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Empower EI: Comparação de Abordagens de Intervenção Precoce para Melhorar a Comunicação em Crianças com Atrasos no Desenvolvimento

16 de outubro de 2026 atualizado por: Megan Roberts, Northwestern University

This study is testing three ways to deliver Early Intervention (EI) services for toddlers with developmental disabilities (DD).

Children enrolled in EI speech therapy will receive one of three approaches:

  1. Therapist Delivered EI: For 28 weeks, the child's speech therapist will work directly with the child to support their communication.
  2. Caregiver Coaching EI: For 28 weeks, the child's speech therapist will coach the caregiver on how to support their child's communication.
  3. Combined EI Approach + Parent-Led Education Program: For 14 weeks, the caregiver will take part in a parent-led education program while the speech therapist works directly with the child to support their communication. During the next 14 weeks, the speech therapist will coach the caregiver on how to support their child's communication.

The goal of this study is to identify which approaches are most effective so that all families can benefit fully from EI services.

Visão geral do estudo

Status

Recrutamento

Condições

Intervenção / Tratamento

Descrição detalhada

High-quality Early Intervention (EI) during the first three years of life, a period of heightened neuroplasticity, is critical to improving outcomes for children with developmental disabilities (DD). There are two EI approaches that may be effective for supporting child communication and improving family outcomes: 1) caregiver coaching, in which the EI therapist teaches the caregiver strategies to help their child's communication, and 2) caregiver psychoeducation, in which a peer mentor teaches the caregiver about skills and resources that are helpful in supporting their child and family.

The aim of the current clinical trial is to determine which EI approaches are most effective, for which families, and why they are effective. This clinical trial also aims to investigate how therapists are delivering the interventions and to characterize the acceptability and feasibility of these interventions for use in real-world settings.

A total of 1,269 toddlers (approximately equal numbers of Black, Latine, and white children) will be enrolled across community-based EI sites. Families will be directly recruited from participating EI therapists' existing caseloads. Caregiver-child dyads will be randomly assigned to one of three groups:

  1. Therapist Delivered EI: For 28 weeks, the child's speech therapist will work directly with the child to support their communication.
  2. Caregiver Coaching EI: For 28 weeks, the child's speech therapist will coach the caregiver on how to support their child's communication.
  3. Combined EI Approach + Parents Taking Action: For 14 weeks, the caregiver will take part in a parent-led education program (Parents Taking Action) while the speech therapist works directly with the child to support their communication. During the next 14 weeks, the speech therapist will coach the caregiver on how to support their child's communication.

Outcomes will assess both caregiver and child domains, including caregiver use of responsive strategies, caregiver capacity to support the child's needs, and child social communication. The study will also examine moderators (e.g., race) and mediators (e.g., caregiver use of responsive strategies) to identify for whom and why each approach is most effective.

A process evaluation will assess implementation fidelity (quality, dosage, adaptations) and explore how fidelity influences effectiveness outcomes. Feasibility, acceptability, and appropriateness of each approach will be evaluated through surveys and interviews with caregivers and EI therapists.

This study is among the first large-scale comparative effectiveness trials of early intervention approaches conducted in real-world EI settings. Findings will inform EI practices and guide caregivers, therapists, and policymakers in selecting interventions that best meet the needs and preferences of diverse families.

Tipo de estudo

Intervencional

Inscrição (Estimado)

1269

Estágio

  • Não aplicável

Contactos e Locais

Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.

Contato de estudo

Locais de estudo

    • Illinois
      • Evanston, Illinois, Estados Unidos, 60201
        • Recrutamento
        • Northwestern University
        • Investigador principal:
          • Megan Roberts, PhD
        • Contato:

Critérios de participação

Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.

Critérios de elegibilidade

Idades elegíveis para estudo

1 ano a 2 anos (Filho)

Aceita Voluntários Saudáveis

Não

Gêneros Elegíveis para o Estudo

Tudo

Descrição

Child Inclusion Criteria:

  • At least 12 months old
  • Functional communication skills at an age equivalent of at least 6 months
  • At least 7 months of Early Intervention (EI) service eligibility remaining
  • Enrolled in the Illinois EI system and is new to the speech-language pathologist's (SLP's) caseload (i.e., no prior EI speech-language therapy experience with the SLP)
  • Plans to receive one hour of speech-language therapy per week in the home or in a private space outside of the home

Child Exclusion Criteria:

- Exposed to a language other than English or Spanish more than 10% of the time

Caregiver Inclusion Criteria:

  • The child's parent, legal guardian, or other family member
  • Self-identifies as Black, Latine (Hispanic), or white
  • Available to participate in weekly EI sessions and study assessments

Caregiver Exclusion Criteria

  • Younger than 18 years old at enrollment
  • Uses a language other than English or Spanish during their interactions with the child more than 10% of the time

Plano de estudo

Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.

