Skip Navigation
Funding Opportunities | Search Funded Research Grants and Contracts

IES Grant

Title: Supporting Early Interventionists of Toddlers with Autism to Build Family Capacity
Center: NCSER Year: 2018
Principal Investigator: Schertz, Hannah Awardee: Indiana University
Program: Early Intervention and Early Learning      [Program Details]
Award Period: 3 years (07/01/2018–06/30/2021) Award Amount: $1,399,769
Type: Development and Innovation Award Number: R324A180083

Co-Principal Investigator: Baggett, Kathleen

Purpose: The purpose of this project was to develop and test a framework, Supporting Early Interventionists of Toddlers with Autism to Build Family Capacity (SEITA). SEITA was designed to assist early intervention providers (EIPs) in implementing the Building Interactive Social Communication (BISC) intervention by helping parents mediate social communication learning in toddlers with emerging signs of autism. Autism spectrum disorder is the fastest-growing developmental disability and recent improvements in early detection are resulting in more toddlers entering early intervention under Part C of the Individuals with Disabilities Education Act. SEITA aimed to help Part C systems address autism's social challenges by enhancing family capacity to support child learning within natural environments. Ultimately, SEITA aims to improve social communication outcomes for toddlers with autism.

Project Activities: The research team conducted three studies to develop and test the SEITA framework. In the first, they used focus groups to inform intervention development by exploring the perspectives of EIPs and parents about intervention-related topics. In the second, they iteratively implemented a preliminary framework while assessing EIP, parent, and toddler outcomes, as well as the feasibility and acceptability of the framework. In the final pilot study, the team used a multiple-baseline single-case design with three EIP/parent/toddler triads participating in each of four focus areas (social reciprocity, positive social behavior, joint attention, and symbolic play) to test the promise of SEITA for improving EIP, parent, and child outcomes.

Key Outcomes: The main findings of the pilot study, as reported by the principal investigator, are as follows:

  • All EIPs changed their practice to incorporate key BISC features, which included applying mediated learning principles to support parents' conceptual learning, guiding parent reflection on parent-toddler interaction, and promoting parent leadership in planning and translating learned concepts into daily interactions.
  • Intervention effects on parents' use of mediational practices to promote toddler social communication learning were demonstrated for all parents.
  • For toddler outcomes, large positive effect sizes were found for social reciprocity, behavior, and symbolic play, and a small effect size was found for joint attention.

Structured Abstract

Setting: Research activities were implemented in homes in urban, rural, and suburban areas of Indiana and Kansas in which Part C early intervention services are delivered.

Sample: Seven EIPs and nine parents participated in the first study. Four EIP/parent/triads participated in study 2, one for each of the four focus areas to field test the draft curricula. The pilot study included 12 triads. Toddlers were under 30 months of age and met the criteria for autism in pre-enrollment diagnostic assessments administered by a trained researcher. Each focus area included three participant triads.

Intervention: Using the SEITA framework, an intervention consultant guides EIPs to implement BISC by helping parents learn to mediate their toddlers' learning in social communication, the core autism challenge, at their incoming preverbal levels. There are three major components to the framework. The first is BISC's social communication content. EIPs, and in turn, parents, learn to distinguish between social and instrumental communicative functions since the former but not the latter is a unique challenge in autism. Social communication includes nonverbal "commenting" or "showing" to initiate social attention or responding to a partner's social initiation, while instrumental communication includes requesting or following directions. To enable the researchers to study outcomes of social communication for consideration in future implementations, each triad in this study was assigned to one of the four focus area (social reciprocity, joint attention, positive social behavior, and symbolic play), though the future intent is to target each area in developmental sequence for all participants. The second component is mediated learning, the intervention process through which the EIP guides parent learning and through which the parent guides toddler learning. The mediated learning processes include focusing/organizing/planning, giving meaning, encouraging self-reliance, and expanding. The third key intervention component is the parent-child relationship, which is the context in which toddler learning occurs. Rather than working directly with the child, the EIP provides systematic and focused support to guide the parent in translating learned concepts into everyday parent-toddler interaction.

Research Design and Methods: This project included three studies. In study 1, the research team gathered information from focus groups of EIPs and interviews with parents about their perception of intervention-related topics (e.g., intervention priorities, their own competencies, feasibility issues, preliminary SEITA features) to inform the development of the initial framework. These activities were coordinated by the intervention consultant, who guided EIPs to implement the framework in the subsequent studies. The research team also developed measures of fidelity and refined outcome measures during this phase. In study 2, the team conducted four adapted single-case design studies to gather initial implementation data. The team iteratively developed and tested the framework with EIPs while gathering data on implementation fidelity, feasibility, and social validity, as well as child outcomes for each focus area. In study 3, the pilot study, the team used a multiple-baseline single-case design to determine the potential efficacy of the refined SEITA framework for improving EIP implementation, parent implementation and use of mediated learning practices, and toddler social communication outcomes. For the latter, three toddlers were assessed in each of four focus areas—social reciprocity, joint attention, positive social behavior, and symbolic play.

Control Condition: For the pilot study, each EIP, parent, and child served as their own control during the baseline phase of the single-case design study.

Key Measures: To determine child eligibility for the study, researchers used the Modified Checklist for Autism in Toddlers—Revised screening tool followed by the Telehealth-ASD-Peds, an adaptation of the Autism Diagnostic Observation Schedule for Toddlers designed for virtual administration. For study 1, data were assessed from transcriptions of EIP focus groups and parent interviews. For studies 2 and 3, the research team measured feasibility, usability, and acceptability/social validity through researcher-developed checklists and rating scales. For child outcomes, one social communication domain was measured for each child, depending on their intervention focus. The Precursors of Joint Attention Measures, an observation coding system, was used to measure social reciprocity (turn taking between caregiver and child) and joint attention (responding and initiating). A separate researcher-developed observation-based coding system (Social Interactive Play Assessment) was used to measure symbolic play during parent-child interaction. Repetitive and challenging behavior were assessed by coding the frequency of child-specific designated behaviors. The Mediation of Social and Transactional Engagement measure was used to assess parents' application of mediated learning principles.

Data Analytic Strategy: The researchers used qualitative analytic procedures to explore focus group and interview data in study 1 and to identify themes that informed the initial SEITA development phase. Single-case design data from study 2 were analyzed using visual analyses. To analyze data from study 3, researchers used both visual analysis (with three children per focus area for child outcomes) and a between-case standardized effect size analysis (with 12 participants each for parent and EIP outcomes).

Related IES Projects: Joint Attention Mediated Learning Intervention for Toddlers with Autism Spectrum Disorders and their Families (R324A120291); Building Interactive Social Communication for Toddlers with Autism in Community-Based Early Intervention Systems (R324A230213)

Products and Publications

ERIC Citations:  Find available citations in ERIC for this award here.