Purpose: Early intervention with children with autism may promote better long-term outcomes and preempt more serious consequences associated with this disorder. There is little research about the efficacy of interventions with infants and toddlers who, at this point, have not yet demonstrated all of their autism diagnostic symptoms. The purpose of this project is to assess the efficacy of an early intervention program called Adaptive Responsive Teaching with one year olds most at risk for autism spectrum disorder. The intervention is intended to improve developmental outcomes and ameliorate symptom severity.

Project Activities: A randomized control trial design will be used to study the efficacy of Adaptive Responsive Teaching intervention for improving social communication, regulatory functioning, and general development and ameliorating the presence or severity of autism symptoms. Families will be randomly assigned to receive the Adaptive Responsive Teaching or a business as usual control group. Both groups will be assessed pre-intervention and post-intervention.

Products: The products of this project will be published reports on the efficacy of Adapted Responsive Teaching and mediators or moderators of intervention effects.

STRUCTURED ABSTRACT

Setting: The research will take place in North Carolina.

Population: Over one hundred infants and their families will participate in this research. The infants will weigh more than 2,500 grams at birth and have been determined to be at risk for autism based on parent ratings using the First Year Inventory screening tool.

Intervention: The researchers will evaluate a parent-mediated, home-based intervention called Adapted Responsive Teaching. Adapted Responsive Teaching targets behaviors linked to the later development of more complex functions (pivotal behaviors) in domains of social-communication and sensory-regulatory functions. An interventionist meets with families for approximately 30 1-hour home visits over a period of 6-8 months to provide them with information, demonstration, and coaching on use of responsive teaching strategies to promote targeted pivotal behaviors for their child. Responsive teaching strategies emphasize reciprocity, contingency; shared control, positive affect, and matching the child’s developmental level and behavioral style. Family action plans are formulated at the end of each session to promote the use of Adapted Responsive Teaching by parents during daily, routine interactions with their child.

Research Design and Methods: Families will be randomly assigned to receive the Adapted Responsive Teaching treatment or a business as usual control group. Both groups will be assessed pre-intervention and post-intervention. An Intervention Coordinator will monitor Adapted Responsive Teaching implementation and services received by children in the control group.

Control Condition: Adapted Responsive Teaching will be compared to a business-as-usual condition in which families of eligible children are referred to community services for early intervention.

Key Measures: Researchers will measure children’s social communication, regulatory function, general development, and presence or severity of autism symptoms. In addition, data will be collected on fidelity of treatment implementation, parent and child demographics and parental responsiveness and use of other community services.

Data Analytic Strategy: An intent-to-treat strategy will be used for data analyses. Analysis of Covariance will be used to evaluate the effects of Adapted Responsive Teaching on infant outcomes and identify potential mediators or moderators of intervention effects.

Products and Publications

Journal article, monograph, or newsletter

Gordon, R.G., and Watson, L.R. (2015). Brief Report: Gestures in Children at Risk for Autism Spectrum Disorders. Journal of Autism and Developmental Disorders, 45(7): 2267–2273. doi:10.1007/s10803–015–2390–0