16.25 vs &lt;emph&gt;M&lt;/emph&gt; = 42.47%, &lt;emph&gt;SD&lt;/emph&gt; = 23.88; &lt;emph&gt;t&lt;/emph&gt;(&lt;reflink idref=&quot;bib208&quot; id=&quot;ref41&quot;&gt;208&lt;/reflink&gt;) = -20.72, &lt;emph&gt;p&lt;/emph&gt; ≤ 0.001) and French program delivery groups (&lt;emph&gt;M&lt;/emph&gt; = 5.68%, &lt;emph&gt;SD&lt;/emph&gt; = 13.86 vs &lt;emph&gt;M&lt;/emph&gt; = 51.12%, &lt;emph&gt;SD&lt;/emph&gt; = 33.74; &lt;emph&gt;t&lt;/emph&gt;(&lt;reflink idref=&quot;bib18&quot; id=&quot;ref42&quot;&gt;18&lt;/reflink&gt;) = -5.46, &lt;emph&gt;p&lt;/emph&gt; ≤ 0.001). Furthermore, there were no significant differences in child vocal responsivity between linguistic groups (&lt;emph&gt;F&lt;/emph&gt;(&lt;reflink idref=&quot;bib1&quot; id=&quot;ref43&quot;&gt;1&lt;/reflink&gt;,&lt;reflink idref=&quot;bib226&quot; id=&quot;ref44&quot;&gt;226&lt;/reflink&gt;) = 1.85, &lt;emph&gt;p =&lt;/emph&gt; 0.18). Child vocal responsivity outcomes are summarized in Table 2.&lt;/p&gt; &lt;hd id=&quot;AN0193858194-26&quot;&gt;Relationship Between Caregiver Implementation Fidelity and Child Vocal Responsivity&lt;/hd&gt; &lt;p&gt;At baseline, Pearson correlation revealed no significant associations between caregiver implementation fidelity and child vocal responsivity (&lt;emph&gt;r&lt;/emph&gt; = 0.107, &lt;emph&gt;p =&lt;/emph&gt; 0.109). Interestingly, there was a significant positive association between caregiver implementation fidelity and child vocal responsivity post-intervention (&lt;emph&gt;r&lt;/emph&gt; = 0.252, &lt;emph&gt;p&lt;/emph&gt; ≤ 0.001), suggesting higher caregiver implementation fidelity was correlated with greater child vocal responsivity following the group-based Social ABCs intervention.&lt;/p&gt; &lt;hd id=&quot;AN0193858194-27&quot;&gt;Caregiver Satisfaction&lt;/hd&gt; &lt;p&gt;Among English- and French-speaking families, caregiver satisfaction with participating in the group-based Social ABCs was high (Table 3). Among English-speaking respondents (&lt;emph&gt;n&lt;/emph&gt; = 211), caregivers reported being completely satisfied with support from their coach (90.9%); felt completely or mostly comfortable implementing Social ABCs strategies at home (97.8%); were mostly comfortable with supporting other family members at home to use the strategies (85.3%); and felt the strategies fit into their daily routine (92.9%). Moreover, caregivers noted that the program also enhanced their understanding of their child&#39;s motivation (96.2%) and increased positive emotion sharing (92.9%).&lt;/p&gt; &lt;p&gt;Table 3. Caregiver Satisfaction With Group-Based Social ABCs.&lt;/p&gt; &lt;p&gt;Graph&lt;/p&gt; &lt;p&gt; &lt;ephtml&gt; &amp;lt;table&amp;gt;&amp;lt;colgroup&amp;gt;&amp;lt;col align=&quot;left&quot; /&amp;gt;&amp;lt;col align=&quot;char&quot; char=&quot;.&quot; /&amp;gt;&amp;lt;col align=&quot;char&quot; char=&quot;.&quot; /&amp;gt;&amp;lt;/colgroup&amp;gt;&amp;lt;thead&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;th align=&quot;left&quot;&amp;gt;Satisfaction item&amp;lt;/th&amp;gt;&amp;lt;th align=&quot;left&quot;&amp;gt;English-speaking (&amp;lt;italic&amp;gt;n&amp;lt;/italic&amp;gt; = 211)&amp;lt;/th&amp;gt;&amp;lt;th align=&quot;left&quot;&amp;gt;French-speaking (&amp;lt;italic&amp;gt;n&amp;lt;/italic&amp;gt; = 22)&amp;lt;/th&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;/thead&amp;gt;&amp;lt;tbody&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Completely satisfied with coach support&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;90.9%&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;95.4%&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Comfortable implementing strategies at home&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;97.8%&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;100%&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Comfortable supporting other family members&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;85.3%&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;90.0%&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Strategies fit into daily routine&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;92.9%&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;95.4%&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Enhanced understanding of child&#39;s motivation&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;96.2%&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;100%&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Increased positive emotion sharing&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;92.9%&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8212;&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;/tbody&amp;gt;&amp;lt;/table&amp;gt; &lt;/ephtml&gt; &lt;/p&gt; &lt;p&gt;1 French-speaking caregivers did not report on positive emotion sharing separately.