Characterizing mechanisms of caregiver-mediated naturalistic developmental behavioral interventions for autistic toddlers: A randomized clinical trial
Year: 2023
Type: article
Study designs: Randomized Controlled Trial, Clinical Trial
Abstract: Child social communication outcomes of caregiver-mediated Naturalistic Developmental Behavioral Interventions (NDBIs) remain variable. To address variability of NDBI outcomes, the current study sought to isolate the effects of the instructional strategies of caregiver-mediated NDBIs (i.e., responsive and directive strategies). Participants included 119 autistic children (18-48 months) and their mothers. In this comparative efficacy trial, mothers were randomized to learn one of two sets of language facilitation strategies (responsive or directive). We explored the main effect of strategy type on proximal (joint engagement) and distal (language) outcomes and the extent to which proximal outcomes mediated the effect of strategy type on distal outcomes. Children in the responsive condition had a significantly greater frequency (d=0.13, 95% CI=[0.10, 0.16]) and mean length (d=.80, 95% CI=[0.40, 1.20]) of supported joint engagement states. Children in the directive condition had a significantly greater frequency of coordinated joint engagement states (d= 0.21, 95% CI=[ 0.25, 0.17]) and scores across multiple language assessments immediately after intervention and at follow-up. At follow-up the effect of strategy type on the frequency of spontaneous directed utterances was fully-mediated by coordinated joint engagement (indirect effect= 2.15, 95% CI=[ 3.785, 0.91]). The current study is an initial step in the identification of the active ingredients and mediators of early caregiver-mediated NDBIs for autistic toddlers.
Source: Autism
Institution: Northwestern University
Language: English
Subfield: Cognitive Neuroscience
Field: Neuroscience
Domain: Life Sciences
Open Access status: green
OpenAlex ID: W4389001021