Characterizing mechanisms of caregiver-mediated naturalistic developmental behavioral interventions for autistic toddlers: A randomized clinical trial

To address the variability of naturalistic developmental behavioral intervention outcomes, the current study sought to isolate the effects of the instructional strategies of caregiver-mediated naturalistic developmental behavioral interventions. In this comparative efficacy trial, mothers of 111 aut...

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Bibliographic Details
Published in:Autism : the international journal of research and practice Vol. 28; no. 7; pp. 1847 - 1860
Main Authors: Jones, Maranda K, Sone, Bailey J, Grauzer, Jeffrey, Sudec, Laura, Kaat, Aaron, Roberts, Megan Y
Format: Journal Article
Language:English
Published: London, England SAGE Publications 01.07.2024
SAGE PUBLICATIONS, INC
Subjects:
Autism
Autism Spectrum Disorder - psychology
Autism Spectrum Disorder - therapy
Autistic children
Autistic Disorder - psychology
Autistic Disorder - therapy
Behavior
Behavior modification
Behavior Therapy - methods
Caregivers
Caregivers - psychology
Child, Preschool
Children
Children & youth
Clinical research
Clinical trials
Communication
Communication (Thought Transfer)
Early intervention
Early Intervention, Educational - methods
Educational Strategies
Efficacy
Female
Humans
Infant
Intervention
Language
Language assessment
Long term
Male
Mothers
Strategies
Teaching Methods
Toddlers
communication and language
autism spectrum disorders
interventions—psychosocial/behavioral
ISSN:1362-3613, 1461-7005, 1461-7005
Online Access:Get full text
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Summary:To address the variability of naturalistic developmental behavioral intervention outcomes, the current study sought to isolate the effects of the instructional strategies of caregiver-mediated naturalistic developmental behavioral interventions. In this comparative efficacy trial, mothers of 111 autistic children (18–48 months) were randomized to learn one of two sets of naturalistic developmental behavioral intervention language facilitation strategies (responsive or directive). We aimed to characterize the effect of strategy type on language outcomes and explore the extent to which joint engagement outcomes mediated language outcomes. Children in the directive condition had significantly greater scores across multiple language assessments. At follow-up, the effect of strategy type on the frequency of spontaneous directed communication acts was fully mediated by coordinated joint engagement (indirect effect = −2.070, 95% CI = [−4.394, −0.06], p < 0.05). Thus, children may benefit from caregiver prompts to facilitate long-term language outcomes. The current study is an initial step in the identification of the mechanisms of caregiver-mediated NDBIs. Lay abstract Caregiver-mediated early interventions support caregivers’ use of strategies to improve their young autistic child’s communication. In the current clinical trial, we sought to isolate the most effective strategies to improve short-term and long-term child communication outcomes. Results demonstrated how children may benefit from caregiver prompts to facilitate long-term language outcomes. In conclusion, the current study improves our understanding of how early intervention facilitates child communication outcomes.
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ISSN:1362-3613
1461-7005
1461-7005
DOI:10.1177/13623613231213283