&lt;/p&gt; &lt;p&gt;Similarly, among French-speaking respondents (&lt;emph&gt;n&lt;/emph&gt; = 22), caregivers reported being completely or very satisfied with support from their coach (95.4%); felt comfortable implementing the Social ABCs strategies at home (100%); were completely comfortable with supporting other family members at home to use the strategies (90.0%); and felt the strategies fit into their daily routine (95.4%). Caregivers also noted that the program enhanced their understanding of their child&#39;s motivation (100%).&lt;/p&gt; &lt;hd id=&quot;AN0193858194-28&quot;&gt;Discussion&lt;/hd&gt; &lt;p&gt;The present study explored the implementation of the group-based Social ABCs, delivered through multiple coach training pathways and French-language service delivery. With implications for program sustainability, findings revealed that (&lt;reflink idref=&quot;bib1&quot; id=&quot;ref45&quot;&gt;1&lt;/reflink&gt;) caregiver implementation fidelity and child vocal responsivity appeared consistent across Social ABCs coach training pathways – whether coaches were trained directly by the expert team, with expert support, or solely by &lt;emph&gt;on-site coach trainers&lt;/emph&gt;; (&lt;reflink idref=&quot;bib2&quot; id=&quot;ref46&quot;&gt;2&lt;/reflink&gt;) increases in caregiver implementation fidelity, child vocal responsivity, and caregiver satisfaction emerged post intervention; and (&lt;reflink idref=&quot;bib3&quot; id=&quot;ref47&quot;&gt;3&lt;/reflink&gt;) French service delivery of the intervention showed early signs of improved accessibility of the program across linguistically diverse communities.&lt;/p&gt; &lt;p&gt;The group-based Social ABCs was adapted to include three distinct training pathways to support the development and sustainability of the program at CHEO. These pathways facilitated the training of 11 new Social ABCs coaches, who subsequently trained caregivers. Early indications suggest that implementing this model was feasible in at least three ways, each with implications for long-term sustainability. First, the training pathways appeared to provide Social ABCs coaches with context-specific instruction aligned with CHEO&#39;s clinical care and organizational structure. This tailored approach aimed to address implementation barriers, including the need to generalize training content to CHEO&#39;s unique client demographics (e.g. French-speaking communities). Second, caregiver implementation fidelity and child vocal responsivity appeared consistent across coach training pathways – whether coaches were trained directly by the expert team, with expert support, or solely through site-led pathways – suggesting the viability of site-led approaches for scaling program delivery. These preliminary findings suggest that caregiver fidelity outcomes were similar regardless of the coach training model, pointing to the potential for sustainable, locally driven program expansion. Third, the structure of the training pathways facilitated access to mentorship and quality assurance, helping coaches maintain alignment with the guidelines, values, and practices of the group-based Social ABCs program. This ongoing support mechanism for quality assurance may play an important role in sustaining implementation quality at CHEO. In addition, caregiver and child outcomes were consistent with previous findings from the original and group-based Social ABCs models ([&lt;reflink idref=&quot;bib4&quot; id=&quot;ref48&quot;&gt;4&lt;/reflink&gt;]; [&lt;reflink idref=&quot;bib6&quot; id=&quot;ref49&quot;&gt;6&lt;/reflink&gt;], [&lt;reflink idref=&quot;bib3&quot; id=&quot;ref50&quot;&gt;3&lt;/reflink&gt;]). That is, gains emerged in caregiver implementation fidelity, caregiver satisfaction, and child vocal responsivity across both English- and French-speaking families – suggesting that the adapted program shows promise as a delivery model. As the group-based Social ABCs continues to expand at CHEO and more clinical outcome evaluations become available, trends in sustainability will become clearer.