Como o estudo é projetado?

Detalhes do projeto

  • Finalidade Principal: Tratamento
  • Alocação: Randomizado
  • Modelo Intervencional: Atribuição Paralela
  • Mascaramento: Dobro

Armas e Intervenções

Grupo de Participantes / Braço
Intervenção / Tratamento
Comparador Ativo: Therapist-Delivered Early Intervention Approach

For 28 weeks, this arm will receive the therapist-delivered early intervention approach.

The therapist-delivered early intervention approach will occur during the child's weekly, hour-long early intervention (EI) sessions. During the sessions, the child's EI speech-language pathologist (SLP) will use responsive strategies directly with the child. Responsive strategies focus on noticing the child's communication and responding with language related to their focus of attention. The SLP will not coach the caregiver during the sessions.

Experimental: Caregiver Coaching Early Intervention Approach

For 28 weeks, this arm will receive the caregiver coaching early intervention approach.

The caregiver-coaching early intervention approach will occur during the child's weekly, hour-long early intervention (EI) sessions. During the sessions, the child's EI speech-language pathologist (SLP) will coach the caregiver to use responsive strategies with their child. Responsive strategies focus on noticing the child's communication and responding with language related to their focus of attention.

Experimental: Combined Early Intervention Approach + Parents Taking Action

For the first 14 weeks, this arm will receive the therapist-delivered early intervention as well as Parents Taking Action. For the following 14 weeks, this arm will receive the caregiver coaching early intervention approach.

The therapist-delivered early intervention approach will occur during the child's weekly, hour-long early intervention (EI) sessions. During the sessions, the child's EI speech-language pathologist (SLP) will use responsive strategies directly with the child. Responsive strategies focus on noticing the child's communication and responding with language related to their focus of attention. The SLP will not coach the caregiver during the sessions.

The caregiver-coaching early intervention approach will occur during the child's weekly, hour-long early intervention (EI) sessions. During the sessions, the child's EI speech-language pathologist (SLP) will coach the caregiver to use responsive strategies with their child. Responsive strategies focus on noticing the child's communication and responding with language related to their focus of attention.

Parents Taking Action (PTA) will be delivered during weekly, one-hour virtual sessions with the caregiver, separate from the child's early intervention (EI) sessions. PTA is a psychoeducation program implemented by a peer mentor (i.e., a culturally-matched caregiver of a child with a developmental disability). During the sessions, the peer mentor will provide information and guidance on a range of topics (e.g., child development, early intervention systems, special education rights/resources, and advocacy) following a structured curriculum.

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Descrição da medida
Prazo
Responsive Strategy Use (RSU) Rating Scale
Prazo: Week 14, Week 28

The Responsive Strategy Use (RSU) Rating Scale will be used to measure caregivers' use of responsive strategies during a naturalistic, caregiver-child interaction. Items on the RSU Rating Scale are rated on a 4-point Likert Scale (0 = Rarely/Never, 3 = Consistently) and averaged to yield the RSU Total Score (Min = 0, Max = 3), with higher scores reflecting a higher frequency of responsive strategy use.

Week 14, Week 28
Family Outcomes Survey - Revised
Prazo: Week 14, Week 28

The Family Outcomes Survey-Revised is a 24-item informant-report questionnaire that assesses caregivers' understanding, confidence, and ability to support their child's needs. The Family Outcomes Total Score (Min = 24, Max = 120) reflects the caregiver's capacity to support their child's needs, with higher scores indicating greater capacity.

Week 14, Week 28
Communication and Symbolic Behavior Scales - Developmental Profile (CSBS-DP)
Prazo: Week 28

The Communication and Symbolic Behavior Scales - Developmental Profile (CSBS-DP) is a structured, norm-referenced, observational measure of child communication. The assessment is scored for 20 items across 7 domains (i.e., Emotion and Eye Gaze, Communication, Gestures, Sounds, Words, Understanding, Object Use). The weighted raw scores for each of the 7 domains are grouped into 3 clusters (social, speech, and symbolic) and combined into a total raw score (min = 0; max = 113). Higher scores indicate better skills.

Week 28

Medidas de resultados secundários

Medida de resultado
Descrição da medida
Prazo
Session Attendance
Prazo: Week 1 to Week 28

Session attendance will be documented in weekly session logs completed by interventionists and summarized as the percentage of planned intervention sessions attended by each family (Min = 0%, Max = 100%).

