A Teacher Instructing Caregivers of Toddlers with Autism Spectrum Disorder How to Spontaneously Increase Words

Background:  Due to the increasingly younger age of average ASD diagnosis, there is tremendous opportunity to start intervening earlier and, thus, more dramatically improve a child’s developmental trajectory. There is growing consensus that toddlers with ASD will experience more robust cascading long-term benefits if interventions are specifically focused on ameliorating core autism deficits. The vast majority of toddlers with an Autism Spectrum Disorder (ASD) receive community Part C Early Intervention (EI) services, however these EI services rarely focus on core ASD deficits.

Objectives: This study investigated the effectiveness of a classroom teacher instructing caregivers of toddlers with ASD how to improve a central ASD impairment, the production of spontaneous words. The manualized intervention was tailored to the unique needs of each toddler with ASD and was specifically focused on improving the quantity of child spontaneous single words. The study was concerned with determining if this increase occurred immediately after the intervention concluded and at a one-month follow-up visit. Secondary goals were to determine if child social communication skills of joint attention and requesting gestures improved as a result of the intervention and whether the intervention was favorably perceived.

Methods:  A multiple-baseline across participant design was used. Three dyads (toddlers with ASD and their primary caregiver) received weekly one-hour home visits from their child’s classroom teacher.  The intervention was manualized and fidelity was high. The primary outcome measure was taped play interactions of the dyad and this measure was coded by a blinded observer.

Results: As a result of the intervention, children used more spontaneous words during play interactions with their caregiver, more joint attention, and more requesting gestures. Effects maintained for 2/3 children and the intervention was favorably perceived by all caregivers.

Conclusions: To our knowledge, this is the first pilot investigation of an ASD intervention aimed at improving a core social communication deficit that was taught to toddler caregivers through an Early Intervention teacher. Findings suggest that teachers can successfully instruct caregivers of toddlers with ASD how to improve social communication. This intervention holds promise for inexpensively increasing the focus of community Part C early intervention services on improving core ASD deficits.