&lt;/p&gt; &lt;p&gt;To our knowledge, this is the first study to report preliminary data on French service delivery of the group-based Social ABCs. Given that CHEO is located in Ottawa, Ontario, Canada – a bilingual community – there is a significant French-speaking population that could benefit from the group-based Social ABCs. Often, families withdraw from clinical interventions when programs are not adaptable to the family&#39;s language of choice; thereby dissuading meaningful engagement. In fact, there are few structured parent-training programs available to French-speaking families with an autistic child ([&lt;reflink idref=&quot;bib10&quot; id=&quot;ref51&quot;&gt;10&lt;/reflink&gt;]). As such, French program delivery of the group-based Social ABCs offered a unique opportunity to explore this clinical need, as well as optimize participation and accessibility of the program to French-speaking communities. Despite a relatively small number of participating French families, preliminary findings revealed no differences in caregiver implementation fidelity or child vocal responsivity between English and French program delivery groups. In fact, French caregivers reported high satisfaction with the implementation and integration of strategies within their daily lives, as well as the impact on their confidence and understanding when interacting with their child. These early indications point to the potential adaptability of the program across linguistically diverse communities, in line with previous work in other cultural contexts ([&lt;reflink idref=&quot;bib3&quot; id=&quot;ref52&quot;&gt;3&lt;/reflink&gt;]).&lt;/p&gt; &lt;p&gt;Consistent with previous work demonstrating the adaptability of the Social ABCs across international and cultural contexts ([&lt;reflink idref=&quot;bib3&quot; id=&quot;ref53&quot;&gt;3&lt;/reflink&gt;]), our adaptation prioritized preservation of core intervention components while ensuring linguistic and contextual relevance. The French-language implementation did not alter the program&#39;s core components or fidelity benchmarks; rather, adaptation involved systematic translation and culturally responsive delivery within a bilingual service context. The positive coaching framework allowed clinicians to individualize examples, routines, and feedback to align with families&#39; cultural practices while maintaining fidelity to intervention principles. Although no significant differences emerged between English- and French-language groups, these findings should be interpreted as preliminary evidence of feasibility and acceptability within a bilingual hospital setting rather than definitive evidence of cross-cultural equivalence. Future prospective and multisite studies with larger francophone samples are needed to more rigorously evaluate linguistic equity and implementation outcomes.&lt;/p&gt; &lt;p&gt;Finally, with the inclusion of multiple coach training pathways, the adapted program appeared to enhance clinicians&#39; capacity to deliver the group-based Social ABCs. Notably, 11 Social ABCs coaches were trained, increasing the average number of children seen by approximately 86.05% over the period of 2 years. That is, this approach not only increased workforce capacity but also improved service reach among autistic children or with suspected autism – thereby preventing delays in accessing support. This approach has implications for the sustainability of the program, not only in reducing workforce burden among clinicians (i.e. reducing burnout and ensuring clinician capacity, competency and commitment to providing exceptional service; [&lt;reflink idref=&quot;bib13&quot; id=&quot;ref54&quot;&gt;13&lt;/reflink&gt;]) but also in fostering sustainment among the CHEO team with minimal input from the expert team.&lt;/p&gt; &lt;hd id=&quot;AN0193858194-29&quot;&gt;Strengths and Limitations&lt;/hd&gt; &lt;p&gt;Our findings suggested that an adapted version of the group-based Social ABCs, delivered through multiple coach training pathways and offered in both English and French, may be feasible for implementation within a large pediatric hospital that serves more than 5500 autistic children annually. Strengths of our study include recruitment of a moderately sized and linguistically diverse community sample and assessment of caregivers&#39; experiences participating in the adapted program.&lt;/p&gt; &lt;p&gt;Despite these strengths, several limitations should be noted. First, the absence of a control group limits our ability to directly assess the impact of the adapted intervention program, as well as the lack of direct clinical assessment. In particular, given the single-group pre-post design and the young age of participants, improvements in child vocal responsivity cannot be disentangled from expected developmental maturation over the 6-week intervention period. Without a comparison or control condition, it is not possible to determine the extent to which observed changes reflect intervention-related effects versus normative developmental trajectories. As such, child outcome findings should be interpreted as preliminary indicators observed within routine clinical practice rather than causal evidence of effectiveness. Future prospective studies employing controlled or longitudinal designs will be necessary to more rigorously evaluate child-level outcomes associated with the adapted group-based model.