Parent-Mediated Intervention for One-Year-Olds Screened as At-Risk for Autism Spectrum Disorder: A Randomized Controlled Trial
Watson, Linda R.; Crais, Elizabeth R.; Baranek, Grace T.; Turner-Brown, Lauren; Sideris, John; Wakeford, Linn; Kinard, Jessica; Reznick, J. Steven; Martin, Katrina L.; Nowell, Sallie W. (2017). Journal of Autism and Developmental Disorders, v47 n11 p3520-3540 . Retrieved from: https://eric.ed.gov/?id=EJ1156961
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examining84Students, gradePK
Single Study Review
Review Details
Reviewed: November 2024
- Single Study Review (findings for Adaptive Responsive Teaching)
- Randomized Controlled Trial
- Meets WWC standards without reservations because it is a randomized controlled trial with low attrition.
This review may not reflect the full body of research evidence for this intervention.
Evidence Tier rating based solely on this study. This intervention may achieve a higher tier when combined with the full body of evidence.
Findings
|
Outcome measure |
Comparison | Period | Sample |
Intervention mean |
Comparison mean |
Significant? |
Improvement index |
|---|---|---|---|---|---|---|---|
|
Mullen Scales of Early Learning (MSEL): Visual Receptive Scale |
Adaptive Responsive Teaching vs. Business as usual |
1 Month |
Full sample;
|
45.20 |
47.40 |
No |
-- |
|
Outcome measure |
Comparison | Period | Sample |
Intervention mean |
Comparison mean |
Significant? |
Improvement index |
|---|---|---|---|---|---|---|---|
|
Mullen scales of early learning (MSEL): Expressive Language Scale |
Adaptive Responsive Teaching vs. Business as usual |
1 Month |
Full sample;
|
41.30 |
41.30 |
No |
-- |
|
Communication and Symbolic Behavior Scales (CSBS): Behavior sample |
Adaptive Responsive Teaching vs. Business as usual |
1 Month |
Full sample;
|
89.20 |
91.60 |
No |
-- |
|
Vineland Adaptive Behavior Scales, 2nd Edition: Communication subscale |
Adaptive Responsive Teaching vs. Business as usual |
1 Month |
Full sample;
|
93.40 |
93.20 |
No |
-- |
|
Outcome measure |
Comparison | Period | Sample |
Intervention mean |
Comparison mean |
Significant? |
Improvement index |
|---|---|---|---|---|---|---|---|
|
Vineland Adaptive Behavior Scales (VABS), 2nd edition: Motor Skills Scale |
Adaptive Responsive Teaching vs. Business as usual |
1 Month |
Full sample;
|
91.00 |
90.20 |
Yes |
|
|
Vineland Adaptive Behavior Scales, 2nd Edition: Daily Living Skills subscale |
Adaptive Responsive Teaching vs. Business as usual |
1 Month |
Full sample;
|
91.90 |
92.70 |
No |
-- |
|
Mullen Scales of Early Learning (MSEL): Fine Motor Scale |
Adaptive Responsive Teaching vs. Business as usual |
1 Month |
Full sample;
|
39.70 |
42.90 |
No |
-- |
|
Outcome measure |
Comparison | Period | Sample |
Intervention mean |
Comparison mean |
Significant? |
Improvement index |
|---|---|---|---|---|---|---|---|
|
Mullen scales of early learning (MSEL): Receptive Language Scale |
Adaptive Responsive Teaching vs. Business as usual |
1 Month |
Full sample;
|
42.40 |
46.60 |
No |
-- |
|
Outcome measure |
Comparison | Period | Sample |
Intervention mean |
Comparison mean |
Significant? |
Improvement index |
|---|---|---|---|---|---|---|---|
|
Vineland Adaptive Behavior Scales, 2nd Edition: Socialization subscale |
Adaptive Responsive Teaching vs. Business as usual |
1 Month |
Full sample;
|
89.80 |
89.50 |
No |
-- |
|
Autism diagnostic observation schedule (ADOS) |
Adaptive Responsive Teaching vs. Business as usual |
1 Month |
Full sample;
|
12.10 |
11.40 |
No |
-- |
Evidence Tier rating based solely on this study. This intervention may achieve a higher tier when combined with the full body of evidence.