Week 1 to Week 28
Intervention Fidelity Checklist
Prazo: Week 1 to Week 28

The Intervention Fidelity Checklist is a rating scale assessing adherence to the intervention protocol. Items on the checklist correspond to the core elements of the respective intervention protocol and are scored based on specific behavioral criteria. The Intervention Fidelity Checklist will be scored on a randomly selected 20% of intervention sessions per participant. Scores will be averaged across sessions to yield an average intervention quality score (Min = 0, Max = 100), with higher scores indicating higher intervention quality.

Week 1 to Week 28
Framework for Reporting Adaptations and Modifications (FRAME)
Prazo: Week 1 to Week 28

The Framework for Reporting Adaptations and Modifications (FRAME) will be used to document intervention adaptations. Adaptations will be documented through intervention session logs and direct observations of intervention sessions. These data will yield the total number of adaptations (Min = 0, Max = NA).

Week 1 to Week 28

Outras medidas de resultado

Medida de resultado
Descrição da medida
Prazo
Early Intervention Program Satisfaction Scale
Prazo: Week 14, Week 28

An adapted version of the Early Intervention Program Satisfaction Scale, a caregiver-report questionnaire, will be used to assess caregiver satisfaction. This survey includes 6 items rated on a 5-point Likert (1 = Very Dissatisfied, 5 = Very Satisfied). The Total Score (Min = 6, Max = 30) reflects caregivers' overall satisfaction with the intervention, with higher scores representing greater satisfaction.

Week 14, Week 28

Colaboradores e Investigadores

É aqui que você encontrará pessoas e organizações envolvidas com este estudo.

Patrocinador

Colaboradores

Investigadores

  • Investigador principal: Megan Roberts, PhD, Northwestern University

Datas de registro do estudo

Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados ​​pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.

Datas Principais do Estudo

Início do estudo (Real)

16 de fevereiro de 2026

Conclusão Primária (Estimado)

1 de março de 2030

Conclusão do estudo (Estimado)

1 de junho de 2030

Datas de inscrição no estudo

Enviado pela primeira vez

11 de novembro de 2025

Enviado pela primeira vez que atendeu aos critérios de CQ

11 de novembro de 2025

Primeira postagem (Real)

13 de novembro de 2025

Atualizações de registro de estudo

Última Atualização Postada (Real)

21 de outubro de 2026

Última atualização enviada que atendeu aos critérios de controle de qualidade

16 de outubro de 2026

Última verificação

1 de outubro de 2026

Mais Informações

Termos relacionados a este estudo

Outros números de identificação do estudo

  • BPS-2024C1-38924

Plano para dados de participantes individuais (IPD)

Planeja compartilhar dados de participantes individuais (IPD)?

SIM

Descrição do plano IPD

De-identified individual participant data (IPD) that underlie the results reported in any publication arising from this trial will be made publicly available via the Dryad repository. The shared dataset will include all variables necessary to reproduce the published findings, including treatment assignment, participant demographics, baseline characteristics, and outcome measures. All data will be de-identified in accordance with HIPAA standards and institutional policies to protect participant confidentiality.

Data will be uploaded to Dryad after publication of the primary results, and will be freely accessible to qualified researchers without restriction. A corresponding DOI will be provided in publications to facilitate data access and citation.

Prazo de Compartilhamento de IPD

Data will be uploaded to the Dryad data repository on November 1st, 2030 and remain there indefinitely.

Critérios de acesso de compartilhamento IPD

De-identified individual participant data (IPD) and supporting documentation (e.g., data dictionaries, survey instruments, codebooks) will be publicly available to any researcher or member of the public. All data will be uploaded to the Dryad Digital Repository, where users can freely access and download the datasets. No special request or application will be required to access the IPD. The data will be shared in a de-identified format to protect participant privacy, and users will be able to access the IPD along with associated documentation necessary to understand and use the data for secondary analyses or replication studies.

Tipo de informação de suporte de compartilhamento de IPD

  • ANALYTIC_CODE

Informações sobre medicamentos e dispositivos, documentos de estudo

Estuda um medicamento regulamentado pela FDA dos EUA

Não

Estuda um produto de dispositivo regulamentado pela FDA dos EUA

Não

Essas informações foram obtidas diretamente do site clinicaltrials.gov sem nenhuma alteração. Se você tiver alguma solicitação para alterar, remover ou atualizar os detalhes do seu estudo, entre em contato com register@clinicaltrials.gov. Assim que uma alteração for implementada em clinicaltrials.gov, ela também será atualizada automaticamente em nosso site .