Randomized Control Trial of the Social ABCs Parent-Mediated Intervention for Toddlers with Confirmed or Suspected ASD

Background: The Social ABC’s is a parent-mediated intervention based on empirically supported Pivotal Response Treatment (PRT; Koegel & Koegel, 2006). The main targets are early (vocal/verbal) communication and positive emotion sharing between child and parent among infants/toddlers who have suspected or diagnosed ASD. Bolstered by promising pilot findings (NAME REMOVED, in press), we have now completed an RCT.

Objectives: To compare groups (treatment vs. control) on post-training and follow-up gains in: (1) child communication, (2) parent-child positive affect sharing (shared smiling), and (3) child engagement (looking at parent’s face).

Methods: 62 parent-toddler dyads were randomized into the Social ABCs(treatment) group or received treatment as usual (controls) across 2 Canadian research sites (Toronto, Halifax). Parents of toddlers aged 16 to 30 months received 8 weeks in-home, live coaching plus 4 weeks refresher and consultation, followed by 12-week parent implementation, and follow-up assessment (week 24). Video-coding occurred for 3 key time-points: Baseline (BL), Post-training (PT; week 12), and Follow-up (F-up; week 24). Positive Emotion Sharing, Social Orienting, and several indices of communication were coded at all 3 time-points. Repeated measures ANCOVAs were used to evaluate change across time-points and groups.

Results: This abstract presents findings from interim analyses (n=31-59), but full analyses will be completed in time for IMFAR. All group X time interactions favour the treatment group, including significant gains (BL vs. F-up) for Auditory Comprehension (receptive language) raw scores on the Preschool Language Scale-4, p =.023. Significant group X time interactions were obtained for several video-coded variables (see Figure 1), with medium-to-large effect sizes (ES): Responsivity (p < .001, ES = .71), Initiations (p < .001, ES = .32), Shared Smiling (p = .020) and a trend for child Social Orienting (p < .053). Parent fidelity of implementation was achieved, also with a group X time interaction in the expected direction (p < .001, ES = .73).

Conclusions: Significant gains, favouring the treatment group, were observed in children’s communication on (proximal) video-coded measures, and a standardized measure of language comprehension, as well as increased shared smiling and child social orienting to their parent. Parents attained fidelity in use of the intervention techniques after 12 weeks of parent training. The parent-training model allows for the integration of intervention into daily activities, thus enabling very early intensive intervention. Next steps involve community translation of this portable, feasible, and cost-effective intervention (underway).