Intervention for Toddlers at Risk for Autism Spectrum Disorders (ASD)

March 9, 2021 updated by: Rebecca Landa, Hugo W. Moser Research Institute at Kennedy Krieger, Inc.

A Comprehensive Approach to Intervention for Toddlers at Risk for ASD

This research is being done to test the effectiveness of an early intervention model for very young children at high risk for autism spectrum disorders (ASD) and their families. If children show improvement in this intervention, the investigators hope that the availability of public services of this type will be increased. Children between 11 months and 21 months old with Autism Spectrum Disorders, or with social and communication delays that indicate high risk for Autism Spectrum Disorders, and their parents may join the study. Treatment must start prior to the second birthday.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

49

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • Maryland
      • Baltimore, Maryland, United States, 21211
        • Kennedy Krieger Institute

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

11 months to 1 year (Child)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Children will be ascertained between 11 months and 21 months of age
  • Must be able to enter the study prior to their second birthday
  • Must then pass an eligibility assessment to determine whether the child meets criteria for ASD and thus qualifies for the study. This assessment will consist of the Baby ADOS and the Mullen Scales of Early Learning. Children must meet criteria for ASD or autism on the ADOS, score more than one standard deviation below the mean on the Receptive or Expressive Language scale of the MSEL, and have a clinical judgment of ASD to be eligible for enrollment into treatment.
  • Parents must agree to participate in the study and commit to having their child participate in the intervention to which they are randomized for 6 months
  • The parent (or other primary caregiver, such as grandparent) in the Parent Enrichment/Training condition must agree to attend the training sessions

Exclusion Criteria:

  • Fail hearing or vision screening (by pediatrician's office, audiologist, or ophthalmologist)
  • Family's first language being other than English (language measures are normed on English speakers, putting non-English speakers at a disadvantage. In addition, the treatment is delivered in English. Children from non-English speaking homes may not make progress, but for reasons other than the efficacy of the intervention.)
  • Head injury (because this may cause some of the symptoms, which may not be due to autism and therefore we would not be able to assess the effects of the intervention on autism)
  • Identified reason for the autism (e.g., fragile X syndrome, Rett syndrome, Tuberous Sclerosis)
  • Inability of the family to attend the playgroup sessions and parent trainings
  • Parents whose hearing or vision is not within normal limits after correction (e.g., hearing aid, glasses)
  • Parents with developmental delays, language or learning impairments, or a psychiatric diagnosis IF the impairment would interfere with parent training (PI will assess on a case by case basis by talking to the parent)
  • Foster children
  • Refusal to allow videotaping of the children's assessments or intervention or to allow videotaped footage to be used for teaching purposes.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Playgroup and Parent Training
  1. One to two-hour individual therapeutic sessions with parent training in the home or clinic, 1x every week over six months;
  2. parent training/enrichment once a week in our clinic for 20 sessions at 1-2 hours;
  3. a playgroup session for 1-2 hours 2x week for 6 months in our clinic and
  4. Community treatment as usual.
Behavioral: Playgroup
The playgroup will be conducted at our center and focuses on providing an invigorating learning environment in which emerging skills/knowledge are skillfully brought to a higher level of maturity, integrated with existing abilities, and used functionally. Learning with and through peers, provides the opportunity to address abnormal peer relationships for developmental level. Providing an enriched environment with toys, structured learning, and opportunities for ongoing engagement we offer the children experiences that they would not otherwise have. Parent training sessions will focus on strategies aimed at improving child social engagement and communication. Parent education sessions will focus on topics related to autism, learning styles, interventions, and resources.
Behavioral: Parent Training
The 1-2 hour individual therapeutic sessions with parent training in the home or clinic (1x every week over six months) are based on our own program which is in development. This program focuses on teaching parents how to encourage social and communication skills in their toddlers and also provides comprehensive information about development. Sessions will focus on knowledge of autism, current access to services, general knowledge of strategies used to facilitate child development, advocacy, knowledge of how to access services, and coping strategies.
Other Names:
  • Enrichment Sessions
Behavioral: Parent Training
In the once-a-week 1 to 2 hour parent training/enrichment, we will ask parents to target specific play and care routines in which they may stimulate their child's development in the ways identified by the therapist. These stimulation times may be provided by the parents, other family members, friends, volunteers or hired assistants. Parents will be encouraged to have their child in direct skill-enhancing engagement for 1-2 hour per day. The therapist will work with the family to identify times during the day that best lend themselves to accomplishing this goal.
Other Names:
  • Individual Therapeutic Sessions
Active Comparator: Parent Training
  1. Parent enrichment sessions once a week for 20 sessions (for 1-2 hours)
  2. Community treatment as usual.
Behavioral: Parent Training
The 1-2 hour individual therapeutic sessions with parent training in the home or clinic (1x every week over six months) are based on our own program which is in development. This program focuses on teaching parents how to encourage social and communication skills in their toddlers and also provides comprehensive information about development. Sessions will focus on knowledge of autism, current access to services, general knowledge of strategies used to facilitate child development, advocacy, knowledge of how to access services, and coping strategies.
Other Names:
  • Enrichment Sessions
Behavioral: Parent Training
In the once-a-week 1 to 2 hour parent training/enrichment, we will ask parents to target specific play and care routines in which they may stimulate their child's development in the ways identified by the therapist. These stimulation times may be provided by the parents, other family members, friends, volunteers or hired assistants. Parents will be encouraged to have their child in direct skill-enhancing engagement for 1-2 hour per day. The therapist will work with the family to identify times during the day that best lend themselves to accomplishing this goal.
Other Names:
  • Individual Therapeutic Sessions

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Developmental Level
Time Frame: 3 months into treatment, 6 months into treatment, and 6 months after treatment ends
Using the Mullen Scales of Early Learning to assess.
3 months into treatment, 6 months into treatment, and 6 months after treatment ends

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Communication
Time Frame: 3 months after treatment starts
Using Communication and Symbolic Behavior Scales to assess.
3 months after treatment starts
Communication
Time Frame: 6 months into treatment
Using Communication and Symbolic Behavior Scales to assess.
6 months into treatment
Communication
Time Frame: 6 months after treatment ends
Using Communication and Symbolic Behavior Scales to assess.
6 months after treatment ends
Presence and Severity of Autism
Time Frame: 3 months after treatment starts
Using Autism Diagnostic Observation Schedule to assess.
3 months after treatment starts
Presence and Severity of Autism
Time Frame: 6 months into treatment
Using Autism Diagnostic Observation Schedule to assess.
6 months into treatment
Presence and Severity of Autism
Time Frame: 6 months after treatment ends
Using Autism Diagnostic Observation Schedule to assess.
6 months after treatment ends

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Hugo W. Moser Research Institute at Kennedy Krieger, Inc.

Collaborators

Autism Speaks

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

January 1, 2008

Primary Completion (Actual)

December 1, 2011

Study Completion (Actual)

December 1, 2011

Study Registration Dates

First Submitted

July 21, 2010

First Submitted That Met QC Criteria

August 10, 2010

First Posted (Estimate)

August 11, 2010

Study Record Updates

Last Update Posted (Actual)

March 10, 2021

Last Update Submitted That Met QC Criteria

March 9, 2021

Last Verified

March 1, 2021

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • NA_00006553

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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