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"Going Mobile"-increasing the reach of parent-mediated intervention for toddlers with ASD via group-based and virtual delivery.

ABSTRACT: Evidence supports early intervention for toddlers with ASD, but barriers to access remain, including system costs, workforce constraints, and a range of family socio-demographic factors. An urgent need exists for innovative models that maximize resource efficiency and promote widespread timely access. We examined uptake and outcomes from 82 families participating in a parent-mediated intervention comprising group-based learning and individual coaching, delivered either in-person (n = 45) or virtually (n = 37). Parents from diverse linguistic, ethnic, and educational backgrounds gained intervention skills and toddlers evidenced significant social-communication gains. Few differences emerged across socio-demographic factors or delivery conditions. Findings highlight the feasibility, acceptability, and promise of group-based learning when combined with individual coaching, with added potential to increase program reach via virtual delivery.

SUBMITTER: Brian J

PROVIDER: S-EPMC9128315 | biostudies-literature | 2022 Dec

REPOSITORIES: biostudies-literature

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"Going Mobile"-increasing the reach of parent-mediated intervention for toddlers with ASD via group-based and virtual delivery.

Brian Jessica J Solish Abbie A Dowds Erin E Roth Ian I Bernardi Kate K Perry Kate K Daoud Sara S Jilderda Sanne S MacWilliam Stacey S Smith Isabel M IM Zwaigenbaum Lonnie L Bryson Susan S

Journal of autism and developmental disorders 20220524 12

Evidence supports early intervention for toddlers with ASD, but barriers to access remain, including system costs, workforce constraints, and a range of family socio-demographic factors. An urgent need exists for innovative models that maximize resource efficiency and promote widespread timely access. We examined uptake and outcomes from 82 families participating in a parent-mediated intervention comprising group-based learning and individual coaching, delivered either in-person (n = 45) or virt ...[more]

PMID: 35608785

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Project description:Intense interests are common in children with and without autism spectrum disorder (ASD), and little research has characterized aspects of interests that are unique to or shared among children with and without ASD. We aimed to characterize interests in a sample of infants at high-familial-risk (HR) and low-familial-risk (LR) for ASD using a novel interview. Participants included HR siblings who were diagnosed with ASD at 24 months (HR-ASD, n = 56), HR siblings who did not receive an ASD diagnosis at 24 months (HR-Neg, n = 187), and a LR comparison group (n = 109). We developed and collected data with the Intense Interests Inventory at 18- and 24-months of age, a semi-structured interview that measures intensity and peculiarity of interests in toddlers and preschool-aged children. Intensity of interests differed by familial risk at 24 months, with HR-ASD and HR-Neg groups demonstrating equivalent intensity of interests that were higher than the LR group. By contrast, peculiarity of interest differed by ASD diagnosis, with the HR-ASD group showing more peculiar interests than the HR-Neg and LR groups at 24 months. At 18 months the HR-ASD group had more peculiar interests than the LR group, though no differences emerged in intensity of interests. This measure may be useful in identifying clinically-relevant features of interests in young children with ASD. We also replicated previous findings of males showing more intense interests at 18 months in our non-ASD sample. These results reveal new information about the nature of interests and preoccupations in the early autism phenotype. LAY SUMMARY: Intense interests are common in young children with autism and their family members. Intense interests are also prevalent among typically-developing children, and especially boys. Here we catalog interests and features of these interests in a large sample of toddlers enriched for autism risk. Children who had family members with autism had more intense interests, and those who developed autism themselves had more unusual interests at 24 months. These results highlight the importance of different aspects of interest in autism.

