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Study summary:
The goal of this study was to test the efficacy of different styles of parent-mediated interventions and to find a method that delivers positive communication outcomes for children with ASD. The participants were randomly assigned to one of two study groups. The first is the caregiver-education model (CEM), a standard practice parent education curriculum. Parents met one-on-one with an interventionist or in small groups to learn about ASD resources, ask questions, and develop tools to better interact with their child. The second group, a caregiver-mediated model (CMM), taught parents to use joint attention skills when interacting with their child. In this model the parent, child, and interventionist worked together, practicing strategies that motivate the child to engage in social communication interactions. The results of these interventions will be compared to determine which parent-mediated intervention style provides the greatest increase in social communication outcomes.

Background:
There is a critical need to develop effective methods for treating language and communication impairment in children with ASD. The approach taken in current intervention research tends to be behavioral and therapist-driven in implementation with less focus on parent training. However, mediating intervention through parents in the home and over everyday activities may prove to be more effective than merely providing parents with information as is typically done in parent groups.

Research Design:
During the course of this three year study, over one hundred children ages 2-5 years old participated across our five sites. Participants were randomized to a joint engagement intervention (two hour sessions, once a week) or a parent education intervention for two hours per week over the course of 12 weeks.

  Caregiver-education model (CEM): In the education model, interventionists worked one-on-one or with a small group of parents of children with ASD in their homes or in community settings, providing them with information, education, and support that would help them to better engage with their child. Parents received information about their child, ASD, and services available in their community. They collaborated with the interventionist to come up with solutions that meet the needs of their child and received answers to questions about their individual experiences.

Caregiver-mediated model (CMM): In this model, the overarching goal was for the parent-child dyad to be in a state of coordinated joint attention in each session. The caregiver-mediated model offered a hands-on approach by teaching parents techniques for altering the home environment and parent-child interactions to maximize engagement and communicative opportunities. The parent and interventionist worked together in the home to build routines around every-day experiences, like playing with toys, reading books, doing chores, and having snack time. Parents received input and guided practice as they engaged their child, created interactive routines, and motivated their child to produce more frequent and mature communication.


 

 
 
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This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number UA3 MC 11055 (AIR-B). This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.
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