&lt;/p&gt; &lt;p&gt;We acknowledge that we did not have detailed information regarding the specific Social ABCs strategies used by caregivers but rather employed an overall caregiver implementation fidelity score. Measures of satisfaction, accessibility, and sustainability were also limited and lack established psychometric properties. In addition, sociodemographic characteristics such as race/ethnicity, socioeconomic indicators, and home language use were not systematically collected as part of routine clinical care and were therefore unavailable for analysis. This limits our ability to examine potential disparities or contextual factors influencing program implementation and outcomes. Future research should incorporate these variables to strengthen the generalizability and equity considerations of findings.&lt;/p&gt; &lt;p&gt;Although the study included both English- and French-speaking families, the French-speaking subgroup represented a relatively small proportion of the overall sample. This limits statistical power to detect language-related differences and constrains the strength of inferences regarding the broader implications of linguistic adaptation. As such, findings related to French-language delivery should be interpreted as preliminary indicators of feasibility and acceptability within routine clinical practice. Nonetheless, demonstrating that the group-based Social ABCs can be delivered in French with high caregiver implementation fidelity and satisfaction represents an important initial step toward improving linguistic accessibility in early autism intervention. Future studies with larger and purposively recruited francophone samples, or multi-site designs across bilingual and francophone service settings, will be necessary to more rigorously evaluate linguistic equity and implementation outcomes.&lt;/p&gt; &lt;p&gt;Within the context of implementation research, retrospective chart reviews can inform preliminary assessments of effectiveness by capturing how interventions perform in real-world clinical practice. However, the lack of prospective data collection and standardized reporting limits the precision of these estimates and highlights the need for future complementary prospective or mixed-methods evaluations.&lt;/p&gt; &lt;hd id=&quot;AN0193858194-30&quot;&gt;Conclusion&lt;/hd&gt; &lt;p&gt;The present study examined the implementation of an adapted version of the group-based Social ABCs for toddlers with confirmed or suspected autism, using a multipathway coach training model and French service delivery of the intervention. Initial findings highlight the importance of flexible and scalable early intervention models to improve accessibility and equity in autism services. By systematically studying this novel delivery approach, we can determine its scalability, potential to reduce wait times, and ability to maintain the benefits of the standard model while fostering a supportive community for parents. Future research will provide critical data to inform best practices in early interventions for autism, ultimately guiding public policy to improve accessibility and outcomes for families.&lt;/p&gt; &lt;p&gt;We would like to express our sincere appreciation to all the members of the Social ABCs expert team for their dedication, commitment, and contributions to the program, which supported the success of this study.&lt;/p&gt; &lt;ref id=&quot;AN0193858194-31&quot;&gt; &lt;title&gt; References &lt;/title&gt; &lt;blist&gt; &lt;bibl id=&quot;bib1&quot; idref=&quot;ref1&quot; type=&quot;bt&quot;&gt;1&lt;/bibl&gt; &lt;bibtext&gt; American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibl id=&quot;bib2&quot; idref=&quot;ref4&quot; type=&quot;bt&quot;&gt;2&lt;/bibl&gt; &lt;bibtext&gt; Boyd B. A., Baranek G. T., Sideris J., Poe M. D., Watson L. R., Patten E., Miller H. (2010). 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Autism in Adulthood, 1(1), 27–36. https://doi.org/10.1089/aut.2018.0004&lt;/bibtext&gt; &lt;/blist&gt; &lt;/ref&gt; &lt;ref id=&quot;AN0193858194-32&quot;&gt; &lt;title&gt; Footnotes &lt;/title&gt; &lt;blist&gt; &lt;bibtext&gt; Renee Baysarowich&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt;Graph&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt;https://orcid.org/0009-0007-1100-7004 Jessica Remedios&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt;Graph&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt;https://orcid.org/0009-0004-6121-1984 Nicholas Denomey&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt;Graph&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt;https://orcid.org/0009-0002-1295-2351 Taylor Johansen&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt;Graph&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt;https://orcid.org/0009-0004-5843-0377 Sarah Raza&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt;Graph