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Parent-Mediated vs. Center Based Intervention for Toddlers with ASD: an RCT
The major focus of the study is to evaluate the relative impact of two different intervention experiences on social and communication development of minority and underserved toddlers with ASD and their parents. We will to compare the relative effects of a home-based parent-mediated versus a center-based professional-mediated intervention. Parents in the Parent-Mediated intervention will be trained using the manualized approach recently developed by the applicant. In this approach, parents are taught to use highly responsive interaction strategies aimed at targeting core social and communication deficits of ASD during daily living activities at home. The comparison condition involves providing Center-Based intervention within a nursery school classroom at Kennedy Krieger Institute’s (KKI) Center for Autism and Related Disorders using the applicant’s NIH STAART early intervention approach. Short term objectives are to (a) provide the new Committee for Culturally Sensitive Practice with the intervention curriculum and overview of instructional strategies and materials for both interventions for their critique; (b) modify the intervention curriculum, strategies and materials based on critiques; (c) consent, assess, and randomize children to one of the two intervention conditions; (d) conduct the intervention; (e) conduct fidelity measures of all staff and provide feedback; (f) conduct post-intervention assessments; and (g) disseminate findings. This study represents the first in a series of studies that will address the long term objectives of improving Part C service delivery to minority and underserved children with ASD, preventing exacerbation of core deficits of ASD and co-morbid disorders, providing the intervention evidence base that will be needed to empower service providers to efficacious intervention, and empowering parents to provide a milieu that enhances development and overall well-being in their children with ASD. Subsequent studies will be aimed at: (1) following these participants to understand longer-term impact of this early intervention; (2) defining moderators and mediators of child and parent outcomes; (3) defining barriers to translating evidence-based practices into community-based settings for minority and underserved toddlers with ASD; and (4) developing models for training Early Intervention providers in evidence-based practice and for monitoring fidelity of implementation. The ultimate outcome of this line of research will be to effect change in community-based practice for minority and underserved children and to shape policy regarding Part C services for children with ASD.