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American Academy of Pediatrics
Article

Parent-Implemented Social Intervention for Toddlers With Autism: An RCT

Amy M. Wetherby, Whitney Guthrie, Juliann Woods, Christopher Schatschneider, Renee D. Holland, Lindee Morgan and Catherine Lord
Pediatrics December 2014, 134 (6) 1084-1093; DOI: https://doi.org/10.1542/peds.2014-0757
Amy M. Wetherby
Departments of aClinical Sciences,
bAutism Institute,
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Whitney Guthrie
bAutism Institute,
dPsychology, Florida State University, Tallahassee, Florida; and
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Juliann Woods
bAutism Institute,
cSchool of Communication Science and Disorders, and
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Christopher Schatschneider
dPsychology, Florida State University, Tallahassee, Florida; and
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Renee D. Holland
bAutism Institute,
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Lindee Morgan
Departments of aClinical Sciences,
bAutism Institute,
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Catherine Lord
eDepartment of Psychiatry, Weill Cornell Medical College, New York, New York
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Abstract

OBJECTIVES: To compare the effects of two 9-month parent-implemented interventions within the Early Social Interaction (ESI) Project. Both individual-ESI, offered 2 or 3 times per week at home or in the community, and group-ESI, offered once per week in a clinic, taught parents how to embed strategies to support social communication throughout everyday activities.

METHODS: Participants in the randomized controlled trial included 82 children diagnosed with autism spectrum disorder at 16 to 20 months. Children were matched on pretreatment nonverbal developmental level and pairs were randomly assigned to treatment condition. Child outcomes included measures of social communication, autism symptoms, adaptive behavior, and developmental level. Child outcomes are reported from baseline to the end of the 9-month interventions.

RESULTS: Children in individual-ESI showed differential change on a standardized examiner-administered observational measure of social communication, as they improved at a faster rate than children in group-ESI. Individual-ESI also showed differential efficacy on a parent report measure of communication, daily living, and social skills, as they showed improvement or stability, whereas group-ESI led to worsening or no significant change on these skills. Finally, individual-ESI showed differential change on examiner-administered measures of receptive language skills, as children in individual-ESI improved significantly, whereas group-ESI showed no change.

CONCLUSIONS: These findings support the efficacy of individual-ESI compared with group-ESI on child outcomes, suggesting the importance of individualized parent coaching in natural environments. The efficacy of a parent-implemented intervention using little professional time has potential for community viability, which is particularly important in light of the lack of main effects on child outcomes of most other parent-implemented interventions.

  • autism
  • early intervention
  • toddlers
  • parent-implemented
  • outcomes
  • Accepted September 10, 2014.
  • Copyright © 2014 by the American Academy of Pediatrics

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Pediatrics
Vol. 134, Issue 6
1 Dec 2014
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Parent-Implemented Social Intervention for Toddlers With Autism: An RCT
Amy M. Wetherby, Whitney Guthrie, Juliann Woods, Christopher Schatschneider, Renee D. Holland, Lindee Morgan, Catherine Lord
Pediatrics Dec 2014, 134 (6) 1084-1093; DOI: 10.1542/peds.2014-0757

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Parent-Implemented Social Intervention for Toddlers With Autism: An RCT
Amy M. Wetherby, Whitney Guthrie, Juliann Woods, Christopher Schatschneider, Renee D. Holland, Lindee Morgan, Catherine Lord
Pediatrics Dec 2014, 134 (6) 1084-1093; DOI: 10.1542/peds.2014-0757
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