Randomized Comparative Efficacy Study of Parent-Mediated Interventions for Toddlers With Autism

• Published in: Journal of consulting and clinical psychology 2015-06, Vol.83 (3), p.554-563
• Main Authors: Kasari, Connie, Gulsrud, Amanda, Paparella, Tanya, Hellemann, Gerhard, Berry, Kathleen
• Format: Article
• Language: English
• Subjects: Autism; Autism Spectrum Disorder - psychology; Autism Spectrum Disorder - therapy; Autism Spectrum Disorders; Autistic Disorder - therapy; Behavior Therapy - methods; Child, Preschool; Clinical outcomes; Clinical psychology; Early Intervention; Female; Human; Humans; Infant; Male; Parent Training; Parent-Child Relations; Parental Stress; Parents - education; Preschool children; Psychoeducation; Stress; Treatment Effectiveness Evaluation; Treatment Outcome
• ISSN: 0022-006X; 1939-2117
• DOI: 10.1037/a0039080

Objective: This study compared effects of two parent-mediated interventions on joint engagement outcomes as augmentations of an early intervention program for toddlers with autism spectrum disorder (ASD). Method: Participants included 86 toddlers (range 22-36 months) with ASD and their primary caregiver. Caregiver-child dyads were randomized to receive 10 weeks of hands-on parent training in a naturalistic, developmental behavioral intervention (joint attention, symbolic play, engagement and regulation-JASPER) or a parent-only psychoeducational intervention (PEI). Dose was controlled in terms of researcher-parent contact and early intervention services received by the child. Results: Results yielded significant effects of the JASPER intervention on the primary outcome of joint engagement. The treatment effect was large (Cohen's f2 = .69) and maintained over the 6-month follow-up. JASPER effects were also found on secondary outcomes of play diversity, highest play level achieved, and generalization to the child's classroom for child-initiated joint engagement. The PEI intervention was found to be effective in reducing parenting stress associated with child characteristics. All secondary effects were generally small to moderate. Conclusions: These data highlight the benefit of a brief, targeted, parent-mediated intervention on child outcomes. Future studies may consider the combination of JASPER and PEI treatments for optimal parent and child outcomes. Trial registry no. NCT00999778. What is the public health significance of this article? To improve outcomes associated with core impairments of toddlers with ASD, this study highlights the impact of direct, hands-on parent coaching of techniques to facilitate child social development. Parents also benefit from expert-delivered educational consultation, as shown by reduced parenting stress, but this treatment is less likely to improve child outcomes.