About

Melanie Pellecchia, PhD, is an Associate Professor of Psychiatry at the Hospital of the University of Pennsylvania. She is also a Consulting Psychologist at the Penn Medicine Autism Clinic within the Department of Psychiatry at the University of Pennsylvania. Her educational background includes a B.S. in Psychology from St. Joseph's University (2000), an M.S.Ed in Applied Behavior Analysis from Temple University (2006), and a Ph.D. in School Psychology from Temple University (2013). Her research focuses on autism and early intervention, with key contributions to caregiver coaching strategies, implementation of evidence-based teaching approaches for autistic students, and understanding family and clinician factors influencing engagement in autism interventions.

Research topics

• Psychology
• Medicine
• Clinical psychology
• Computer Science
• Applied psychology
• Psychiatry
• Developmental psychology
• Business
• Nursing
• Marketing

Selected publications

• Evaluating Social Communication Outcomes in Young Children Following Caregiver-Mediated Early Intervention

  ScholarlyCommons (University of Pennsylvania) · 2025-09-05

  otherOpen accessSenior author

  During the 10-week PURM research experience, I worked on Project PEACE for ImPACT, a community-partnered study within Philadelphia’s early intervention system that supports young children with autism spectrum disorder (ASD). My work involved behavioral coding of parent coaching sessions, observation of provider consultations, and participation in small-group interventions for children ages 3–5. I also engaged in weekly journal clubs on autism intervention and implementation science and assisted in dissemination efforts. A primary focus of my project was assessing child outcomes, with an emphasis on social communication. Using the Project AIM framework (Sandbank et al., 2019), I applied a structured approach to categorizing child outcomes within the PEACE for ImPACT dataset. Specifically, I analyzed Social Communication Checklist (SCC) data from the study’s first and second cohorts across four domains: social engagement, expressive language, receptive language, and imitation & play. Using paired-sample t-tests, I compared baseline scores to week 24 scores, which revealed statistically significant improvements across all domains and the total SCC score (p < .05). These findings suggest that the intervention was associated with meaningful gains in social communication skills. This work contributes to the broader effort to evaluate and enhance early intervention strategies for children with ASD in community-based contexts.

  Publisher

• Short report: Associations of family characteristics and clinicians’ use of caregiver coaching in early intervention

  Autism · 2025-02-11 · 1 citations

  articleOpen accessSenior authorCorresponding

  There is a great demand for quality early intervention services for autistic children and their families. Caregiver-mediated interventions are critical components of evidence-based early intervention. However, their implementation in publicly funded systems is often done with poor fidelity. Qualitative evidence suggests that family characteristics impact clinicians’ use of caregiver-mediated intervention coaching strategies. We estimated associations between family characteristics and clinicians’ use of a caregiver-mediated intervention in a publicly funded early intervention system, leveraging data from a pilot randomized trial. Data were collected from 12 clinicians and 34 families. We used multiple linear regression models to estimate associations. The association between household income and clinicians’ overall coaching fidelity demonstrated a quadratic trend ( b = −10.4, standard error = 4.1, p &lt; 0.05) with low fidelity for low- and high-income families relative to middle-income families. Use of in vivo feedback, one component of coaching, was similarly associated with income ( b = −0.5, standard error = 0.2, p &lt; 0.05). Clinicians’ coaching fidelity was lower among families in exclusively English-speaking homes than for families who speak other languages ( b = 18.4, standard error = 8.8, p &lt; 0.05). Results suggest that associations between family characteristics and clinician behavior may be more nuanced than previously understood. Lay abstract There is a high demand for quality early intervention services for autistic children and their families. A key part of effective early intervention is teaching caregivers how to support their child’s development through caregiver-mediated interventions. However, in publicly funded programs, these strategies are often not followed correctly. Some studies suggest that family characteristics may influence how well clinicians apply these coaching methods. In this study, we explored the connection between family factors, like household income and language spoken at home, and the way clinicians coached families. We found that clinicians used coaching strategies less consistently with both lower- and higher-income families compared to middle-income ones. In addition, families that spoke only English at home received less consistent coaching than those who spoke other languages. These findings highlight the complex relationship between family background and how early intervention services are delivered, suggesting a need for further research.

