Parent-Child Group Intervention for Young Children with ASD

Background: ASD affects approximately 1 in 68 children in the U.S., according to the Center for Diseases Control (Baxter et al., 2014). More children than ever are being diagnosed or identified as at-risk for ASD in the first years of life. Despite strong evidence for the positive impact of early intervention that begins immediately following diagnosis (Koegel et al., 2014), and despite evidence that intervention delivered in the first three years of life has higher impact on outcomes in comparison to later start (Vivanti et al., 2016), access to high quality treatment is quite limited, and this is particularly true for very young children. While we can identify early signs of ASD as early as 12 months of age, on average children with ASD in the U.S. start intervention after 3 years of age (CDC, 2016). Therefore, the majority of children miss an important developmental window shown to significantly improve children’s outcomes. Barriers preventing very early access to intervention include a continuous increase in the number of children diagnosed, as well as scarcity of specialized providers. One way of increasing access to intervention is to teach intervention strategies to parents immediately after diagnosis.

Objectives:  The aim of this project was to adapt an existing evidence based intervention, the Early Start Denver Model (ESDM) (Rogers and Dawson, 2010), to a parent-child group delivery in order to increase access to treatment in the period immediately following diagnosis, and thereby improve child outcomes.

Methods:  The Parent-Child group ESDM was delivered to 5 young children with ASD, between 24 and 48 months of age, and their caregivers. Each family participating in the study received one 1-hour session per week of the treatment, delivered in a group of 5 child -caregiver dyads, for 12 weeks. During the first portion of each session the therapist covered an ESDM teaching strategy with the caregivers, while the children played under the supervision of student research assistants. During the last portion of the session, the caregivers joined their children and practiced the ESDM teaching strategies with the coaching of the therapist.

Results: Preliminary data indicated gains in social-communication behaviors in children. Acceptability of the program was very good as indicated by retention of all participants. Moreover, results from a five-point Likert-based scale survey indicated that the caregivers agreed or strongly agreed that the program was useful and satisfying.

Conclusions: Our preliminary results suggest that the ESDM delivered in group may be useful to teach intervention skills to parents and to increase social communication in young children with ASD.