Examining an Adaptive Telehealth Intervention
Condition: Autism Spectrum Disorder
MeSH terms: Autism Spectrum Disorder
Study type: Interventional

Summary: 
      The purpose of this study is to explore the acceptability and effects of internet-based
      approaches for helping parents learn early intervention strategies (e.g., methods or tips for
      improving a child's behavior and development). As part of this study, families will be
      randomly(selected by chance like the flip of a coin) assigned to one of two different formats
      of an interactive telehealth program called Mirror Me. One format families complete on their
      own, the other involves the option to meet with a parent coach over the internet for
      feedback. The goal of the study is to understand how parents/caregivers and children benefit
      from using online programs, and to identify barriers (blocks) and facilitators (helpers) to
      this kind of service delivery model.
    

Detailed description: 
      Mirror Me is a telehealth parent training intervention that teaches parents to promote their
      child's social imitation during play and daily routines. It uses content from Reciprocal
      Imitation Training (RIT), an evidence-based NDBI that teaches social imitation within
      affect-laden playful interactions. RIT techniques include imitating the child (contingent
      imitation), modeling language, behavioral prompting, and natural reinforcement during
      child-direct activities. There is strong empirical support for the effect of individual
      techniques on imitation, joint attention, and language and RIT has been cited as one of only
      seven early intervention packages with "strong" evidence of efficacy with children < 3 with
      ASD or at risk for ASD. Because RIT focuses on a skill that emerges early in development and
      does not require language competency, it can be used with children at very young
      chronological, language, and developmental levels, making it an ideal early intervention.
      Given that RIT is meant to be used in a child's natural environment and only involves a
      handful of intervention techniques, it is well suited for delivery in a parent training
      format, with initial data supporting the effectiveness of parent training in RIT. Mirror Me
      presents intervention content in four interactive modules. Program development was guided by
      the technology acceptance model, media richness theory, and principles of instructional
      design. To ensure usability and acceptability, the investigators used an iterative
      development process with input from pilot participants. The investigators have subsequently
      upgraded the website to ensure mobile compatibility, user-friendly material, and enhanced
      assessment and monitoring capabilities. Mirror Me can be used as a standalone website or in
      combination with remote parent "coaching." Initial data indicate roughly one third to one
      half of parents learn RIT techniques from the website alone, while the rest require coaching.
      These data support the investigation of a stepped-care telehealth intervention, where parents
      use the Mirror Me website and then receive remote parent coaching, if the anticipated
      response to the program is not observed.
    

Intervention name(s): Mirror Me; Remote Coaching
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Mirror Me is a telehealth parent training intervention that teaches parents to promote their child's social imitation during play and daily routines. It uses content from Reciprocal Imitation Training (RIT), an evidence-based NDBI that teaches social imitation within affect-laden playful interactions. Mirror Me presents intervention content in four interactive modules. Program development was guided by the technology acceptance model, media richness theory, and principles of instructional design.; Trained therapists will provide feedback to parents as they use the RIT techniques with their child at home. All sessions will follow a similar format including a discussion of accomplishments and challenges, parent practice with feedback, problem solving, and planning for the next week
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment