Autism Sibling, Autism Spectrum Disorder
Conditions
Keywords
parent-mediated, caregiver-mediated
Brief summary
This project will look at whether a novel approach to language intervention that encourages looking to audiovisual speech cues for infants with autistic older siblings (Baby Sibs), who are highly likely be diagnosed with autism or developmental language disorder (DLD). This study will specifically look at (a) whether caregivers find this approach to be easy to implement in their homes, (b) whether they find this approach to be acceptable, and (c) whether caregivers use the taught strategies in interactions with their infants.
Detailed description
This project will test the feasibility and acceptability of a novel approach to language intervention based on Milieu Teaching (Milieu Teaching-AV) that encourages looking to audiovisual speech cues for infants with autistic older siblings (Sibs-autism), who are highly likely be diagnosed with autism or developmental language disorder (DLD). The main question\[s\] it aims to answer are: 1. Can caregivers be trained in Milieu Teaching-AV, such that they are using the trained strategies in play with their infant children? 2. Do caregivers find these procedures to be acceptable and feasible to use in their everyday life.
Interventions
BEHAVIORALMilieu Teaching-AV
In Milieu Teaching-AV, coaches will teach caregivers to engage the child in play or routines around a standardized set of toys, follow the child's attention or communication lead around these toys, and respond to the infant's communication acts by modeling and expanding those communication acts into more sophisticated strategies. While responding to infant communication acts, coaches will slowly move the referent of the infant's lead near the face at approximately the level of the mouth, wait for the infant to shift his/her gaze towards the new referent position if necessary, and provide all models, prompting, and expanding while maintaining placement of the referent near the mouth.
Sponsors
Father Flanagan's Boys' Home
National Institute on Deafness and Other Communication Disorders (NIDCD)
Vanderbilt University Medical Center
Study design
Allocation
RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Masking description
Outcome assessors will be naive to the phase of treatment and the hypotheses. Additionally, there will be at least one naive member of the study team that can decide when to implement phase changes.
Intervention model description
This study will utilize single-case research design studies, which are experimental and can be used to demonstrate the effects of treatment with as few as 1-3 participants. The investigators will specifically conduct up to two multiple probe across participants (MPP) design studies with caregiver/Baby Sib dyads. These studies will focus on whether caregivers can be trained to administer the proposed intervention and whether implementers (hereafter referred to as coaches) can conduct the sessions as manualized with a high degree of procedural fidelity. This experimental design also can be used to determine whether the pre-emptive intervention produces positive effects on the proximal child variable of looking to mouth of their caregiver. Each intervention session will be video recorded to have coders naïve to condition monitor the fidelity of procedures and caregiver strategy use.
Eligibility
Sex/Gender
ALL
Age
5 Months to 12 Months
Healthy volunteers
No
Inclusion criteria
* an older sibling with an autism diagnosis, confirmed by either (a) a detailed developmental interview and administration of the Autism Diagnostic Observation Schedule or (b) by record review * monolingual English-speaking household
Exclusion criteria
* adverse neurological history * known genetic condition * pre-term birth (gestation \< 37 weeks) * caregiver report of a diagnosed vision impairment or hearing loss
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Caregiver strategy use | From enrollment to the end of the treatment (i.e., all baseline and treatment sessions, up to 20 weeks) | Proportion of milieu teaching trials during a caregiver-child free play session wherein the caregiver moves the referent of the child's lead towards the mouth |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Caregiver attitudes on the feasibility of Milieu Teaching-AV - Quantitative | At the conclusion of the treatment (i.e., following all intervention sessions; up to 20 weeks) | Caregiver attitudes towards the feasibility of this approach will be conducted via the Feasibility Intervention Measure Score (range of scores = 4-20) |
| Caregiver attitudes on the acceptability of Milieu Teaching-AV - Quantitative | At the conclusion of the treatment (i.e., following all intervention sessions; up to 20 weeks) | Caregiver attitudes towards the feasibility of this approach will be conducted via the Acceptability of Intervention Measure Score (range of scores = 4-20) |
| Caregiver attitudes on the feasibility of Milieu Teaching-AV - Qualitative | At the conclusion of the treatment (i.e., following all intervention sessions; up to 20 weeks) | Caregiver attitudes towards the feasibility of this approach will be conducted via the coding of a qualitative interview. |
| Caregiver attitudes on the acceptability of Milieu Teaching-AV - Qualitative | At the conclusion of the treatment (i.e., following all intervention sessions; up to 20 weeks) | Caregiver attitudes towards the acceptability of this approach will be conducted via the coding of a qualitative interview. |
Countries
United States
Outcome results
None listed