https://orcid.org/0000-0002-3666-8585&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Renee Baysarowich: Conceptualization; Data curation; Formal analysis; Investigation; Methodology; Project administration; Supervision; Validation; Visualization; Writing – original draft; Writing – review &amp;amp; editing.Jessica Remedios: Conceptualization; Investigation; Methodology; Writing – original draft; Writing – review &amp;amp; editing.Kelly King: Data curation; Methodology; Writing – original draft; Writing – review &amp;amp; editing.Martine Brunet: Data curation; Methodology; Writing – original draft; Writing – review &amp;amp; editing.Nicholas Denomey: Data curation; Project administration; Writing – original draft; Writing – review &amp;amp; editing.Justyna Litwinska: Methodology; Resources; Supervision; Writing – review &amp;amp; editing.Taylor Johansen: Conceptualization; Methodology; Resources; Writing – review &amp;amp; editing.Sarah Raza: Data curation; Formal analysis; Investigation; Methodology; Writing – original draft; Writing – review &amp;amp; editing.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; The authors received no financial support for the research, authorship, and/or publication of this article.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; The data that support the findings of this study may be available from the authors, but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are however available from the authors upon reasonable request and with permission of the CHEO RI Research Ethics Board.&lt;/bibtext&gt; &lt;/blist&gt; &lt;/ref&gt; &lt;aug&gt; &lt;p&gt;By Renee Baysarowich; Jessica Remedios; Kelly King; Martine Brunet; Nicholas Denomey; Justyna Litwinska; Taylor Johansen and Sarah Raza&lt;/p&gt; &lt;p&gt;Reported by Author; Author; Author; Author; Author; Author; Author; Author&lt;/p&gt; &lt;/aug&gt; &lt;nolink nlid=&quot;nl1&quot; bibid=&quot;bib12&quot; firstref=&quot;ref2&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl2&quot; bibid=&quot;bib15&quot; firstref=&quot;ref3&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl3&quot; bibid=&quot;bib14&quot; firstref=&quot;ref6&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl4&quot; bibid=&quot;bib16&quot; firstref=&quot;ref7&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl5&quot; bibid=&quot;bib17&quot; firstref=&quot;ref8&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl6&quot; bibid=&quot;bib18&quot; firstref=&quot;ref9&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl7&quot; bibid=&quot;bib11&quot; firstref=&quot;ref11&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl8&quot; bibid=&quot;bib10&quot; firstref=&quot;ref27&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl9&quot; bibid=&quot;bib300&quot; firstref=&quot;ref32&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl10&quot; bibid=&quot;bib235&quot; firstref=&quot;ref34&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl11&quot; bibid=&quot;bib226&quot; firstref=&quot;ref35&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl12&quot; bibid=&quot;bib210&quot; firstref=&quot;ref36&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl13&quot; bibid=&quot;bib228&quot; firstref=&quot;ref39&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl14&quot; bibid=&quot;bib227&quot; firstref=&quot;ref40&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl15&quot; bibid=&quot;bib208&quot; firstref=&quot;ref41&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl16&quot; bibid=&quot;bib13&quot; firstref=&quot;ref54&quot;&gt;&lt;/nolink&gt;
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  Data: Expanding Training Capacity for the Group-Based Social ABCs Program: Evaluation of Coaching Models and French-Language Implementation in a Pediatric Hospital
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Renee+Baysarowich%22&quot;&gt;Renee Baysarowich&lt;/searchLink&gt; (ORCID &lt;externalLink term=&quot;https://orcid.org/0009-0007-1100-7004&quot;&gt;0009-0007-1100-7004&lt;/externalLink&gt;)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Jessica+Remedios%22&quot;&gt;Jessica Remedios&lt;/searchLink&gt; (ORCID &lt;externalLink term=&quot;https://orcid.org/0009-0004-6121-1984&quot;&gt;0009-0004-6121-1984&lt;/externalLink&gt;)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Kelly+King%22&quot;&gt;Kelly King&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Martine+Brunet%22&quot;&gt;Martine Brunet&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Nicholas+Denomey%22&quot;&gt;Nicholas Denomey&lt;/searchLink&gt; (ORCID &lt;externalLink term=&quot;https://orcid.org/0009-0002-1295-2351&quot;&gt;0009-0002-1295-2351&lt;/externalLink&gt;)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Justyna+Litwinska%22&quot;&gt;Justyna Litwinska&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Taylor+Johansen%22&quot;&gt;Taylor Johansen&lt;/searchLink&gt; (ORCID &lt;externalLink term=&quot;https://orcid.org/0009-0004-5843-0377&quot;&gt;0009-0004-5843-0377&lt;/externalLink&gt;)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Sarah+Raza%22&quot;&gt;Sarah Raza&lt;/searchLink&gt; (ORCID &lt;externalLink term=&quot;https://orcid.org/0000-0002-3666-8585&quot;&gt;0000-0002-3666-8585&lt;/externalLink&gt;)