Sample Characteristics
Characteristics of study sample as reported by study author.
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Female: 31%
Male: 69% -
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North Carolina
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Race Black 21% Other or unknown 10% White 69% -
Ethnicity Not Hispanic or Latino 99% Other or unknown 1% -
Eligible for Free and Reduced Price Lunch Other or unknown 100%
Study Details
Setting
The study took place in the homes of caregivers of children between the ages 13 and 16 months, located in six central counties in North Carolina.
Study sample
The study was a non-compromised individual-level RCT that included multiple sites. The researchers randomly assigned 45 children (between the ages of 13 and 16 months) to the intervention group and 42 children (between the ages of 13 and 16 months) to the comparison group. A total of 87 children were included in the study. To be eligible for the study, children had to have been identified as high risk for being diagnosed with autism spectrum disorder, have had a birth weight greater than 2,500 grams, had availability of one caregiver to participate in home-based intervention sessions, and live in a household wherein English was the primary language. The researchers also purposefully recruited only non-Hispanic families. Approximately 69% of the children were male and 31% were female; 69% of the sample were White, 21% were Black, and 10% were mixed race or another race; 99% of the sample were non-Hispanic and 1% did not report ethnicity (all were in the comparison condition). The study did not report other demographic information.
Intervention Group
The Adaptive Responsive Teaching (ART) intervention is a program that was tailored by the research team to be appropriate for children at risk of an autism diagnosis and is delivered to parents or caregivers in a home setting. This intervention focused on bolstering skills related social-communication (such as social play, conversation, and vocalization) and sensory regulation (such as self-regulation, attention, and cooperation). The planned dosage was 30 in-home sessions and six additional contacts through phone or email across six to eight months.
Comparison Group
Children in the comparison group received business-as-usual support and were assigned to the Referral to Early Intervention and Monitoring (REIM) group. The caregivers of children assigned to this condition did not receive any intervention services from the intervention team. Caregivers who asked for EI services were supported by the research team to receive contact information for community EI services (caregivers in both the intervention and comparison group had this option available, so access to REIM did not differ by condition).
Support for implementation
Six interventionists supported the implementation of the intervention and had experience in child development, ASD, and EI. The interventionists held education sessions to introduce the ART intervention to caregivers and provide supporting materials on how to use ART in their homes.
An indicator of the effect of the intervention, the improvement index can be interpreted as the expected change in percentile rank for an average comparison group student if that student had received the intervention.
For more, please see the WWC Glossary entry for improvement index.
An outcome is the knowledge, skills, and attitudes that are attained as a result of an activity. An outcome measures is an instrument, device, or method that provides data on the outcome.
A finding that is included in the effectiveness rating. Excluded findings may include subgroups and subscales.
The sample on which the analysis was conducted.
The group to which the intervention group is compared, which may include a different intervention, business as usual, or no services.
The timing of the post-intervention outcome measure.
The number of students included in the analysis.
The mean score of students in the intervention group.
The mean score of students in the comparison group.
The WWC considers a finding to be statistically significant if the likelihood that the finding is due to chance alone, rather than a real difference, is less than five percent.
The WWC reviews studies for WWC products, Department of Education grant competitions, and IES performance measures.
The name and version of the document used to guide the review of the study.
The version of the WWC design standards used to guide the review of the study.
The result of the WWC assessment of the study. The rating is based on the strength of evidence of the effectiveness of the intervention. Studies are given a rating of Meets WWC Design Standards without Reservations, Meets WWC Design Standards with Reservations, or >Does Not Meet WWC Design Standards.
A related publication that was reviewed alongside the main study of interest.
Study findings for this report.
Based on the direction, magnitude, statistical significance, and sample size of the findings within a domain, the WWC assigns effectiveness ratings as one of the following: Tier 1 (strong evidence), Tier 2 (moderate evidence), Tier 3 (promising evidence), uncertain effects, and negative effects. For more detail, please see the WWC Handbook.
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Tier 1 Strong indicates strong evidence of effectiveness,
Tier 2 Moderate indicates moderate evidence of effectiveness, and
Tier 3 Promising indicates promising evidence of effectiveness,
as defined in the
non-regulatory guidance for ESSA
and the regulations for ED discretionary grants (EDGAR Part 77).