Office of Epidemiology and Research, Division of Research

Advancing Applied MCH Research

Toddlers and Families Together: Addressing Early Core Features of Autism

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Project Number: R40 MC 26197
Grantee: UNC-CH
Department/Center: FPG Child Development Inst.
Project Date: 9/1/2013

Final Report


Principal Investigator

Connie Wong, Ph.D.
517 South Greensboro Street CB# 8040
Chapel Hill, NC  27599-8040
Phone: 919-966-9476


  • Toddlerhood (13-35 months)


Given the prevalence of 1 in 88 children along with the increase in early diagnoses of Autism Spectrum Disorders (ASD) and that those caregivers of children with ASD report greater stress than parents of children with other disabilities, it is extremely important to establish practical and evidence-based programs for toddlers with or at risk for ASD and their families. Therefore, we aim to test the efficacy of an innovative group-based model of intervention for Toddlers and Families Together to target the early core features of ASD with the overarching goal of improving maternal health and child developmental outcomes. Specific aims include: 1) examining the effects of TAFT on caregiver outcomes of stress, coping, support, and interaction style; 2) examining the effects of TAFT on children’s engagement, behavior regulation, joint attention, and play; and 3) examining caregiver and child characteristics affecting optimal treatment outcomes. With the support of Early Head Start, 96 toddlers between the ages of 16 and 36 months with or at risk for ASD (as identified with a positive screen for ASD on the ASQ:SE or MCHAT) and their families will be randomized in a 2:1 ratio to the Toddlers and Families Together (TAFT) intervention group (n=64) or a services as usual control group (n=32). The TAFT intervention content of behavior regulation, joint attention, and play will be provided to 16 groups of 4 toddlers and their families. These intervention targets will be embedded within a context of everyday routines and activities for toddlers within eight weekly 3-hour group sessions that also include a family education segment to learn, practice, and discuss the topic strategy with one facilitator while other intervention staff members engage the toddlers in various learning activities. A series of quantitative and qualitative measures are used to assess the efficacy of the intervention in changing family and child outcomes which includes the use of standardized caregiver report measures, semi-structured interviews, caregiver diaries, caregiver implementation ratings, video-recorded caregiver-child interactions, semi-structured assessments of play and joint attention, and standardized child measures of autism and early development. The research aims of the project will be evaluated using ANCOVA models with each outcome being regressed on a treatment indicator, the pre-test score, and potential moderators.




Autism, Cognitive & Linguistic Development, Early Intervention, Mental Health & Wellbeing, Parent-Child Relationship, Parenting, Social & Emotional Development, Developmental Disabilities, Special Health Care Needs

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