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  Label: Abstract
  Group: Ab
  Data: Autism is the fastest growing neurodevelopmental condition in Canada. Caregiver-mediated interventions, such as the Social ABCs, improve early social communication and caregiver empowerment. To enhance accessibility, Social ABCs was adapted into a condensed, group-based model. This study evaluated its implementation and sustainability at a large pediatric hospital, examining child and caregiver outcomes across multiple coach training pathways and French-language delivery. A retrospective chart review included 361 families (children 12-42 months with suspected or confirmed autism) who completed six weekly group sessions and nine individual caregiver coaching sessions between 2020 and 2024. Coaches were trained via expert-led, hybrid, or site-led pathways. Caregiver implementation fidelity improved from 33.6% to 70.0% (p &lt; 0.001), with similar gains in English and French. Child vocal responsivity increased from 5.7% to 43.2% (p &lt; 0.001), and post-intervention caregiver fidelity correlated with child responsivity (r = 0.25, p &lt; 0.001). Fidelity and responsivity outcomes did not differ by training pathway, supporting site-led training. Multiple pathways expanded clinician capacity, increasing children served by ~86% within 2 years. These findings suggest that group-based Social ABCs may improve caregiver and child outcomes, increase service capacity, and enhance accessibility for French‑speaking families, supporting feasibility of multi‑pathway training models for scaling early autism interventions.
– Name: AbstractInfo
  Label: Abstractor
  Group: Ab
  Data: As Provided
– Name: DateEntry
  Label: Entry Date
  Group: Date
  Data: 2026
– Name: AN
  Label: Accession Number
  Group: ID
  Data: EJ1506556
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=eric&AN=EJ1506556
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1177/13623613261434573
    Languages:
      – Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 10
        StartPage: 1478
    Subjects:
      – SubjectFull: Foreign Countries
        Type: general
      – SubjectFull: French
        Type: general
      – SubjectFull: Autism Spectrum Disorders
        Type: general
      – SubjectFull: Intervention
        Type: general
      – SubjectFull: Toddlers
        Type: general
      – SubjectFull: Coaching (Performance)
        Type: general
      – SubjectFull: Group Instruction
        Type: general
      – SubjectFull: Program Implementation
        Type: general
      – SubjectFull: Fidelity
        Type: general
      – SubjectFull: Caregiver Training
        Type: general
      – SubjectFull: Child Caregivers
        Type: general
      – SubjectFull: English
        Type: general
      – SubjectFull: Satisfaction
        Type: general
      – SubjectFull: Hospitals
        Type: general
      – SubjectFull: Interpersonal Communication
        Type: general
      – SubjectFull: Canada
        Type: general
    Titles:
      – TitleFull: Expanding Training Capacity for the Group-Based Social ABCs Program: Evaluation of Coaching Models and French-Language Implementation in a Pediatric Hospital
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Renee Baysarowich
      – PersonEntity:
          Name:
            NameFull: Jessica Remedios
      – PersonEntity:
          Name:
            NameFull: Kelly King
      – PersonEntity:
          Name:
            NameFull: Martine Brunet
      – PersonEntity:
          Name:
            NameFull: Nicholas Denomey
      – PersonEntity:
          Name:
            NameFull: Justyna Litwinska
      – PersonEntity:
          Name:
            NameFull: Taylor Johansen
      – PersonEntity:
          Name:
            NameFull: Sarah Raza
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 06
              Type: published
              Y: 2026
          Identifiers:
            – Type: issn-print
              Value: 1362-3613
            – Type: issn-electronic
              Value: 1461-7005
          Numbering:
            – Type: volume
              Value: 30
            – Type: issue
              Value: 6
          Titles:
            – TitleFull: Autism: The International Journal of Research and Practice
              Type: main
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