Project description:Background and aimsThe quality of parent verbal input-diverse vocabulary that is well-matched to the child's developmental level within interactions that are responsive to their interests-has been found to positively impact child language skills. For typically developing (TD) children, there is evidence that more advanced linguistic and social development differentially elicits higher quality parent input, suggesting a bidirectional relationship between parent and child. The purpose of this study was to evaluate if toddlers with ASD also differentially elicit parental verbal input by (1) analyzing the quality of parent input to the communicative behavior of their toddlers with ASD, (2) examining if parents respond differentially to more advanced toddler communicative behavior, as measured by the coordination of multiple communicative behaviors, and (3) exploring the relationship between parental responsiveness to child communicative behaviors and change in child communication and social skills.MethodsParticipants were 77 toddlers with ASD age 18-39 months and a parent who participated in a larger RCT. Ten-minute parent-toddler interactions were recorded prior to a 12-week intervention. Parent response to child communicative behaviors was coded following each child communicative behavior as no acknowledgment, responsive, directive, or nonverbal acknowledgment. Parent number of different words and difference between parent and child MLU in words were calculated separately for responsive and directive parent utterances. Child growth in language and social skills was measured using the Vineland II Communication and Socialization domain scores, respectively.Results(1) Parents were largely responsive to their toddler's communication. When being responsive (as opposed to directive), parents used a greater number of different words within utterances that were well-matched to child language; (2) when toddlers coordinated communicative behaviors (versus producing an isolated communicative behavior), parents were more likely to respond and their replies were more likely to be responsive; and (3) parent responsiveness to child coordinated communication was significantly correlated with change in Vineland II Socialization but not Communication. A unique role of gaze coordinated child communication in eliciting responsive parental behaviors and improving growth in child social skills emerged.ConclusionsOur results support a bidirectional process between responsive parent verbal input and the social development of toddlers with ASD, with less sophisticated child communicative behaviors eliciting lower quality parent input.Implications: Our findings highlight the critical role of early parent-mediated intervention for children with ASD generally, and to enhance eye gaze through parent responsivity more specifically.

Project description:BackgroundVulnerable children, including those with neuro-developmental delays and disabilities, often face barriers in accessing early primary education, thus hindering progress toward Sustainable Development Goal 4.2. Evidence-based interventions are essential to enhancing inclusivity and establishing sustainable implementation strategies to address this challenge. This study, Every Newborn-Reach up Early Education Intervention for All Children (EN-REACH), builds on the previous Every Newborn- Simplified Measurement Integrating Longitudinal Neurodevelopmental and Growth (EN-SMILING) observational cohort study. This paper provides the protocol for a cluster randomized controlled trial (cRCT) to evaluate the effectiveness of a parenting group intervention program for enhancing school readiness in Bangladesh, Nepal, and Tanzania, and an embedded process evaluation to inform scalability and feasibility.MethodsEN-REACH is a cRCT with at least 150 clusters to evaluate the impact of a parent training program led by trained parent-teacher facilitator pairs, focusing on children aged 4 ~ 6 years preparing for preschool. Approximately 500 participants from the EN-SMILING cohort at each site have been identified. A geographic information system will define ~ 50 clusters in each of the three countries, each with approximately ten parent-child dyads. Half the clusters will be randomly assigned to intervention and control groups. The primary outcome is "school readiness", assessed using the Measuring Early Learning Quality and Outcomes tool. Secondary outcomes include Intelligence Quotient, child functioning, growth, visual, and hearing assessments. Data will be collected at baseline, and post-intervention data following implementation of the parent group intervention sessions over approximately 5 months. Quantitative data on coverage and quality care, combined with qualitative insights from children, caregivers, facilitators, and stakeholders' perspectives, will be used to conduct a process evaluation applying the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. DISCUSSION: This protocol details a trial focused on enhancing school readiness and cognitive abilities in young children, inclusive of those with disabilities, aiming to bridge gap from home to early primary education. EN-REACH aims to provide insights into the effectiveness and acceptability of a co-designed disability-inclusive school readiness program in three countries, potentially impacting national and global policies for all children, including those with disabilities.Trial registrationThe trial was retrospectively registered on clinicaltrials.gov on 29 February 2024 (NCT06334627).

Dataset Information

"Going Mobile"-increasing the reach of parent-mediated intervention for toddlers with ASD via group-based and virtual delivery.

Publications

"Going Mobile"-increasing the reach of parent-mediated intervention for toddlers with ASD via group-based and virtual delivery.

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