Symptoms of autism significantly peak during the critical early childhood period when rapid
neurological change is occurring. For this reason one can hypothesize that early intervention may be more effective in terms of immediate impact and also more far-reaching in terms of broader aspects of optimal brain and behavioral development. In fact, recent evidence shows that timely access to high quality, early intervention is associated with positive cognitive, adaptive behavior, and language outcomes for young children with autism spectrum disorders (ASD). There is also evidence to suggest that children's access to early intervention promotes parental mental health and wellbeing. One of the critical problems early intervention must address is that socioeconomic status can serve as a barrier to families' access to high quality services. Thus, there is a pressing need to provide families and children from these communities of lower socioeconomic status with efficient access to services. This project will focus on families residing in rural communities in the state of North Carolina. Our intervention approach is based on the fundamental tenets of TEACCH, with its structured teaching intervention being widely accessible in the state; however, there is limited evidence of its effectiveness. We have adapted the structured teaching intervention and developed the Home TEACCHing Program (HTP) to be more developmentally appropriate for toddlers with ASD, and more responsive to needs of families in rural communities. HTP is a 6-month intervention that includes group-based parent education and inhome individualized coaching and feedback from a trained therapist. Our pilot data provides an initial proof-of-principle as to the potential efficacy of our modified intervention approach. The goal of this project is to evaluate the efficacy of HTP, home-based early intervention program for toddler-aged children with autism spectrum disorder and their families. The specific aims of the project are (1) determine the efficacy of the intervention on improving the developmental outcomes of toddlers with ASD, (2) determine if parental participation in the intervention is associated with improved quality of life and decrease levels of stress, and (3) examine moderators of the intervention. To accomplish the aims of this project, we will conduct a randomized controlled treatment trial. We propose to enroll 60 participants (n = 20 per year) with ASD between the ages of 18 to 35 months who will be randomly assigned to receive the supplemental HTP treatment or remain in community-based early intervention services. Following baseline assessments, children and families will be randomly assigned in blocks of six to ensure at least three parents are assigned to the HTP group at a time. Outcome data will be collected using blinded assessors and behavior coders in clinic settings. This project is designed to positively impact the early development of very young children with ASD and the well-being of their families residing in rural communities.
Rural, Parenting, Stress, Social & Emotional
Development, Cognitive & Linguistic Development, Developmental Disabilities