Effects of Parent-Mediated Early Intervention on Child Behavioral Outcomes in An Underserved Population

Background:  

There has been less research on the outcomes of children from underserved populations (i.e. low socioeconomic status) enrolled in early intervention. The Early Social Interaction - Community Outreach Project (ESI-CO) was developed from the Early Social Interaction (ESI) project (Woods & Wetherby, 2003) but modified to better meet the needs of families from an underserved population. Caregivers participating in ESI-CO demonstrated an increase in the use of strategies to increase their child’s social and communication skills (Carr, Lopez, Barriger, Jeanpierre, & Lord, 2011).  Changes in child behavior, however, have not yet been analyzed. 

Objectives:  

This study investigates the effects of a parent-mediated intervention on child behavioral outcomes in children from an underserved population. In addition to standard measures such as the ADOS, Mullen, and Vineland, this study applies the use of a new measure, the Autism Diagnostic Observation Schedule –Change (ADOS-C) to assess change in child behavior across a short-term intervention.

Methods:  

Eligible families were caregivers with limited education and family income whose child received a diagnosis of ASD.  Participants were eight child-caregiver dyads who received 24 in-home treatment sessions.   Dyads were also video recorded weekly engaging in short, interactive play activities. The activities were introduced using a multiple baseline design and were either targeted or non-targeted to assess the effects of treatment. Child outcome was measured two ways:  full assessment at pre-and post-treatment and weekly coding of child-caregiver interactions.  Full assessments, including the ADOS, Mullen, and Vineland, were conducted to assess broad changes in child outcome whereas the weekly child-caregiver interactions were coded using the ADOS-C to assess subtle changes in social and communication skills over treatment.

Results:  

Paired t-test analysis yielded no significant differences between pre and post treatment assessments in ADOS, Mullen, and Vineland scores. Currently, child-caregiver interactions are being scored using the ADOS-C.  Paired t-tests and effect size calculations will be used to analyze change in child outcome from pre- to post-treatment.  A total of 96 interactions (12 per child-caregiver dyad) will be included in the final analysis. We hypothesize children will demonstrate improvements in social and communication skills as measured by the ADOS-C over the course of the intervention.  

Conclusions:  

This is one of the first investigations of a parent-mediated intervention in an underserved population.  Implications related to the design of the intervention program and use of instruments measuring social and communication skills in diverse populations will be discussed.