  PublisherDOI

• Implementing an Evidence-Informed Teaching Approach for Autistic Students in Bengaluru, India

  Journal of Autism and Developmental Disorders · 2025-09-30

  articleOpen access

  PURPOSE: There is a lack of evidence-informed teaching approaches for autistic students, particularly in culturally diverse, low-resource settings. This study implemented a manualized, evidence-informed teaching approach called Classroom Pivotal Response Teaching (CPRT) in an urban special education school in Bengaluru, India. CPRT provides teaching strategies that addresses student motivation, initiation, and generalization during implementation of learning goals. All students in the study had diagnoses of moderate to severe autism, and some also had intellectual disability. METHODS: We assessed the acceptability, feasibility, and implementation fidelity of CPRT using a mixed-methods approach. Eight special educators were trained in CPRT over ten weeks. RESULTS: All eight educators were successfully trained to fidelity, and six of eight teachers maintained fidelity 1.5 to 4 months after training. Further, qualitative data indicated that CPRT was considered acceptable and beneficial, particularly to student engagement, skill acquisition, and speech, as well as teachers' self-efficacy. CPRT was feasible to educators in individual teaching settings and for high-priority learning goals, as opposed to group settings for all learning goals, due to time and resource constraints. CONCLUSION: Overall, this study demonstrates the promise of CPRT in special education settings in India, suggesting the need for a larger-scale efficacy trial.

  PublisherOA PDFDOI

• A Pilot Evaluation of the PEACE Implementation Toolkit to Improve the Use of Caregiver Coaching in Early Intervention

  Behavioral Sciences · 2025-08-26

  articleOpen access1st authorCorresponding

  Caregiver coaching is an essential component of caregiver-mediated interventions for young autistic children. Previous research evaluating usual practice in early intervention (EI) has found that EI providers often do not use caregiver coaching. Increasing the use of caregiver coaching strategies is critical to improving the outcomes of EI. We used a community-partnered process to develop a toolkit of implementation strategies to improve the use of caregiver coaching in EI. This study presents findings from a preliminary evaluation of the toolkit using a non-concurrent multiple-baseline design across groups of providers and caregiver-child dyads. The results indicate that providers' caregiver coaching fidelity improved following the introduction of the toolkit. Caregivers demonstrated moderate growth in their use of supportive parenting techniques. All providers rated the toolkit as acceptable, appropriate, and feasible. The findings suggest that a toolkit of implementation strategies tailored to support the needs of community-based providers shows promise for improving caregiver coaching in EI.

  PublisherOA PDFDOI

• Organized CHAOS: Caregiver Coaching in Early Intervention

  ScholarlyCommons (University of Pennsylvania) · 2025-09-15

  otherOpen accessSenior author

  Project ImPACT is an early intervention program for autistic children that relies on caregiver coaching to support learning in everyday settings. Although this approach improves developmental outcomes, families from minoritized and low socioeconomic backgrounds often face barriers to accessing it. These families are also more likely to experience household chaos—such as noise, crowding, and unstable routines—which has been linked to difficulties in children’s emotion regulation, cognition, and behavior. Research shows that providers are less likely to use caregiver coaching with these families, worsening inequities in care. This project examined how household chaos relates to provider fidelity in delivering Project ImPACT within publicly funded early intervention.

  Publisher

• Metrics to evaluate implementation scientists in the USA: what matters most?

  UNC Libraries · 2025-12-19

  articleOpen access
  PublisherDOI

• Brief Report: A Scoping Review of Caregiver Coaching Strategies Within Caregiver-Mediated Interventions for Autism

  Infants & Young Children · 2024-08-22 · 5 citations

  reviewOpen access1st authorCorresponding

  Caregiver-mediated interventions for young autistic children are increasingly considered standard of care. These interventions share two sets of components: strategies to improve children’s communication, behavior, and development; and procedures to coach caregivers to implement those strategies. To date, no review has examined how caregiver coaching is described in caregiver-mediated intervention manuals. We assessed how caregiver coaching is described in caregiver-mediated intervention manuals for young autistic children. We conducted a scoping review to identify publicly available manuals that are designed to support providers in their practice; target core or co-occurring symptoms that affect young autistic children; and were tested as caregiver-mediated interventions in randomized controlled trials. We identified 11 publicly available manuals that met inclusion criteria. Manuals were coded using a summative content analysis to identify the presence and frequency of descriptions of caregiver coaching. The content analysis highlighted a wide range in the descriptions of caregiver coaching. Many intervention manuals did not include specific descriptions of caregiver coaching. Intervention developers should include explicit information about how to coach caregivers. Implementation strategies that specifically target caregiver coaching can serve as critical supports to increase the use of coaching in early intervention.

  PublisherOA PDFDOI

• A multi-constituent qualitative examination of facilitators and barriers to caregiver coaching for autistic children in publicly funded early intervention

