Intensive Intervention for Toddlers With Autism (EARLY STEPS)
Condition: Autism; Autism Spectrum Disorder
MeSH terms: Autistic Disorder; Autism Spectrum Disorder
Study type: Interventional

Summary: 
      Goals of the current project: (1) Does the Early Start Denver Model experimental intervention
      for toddlers with autism reduce disability associated with autism significantly more than
      standard community interventions?; and (2) What environmental, child, and biological
      characteristics mediate and moderate intervention response and outcomes at age 4?
    

Detailed description: 
      Thanks to the development of better diagnostic tools and a greater level of professional
      education, autism is being identified in two year olds and in even younger children, with
      such early diagnosis justified by the rationale that the earlier intervention begins, the
      better the outcomes may be. However, there are no published outcome data on intervention
      models or effectiveness for children who begin intervention by or before 24 months.
      Furthermore, some teaching procedures considered appropriate for older children, (e.g., 40
      hours per week of adult-directed intervention, much repetitive practice while sitting at a
      table (Lovaas, 2002), 1987) are considered developmentally inappropriate for toddlers
      (Sandall, McLean, & Smith, 2000).

      Dawson and Rogers have implemented a feasibility study of a intervention designed for
      toddlers with autism using a randomized controlled design. The approach involves a
      relationship-based frame to accomplish developmentally based objectives using naturalistic
      application of applied behavior analytic principles. The approach fuses the Denver Model
      (Rogers, Hall, Osaki, Reaven, & Herbison, 2000) and Pivotal Response Training (Koegel,
      Koegel, & Carter, 1999), and is delivered 1:1 for 25 or more hours per week to 24 toddlers
      with autism for a two year period. The contrast group receives standard community based
      intervention. Preliminary results demonstrate large and significant group effects after only
      12 months and considerable variability of intervention outcomes in both groups.

      All families will be referred to the appropriate community service programs, if they have not
      been referred previously.
    

Intervention name(s): Early Start Denver Model; Standard community care
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Phase 1 of ESDM intervention: 12 weekly, 1 to 1.5 hr. sessions focused on teaching & coaching parents to use the ESDM in all natural caretaking routines & play periods with their child. Parents are taught & coached on 1 aspect of the ESDM each week in the clinic session, & then practice it at home daily in natural family routines & play.
Phase 2: each child in the ESDM will receive 25 hrs. a week of ESDM intervention in their homes, 50 wks. a year, for 2 years. 20 hrs. weekly will be delivered by trained interventionists (ITs); 5 hrs. weekly will be delivered by parents. (ITs) will provide ten 2 hour teaching episodes involving play activities per week in the home. Parents will continue to deliver the ESDM in natural family routines & play activities. In addition, each child will receive additional services through public services, or other therapies that the parents may choose, for several more hrs. per week.; Treatment and interventions, chosen by families, meeting current standards of community intervention for toddlers with autism and ASD
Other intervention name(s): intensive intervention for infants and toddlers with autism and ASD; autism treatment; PDD NOS; University of California, Davis; Sally Rogers; University of Washington and early autism intervention; University of Michigan and early intervention; Current, standard community based intervention for toddlers with autism; intensive intervention for infants and toddlers with autism and ASD; autism treatment; PDD NOS; University of California, Davis; Sally Rogers; University of Washington and early autism intervention; University of Michigan and early intervention
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: autism; autism spectrum disorder; intensive intervention for toddlers with autism; PDD NOS; early steps study; early start denver model; early intervention for infants and toddlers with autism; toddler treatment; Sally Rogers; University of California, Davis; University of Michigan; MIND Institute