|Title:||Evaluation of a Comprehensive Community-based Intervention for Toddlers with ASD|
|Principal Investigator:||McBride, Bonnie||Awardee:||University of Oklahoma Health Sciences Center|
|Program:||Early Intervention and Early Learning [Program Details]|
|Award Period:||7/1/2011–6/30/2015||Award Amount:||$2,887,900|
|Type:||Efficacy and Replication||Award Number:||R324A110353|
Purpose: Prevalence rates for autism spectrum disorders (ASD) have risen dramatically in recent years and children are being identified earlier (i.e., under the age of 3). This has placed pressure on state early intervention systems to serve young children with ASD. However there are few treatment models available that are both feasible across different types of community settings and have demonstrated effectiveness.
The overarching purpose of the current project is to conduct a randomized trial to evaluate the efficacy of a previously developed and pilot-tested model for very young children with ASD called Project DATA (Developmentally Appropriate Treatment for Autism)–Toddler. The major goals will be to examine whether children receiving this intervention show greater gains in cognitive functioning, language, social relatedness, and adaptive behavior; whether parents of these children demonstrate gains in recommended parenting strategies and decreased stress; and whether the intervention is acceptable in terms of general satisfaction and ability to work effectively within the context of different cultures. The ultimate aim of the research is to enable feasible and beneficial community-based services for toddlers with ASD.
Project Activities: In this study, each child and their caregiver(s) will be randomly assigned to either the experimental condition (DATA–Toddler) or a comparison condition (standard care). After an intensive week-long training for the interventionist, follow up monitoring (fidelity checks) is scheduled weekly for the first four weeks to ensure appropriate implementation.
Child assessments and parent reports will be administered pre-intervention and quarterly thereafter, including measures of symptoms, cognitive functioning, language, problem behavior, social behavior, engagement, and parent and family stress. Measures of adaptive behavior, family routines, and received child services will be collected at baseline and post-treatment.
Products: Products from this project will include published reports and presentations on the efficacy of DATA–Toddler.
Setting: The research will take place in a community-based child care setting in Oklahoma City and a clinical intervention development setting in Seattle. These sites, which are state-funded early intervention programs, represent diversity in setting, staffing, and recruitment characteristics.
Population: The population will consist of 80 toddlers, aged 18 to 30 months, diagnosed with ASD and meeting standardized symptom criteria.
Intervention: The Project DATA–Toddler model is designed to be feasible for community and early intervention education settings and blends practices from the fields of applied behavior analysis, early childhood education, and early childhood special education. It includes home-based, center-based, and early education setting services delivered by paraprofessional interventionists with supervision from certified professional staff. Each child receives 17 hours of focused intervention each week, as well as an additional 5 hours of parent-delivered intervention at home, for two years. The model has five major components, including an integrated early childhood experience (integrated play group with supports to facilitate interactions), intensive one-to-one instruction, technical and social support for families, collaboration and coordination across services, and support for planning and transition.
Research Design and Methods: The study will follow a simple two-arm randomized controlled trial. Each child and their linked caregiver(s) will be randomly assigned, stratified by site, to either the experimental condition (DATA–Toddler) or a comparison condition (standard care). The project will use procedural monitoring to maintain treatment fidelity, balancing of key baseline group differences, blinded data collection with inter-rater reliability checks, and multiple core symptom assessments. Data on child outcomes and parent reports will be collected pre-intervention and quarterly thereafter.
Control Condition: The children in the control group will receive standard (business-as-usual) care, including services offered through their state early intervention system.
Key Measures: The intervention will be evaluated using both standardized and non-standardized measures administered to the child, direct observation, and parent report. Measures used include diagnostic assessments such as the Autism Diagnostic Observation Schedule (ADOS); Mullen Scales of Early Learning; MacArthur-Bates Communicative Development Inventory (CDI); Vineland Adaptive Behavior Scale-Survey Edition; Aberrant Behavior Checklist; Brief Infant Toddler Social Emotional Assessment (BITSEA); and measures of engagement and play, parent and family stress, and consumer satisfaction.
Data Analytic Strategy: The study will model change over time with a mean and covariance structural analysis, using latent growth curve modeling when appropriate. For measures capturing categorical change (developmental stages captured by measures of early learning and communication), ordinal-ranked stages will be analyzed using generalized linear mixed modeling. Mediation and moderation analyses will be incorporated into the models to examine potential explanations for variation in size of individual change and to generate hypotheses worth investigating in larger trials.
Schwartz, I. S., Ashmun, J., McBride, B., & Sandall, S. (2017). The Project DATA Model for Teaching Preschoolers with Autism. Baltimore: Brookes. .
Book chapter, edition specified
Schwartz, I. S., & McBride, B. (2014). Getting a Good Start: Effective Practices in Early Intervention. In ,K. D. Burton and P. Wolfberg, (Eds.), Educating Learners on the Autism Spectrum: Preparing Highly Qualified Educators and Related Practitioners (2nd Edition). (pp. 82–105). Kansas City, KS: Autism Asperger Publishing Company.
Journal article, monograph, or newsletter
Gauvreau, A. N. and Schwartz, I. S. (2013). Using Visual Supports to Promote Appropriate Behavior in Young Children with Autism and Related Disabilities. Young Exceptional Children , 15. Retrieved from https://bookstore.dec-sped.org/product-p/15.htm.
Schwartz, I. S., & Kelly, E. (in press). A response to clinical corner question: What are the benefits of inclusion for children with ASD?
Schwartz, I.S., Thomas, C.J., McBride, B.J., and Sandall, S.R. (2013). A School-Based Preschool Program for Children With ASD: A Quasi-Experimental Assessment of Child Change in Project DATA. School Mental Health, 5(4): 221–232. doi:10.1007/s12310–013–9103–7