  Autism · 2024-08-22 · 1 citations

  articleOpen accessSenior author

  Caregiver coaching is an evidence-based practice for autistic children that is poorly implemented in community-based early intervention. Previous studies have identified factors that influence implementation of caregiver coaching in early intervention; however, multi-informant (e.g., caregiver, provider, leadership) qualitative research is lacking. As such, the purpose of this study was to simultaneously examine the perspectives of caregivers and early intervention providers and agency leaders for triangulation of perceived barriers and facilitators to caregiver coaching in community-based early intervention. Interviews with 36 providers, 6 agency leaders, and 20 caregivers of autistic children were conducted. We used qualitative thematic analysis to identify barriers and facilitators, which we then mapped onto the Consolidated Framework for Implementation Research post hoc. Several themes emerged, including at the outer setting level (i.e., COVID-19 pandemic), inner setting level (i.e., caregiver views toward telehealth), individual characteristic level (i.e., caregiver attitudes toward coaching, caregivers concerns preventing progress, caregiver expectations regarding services, caregiver stress), and implementation process level (i.e., caregiver and provider collaboration, caregiver and provider relationship, caregivers coordinating services, caregiver involvement, provider flexibility). We offer suggestions for implementation strategies that will increase adoption of caregiver coaching in early intervention for autistic children and their families. Lay Abstract Caregiver coaching is an evidence-based practice for young autistic children, but it is not widely used in community-based early intervention services. Previous research has explored why caregiver coaching is not widespread in early intervention, but only from the perspective of early intervention providers. Caregivers, providers, and administrators are all involved in the decision of whether to use caregiver coaching in early intervention. Therefore, it is important to include all perspectives in research regarding this practice. In this study we interviewed 20 caregivers of autistic children, 36 early intervention providers, and 6 administrators from early intervention agencies and asked questions about their perspectives regarding the use of caregiver coaching in early intervention. We did this to figure out what factors help and hinder the use of caregiver coaching in this setting and to see how caregivers, providers, and administrators agreed or disagreed on these factors. All participants agreed that caregivers’ attitudes and expectations can influence whether caregiver coaching is used. In addition, all participants agreed that when caregivers and providers collaborate and have a strong working relationship, it can facilitate the use of caregiver coaching in early intervention. Other factors, such as caregiver stress and provider flexibility were also discussed. Based on these findings, we suggest strategies that can be used to possibly increase the use of caregiver coaching in early intervention for autistic children and their families.

  PublisherOA PDFDOI

• A mixed-methods evaluation of organization and individual factors influencing provider intentions to use caregiver coaching in community-based early intervention

  Implementation Science Communications · 2024-02-27 · 10 citations

  articleOpen access1st authorCorresponding

  BACKGROUND: Most psycho-social interventions contain multiple components. Practitioners often vary in their implementation of different intervention components. Caregiver coaching is a multicomponent intervention for young autistic children that is highly effective but poorly implemented in community-based early intervention (EI). Previous research has shown that EI providers' intentions, and the determinants of their intentions, to implement caregiver coaching vary across components. Organizational culture and climate likely influence these psychological determinants of intention by affecting beliefs that underlie attitudes, norms, and self-efficacy to implement an intervention. Research in this area is limited, which limits the development of theoretically driven, multilevel implementation strategies to support multi-component interventions. This mixed methods study evaluated the relationships among organizational leadership, culture and climate, attitudes, norms, self-efficacy, and EI providers' intentions to implement the components of caregiver coaching. METHODS: We surveyed 264 EI providers from 37 agencies regarding their intentions and determinants of intentions to use caregiver coaching. We also asked questions about the organizational culture, climate, and leadership in their agencies related to caregiver coaching. We used multilevel structural equation models to estimate associations among intentions, psychological determinants of intentions (attitudes, descriptive norms, injunctive norms, and self-efficacy), and organizational factors (implementation climate and leadership). We conducted qualitative interviews with 36 providers, stratified by strength of intentions to use coaching. We used mixed-methods analysis to gain an in-depth understanding of the organization and individual-level factors. RESULTS: The associations among intentions, psychological determinants of intentions, and organizational factors varied across core components of caregiver coaching. Qualitative interviews elucidated how providers describe the importance of each component. For example, providers' attitudes toward coaching caregivers and their perceptions of caregivers' expectations for service were particularly salient themes related to their use of caregiver coaching. CONCLUSION: Results highlight the importance of multi-level strategies that strategically target individual intervention components as well as organization-level and individual-level constructs. This approach holds promise for improving the implementation of complex, multicomponent, psychosocial interventions in community-based service systems.

  PublisherOA PDFDOI

• Programmatic Costs of Project ImPACT for Children with Autism: A Time-Driven Activity Based Costing Study

  Administration and Policy in Mental Health and Mental Health Services Research · 2023-01-13 · 19 citations

  articleOpen accessSenior author
  PublisherOA PDFDOI

Frequent coauthors

• David S. Mandell

  May Institute

  59 shared

• Rinad S. Beidas

  Northwestern University

  23 shared

• Aubyn C. Stahmer

  University of California, Davis

  20 shared

• Ming Xie

  Dalian Maritime University

  16 shared

• Steven C. Marcus

  16 shared

• Heather J. Nuske

  Penn Center for AIDS Research

  15 shared

• Liza Tomczuk

  Penn Center for AIDS Research

  15 shared

• Keiran Rump

  University of Pennsylvania

  11 shared

Labs

• Melanie Pellecchia LabPI