Effectiveness Trial of Mobile ESI for Toddlers With Autism Identified by Early Screening in Primary Care

Description

The goal of this collaborative R01 is to demonstrate the therapeutic value and community-wide implementability of an early intervention (EI) platform for toddlers with autism spectrum disorder (ASD) that is completely virtual, from recruitment through intervention. This platform-Early Social Interaction Mobile Coaching (ESI-MC) deploys individual telehealth sessions with coaching and feedback to help families embed intervention in everyday activities. Specifically, the investigators will conduct an effectiveness trial of ESI-MC to address the important question of whether starting evidence-based intervention earlier leads to better outcomes than starting later. The investigators will address this question by using a modified stepped wedge design and blended implementation research to analyze data obtained with ESI-MC start at 18, 24, or 30 months. The investigators will diagnostically ascertain 240 children from a pool of 360 18-month-olds with early signs of autism, 30 in each of 8 US regions (Central and SW Florida; Atlanta, GA; suburbs of Philadelphia, PA; New York City, NY; Cincinnati, OH; Chicago, IL; Seattle, WA; and Los Angeles, CA). Research participants will be recruited using a new virtual platform-My Baby Navigator-linking a new surveillance and screening tool, an app to upload video-recorded home observations and telehealth intervention sessions, and a package of educational resources. The 240 children will be randomly assigned to one of three ESI-MC timing groups. ESI-MC will be delivered by community-based early intervention providers (EIPs) currently working within the the early intervention system in the recruitment regions. The investigators will measure child active engagement and social communication change every 6 months as the primary outcome variables. Outcome measures of developmental level, autism symptoms, and adaptive behavior will be examined to measure differential treatment effects. Maximizing the use of mobile technology, ESI-MC offers the prospect of a community-viable, scalable and sustainable treatment to improve EI services for toddlers with ASD, particularly among minority and low-resource communities.

Conditions

Autism Spectrum Disorder

Study Overview

Study Details

Study overview

The goal of this collaborative R01 is to demonstrate the therapeutic value and community-wide implementability of an early intervention (EI) platform for toddlers with autism spectrum disorder (ASD) that is completely virtual, from recruitment through intervention. This platform-Early Social Interaction Mobile Coaching (ESI-MC) deploys individual telehealth sessions with coaching and feedback to help families embed intervention in everyday activities. Specifically, the investigators will conduct an effectiveness trial of ESI-MC to address the important question of whether starting evidence-based intervention earlier leads to better outcomes than starting later. The investigators will address this question by using a modified stepped wedge design and blended implementation research to analyze data obtained with ESI-MC start at 18, 24, or 30 months. The investigators will diagnostically ascertain 240 children from a pool of 360 18-month-olds with early signs of autism, 30 in each of 8 US regions (Central and SW Florida; Atlanta, GA; suburbs of Philadelphia, PA; New York City, NY; Cincinnati, OH; Chicago, IL; Seattle, WA; and Los Angeles, CA). Research participants will be recruited using a new virtual platform-My Baby Navigator-linking a new surveillance and screening tool, an app to upload video-recorded home observations and telehealth intervention sessions, and a package of educational resources. The 240 children will be randomly assigned to one of three ESI-MC timing groups. ESI-MC will be delivered by community-based early intervention providers (EIPs) currently working within the the early intervention system in the recruitment regions. The investigators will measure child active engagement and social communication change every 6 months as the primary outcome variables. Outcome measures of developmental level, autism symptoms, and adaptive behavior will be examined to measure differential treatment effects. Maximizing the use of mobile technology, ESI-MC offers the prospect of a community-viable, scalable and sustainable treatment to improve EI services for toddlers with ASD, particularly among minority and low-resource communities.

Effectiveness Trial of the Early Social Interaction (ESI) Model Using Mobile Technology for Toddlers With Autism Identified From Early Screening in Primary Care

Effectiveness Trial of Mobile ESI for Toddlers With Autism Identified by Early Screening in Primary Care

Condition
Autism Spectrum Disorder
Intervention / Treatment

-

Contacts and Locations

Los Angeles

University of California Los Angeles, Los Angeles, California, United States, 90095

Tallahassee

Florida State University Autism Institute, Tallahassee, Florida, United States, 32309

Atlanta

Emory University, Atlanta, Georgia, United States, 30329

Chicago

Rush University, Chicago, Illinois, United States, 60612

White Plains

Weill Cornell Medical College, White Plains, New York, United States, 10605

Cincinnati

Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States, 45229

Philadelphia

Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States, 19149

Seattle

Seattle Children's Hospital, Seattle, Washington, United States, 98145

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

For general information about clinical research, read Learn About Studies.

Eligibility Criteria

  • * Parent(s) complete the SoCo CheckUp by the time the child is 18 months of age and results will indicate positive risk for autism
  • * Parent(s) submit a home observation video of the parent engaging their child for an hour in 6 everyday activities by the time the child is 18 months of age
  • * Results of the SORF rated from the home observation indicate risk for autism
  • * The child receives a clinical best estimate diagnosis of autism spectrum disorder based on a diagnostic and developmental evaluation by 18 months (+/-2 months) of age, which includes completion of the ADOS
  • * The child will have sufficient trunk stability and control of arm and hand movements to hold objects and make simple gestures (give, show, reach)
  • * Parent(s) agree to be in the intervention study by the time the child is 18 months (+/- 2 months) of age
  • * The primary language at home is English or Spanish (the SoCo CheckUp and all Baby Navigator tools are available in these languages)
  • * The family lives within 45 miles of one of the 8 recruitment sites.
  • * Child does not meet diagnostic criteria for autism
  • * Family does not agree to be video recorded
  • * Family does not agree to receive the intervention via mobile technology
  • * Enrollment in EI at the time of screening
  • * A sibling is already enrolled in the trial
  • * Children with significant motor, visual, or hearing impairments
  • * Children born with very low birth weight or significant medical complications (e.g., seizure disorder)

Ages Eligible for Study

15 Months to 20 Months

Sexes Eligible for Study

ALL

Accepts Healthy Volunteers

Yes

Collaborators and Investigators

Florida State University,

Amy Wetherby, PhD, PRINCIPAL_INVESTIGATOR, Florida State University

Study Record Dates

2027-09-30