Effects of a Short-term Parent Mediated Social Training on Developmental Trajectories in Infants

Study Overview
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Brief Summary
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This study is being done to examine the feasibility and impact of the Infant Achievements caregiver coaching treatment on caregiver child-engagement strategies used during play with their infant. The investigators will examine effects on infants' social and communication behavior. This randomized controlled trial will compare caregivers and infants in the Infant Achievements (IA) coaching group to caregivers and infants in the Caregiver Education (CE) no-coaching group. A total of 64 eligible participants (16 children plus their caregiver per group) will participate in the study.

Detailed Description
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This study is being done to examine the feasibility and impact of the Infant Achievements caregiver coaching treatment on caregiver child-engagement strategies used during play with their infant. The investigators will examine effects on infants' social and communication behavior. This randomized controlled trial will compare caregivers and infants in the Infant Achievements (IA) coaching group to caregivers and infants in the Caregiver Education (CE) no-coaching group. A total of 64 eligible participants (16 children plus their caregiver per group) will participate in the study. Parents in the IA group will be coached, at home twice a week, to implement the intervention by trained research staff. Parents in the CE group will be taught about child development and well-being in their home, weekly, with a weekly follow-up phone call by trained research staff. In both groups: Videotaped caregiver-child interaction data will be gathered in the home. Baseline, post-treatment and follow-up measures will also be collected at the investigators' child development research center. Families with children between the ages of 8 and 12 months with developmental concerns may be eligible to participate. Developmental concerns are defined as infrequent production of specific communication or social behaviors, or in immature or qualitatively atypical forms. These concerns will be documented via the Autism Observation Scale for Infants, Communication and Symbolic Behavior Scale (CSBS) Infant-Toddler Checklist, and/or Mullen Scales of Early Learning. Recruitment will occur from the Kennedy Krieger Institute (KKI), community agencies, and community events. Recruitment flyers will be distributed within those programs. In addition, a social media blurb will be placed on the KKI and other relevant groups' Facebook pages, KKI Center for Autism and Related Disorders newsletter, KKI websites, and may be sent to relevant local newsletters/magazines for families of young children.

Official Title
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Effects of a Short-term Parent Mediated Social Training on Developmental Trajectories in Infants

Conditions
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Younger Sibling of Child With Autism Spectrum Disorder, Signs of Developmental Delay, Signs of Communication Delay, Signs of Social Delay

Intervention / Treatment
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* Behavioral: Infant Achievements
* Behavioral: Caregiver Education (CE)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Child participants must be between the ages of 8 months and 12 months at the beginning of the study. Family must speak English at least 75% in the home. Children must receive an AOSI concern score ≥7 OR a T-score of ≤39 on either the Mullen Receptive Language or Expressive Language subscale. OR Score in the Concern range on either the Composite or Total Score of the parent-completed Communication and Symbolic Behavior Scales Developmental Profile (CSBS DP) Infant-Toddler Checklist. Exclusion Criteria: History of head injury, seizure disorder, severe aggression or self-injurious behavior, prenatal illicit drug or excessive alcohol exposure. Any hearing or visual impairment Any severe birth trauma Any birth defects or genetic disorders Gestational age < 35 weeks and/or Birth weight less than 1,500g Cannot be living in foster care. Location of in-home visits >35 miles of the Center for Autism and Related Disorders

Ages Eligible for Study
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Minimum Age: 8 Months
Maximum Age: 12 Months

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Infant Achievements<br>Families randomized to the IA condition will receive 17 in-home sessions. These include a one-time start up session followed by twice-weekly visits in which they will be coached on how to implement the IA strategies. Families will receive a set of developmentally appropriate toys. | Behavioral: Infant Achievements<br>* Play-based intervention for caregivers and infants. The efficacy of the Infant Achievements intervention for improving communication and social behavior in infants who are at risk for communication, social, or developmental delay.<br>|
| Experimental: Caregiver Education<br>In this condition, parents will receive 17 sessions with a trained study team member focused on promoting child development and well-being. Sessions include a one-time start-up visit followed by one in-home visit and one phone contact per week. Families will receive a set of developmentally appropriate toys. | Behavioral: Caregiver Education (CE)<br>* Parents in the CE group will be taught about child development and well-being in their home, weekly, with a weekly follow-up phone call by trained research staff.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in parent behavior during the Parent-Child Play Sample | This measure is a natural observation of parent and child unstructured playing, and will be used to assess change in caregiver's use of child-responsive engagement strategies | Change from behavior at Baseline to behavior at 8 weeks post-baseline, and from Baseline to 8 weeks post-intervention | 
| Change in child communication and social engagement sample during the Parent-Child Play Sample | This outcome will be coded from the Parent-Child Play Sample | Change from behavior at Baseline to behavior at 8 weeks post-baseline, and from Baseline to 8 weeks post-intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in scores on the Mullen Scales of Early Learning Receptive and Expressive Language Raw Scores | Receptive Language score (score range 0-48); Expressive Language Score (score range 0-50); higher scores indicate better outcome for both scales | Change from Baseline to 8 weeks post-baseline, and from Baseline to 8 weeks post-intervention | 
| Change in scores on the MacArthur-Bates Communication Development Inventory | Number of words understood (range 0-396); Number of words produced (0-396); Total actions & gestures (0-63); higher scores indicate better outcomes for all scales | Change from Baseline to 8 weeks post-baseline, and from Baseline to 8 weeks post-intervention | 
| Change in scores on the CSBS Behavior Sample | Frequency of initiation of joint attention; frequency of communicative consonants (range 0-6), gestures (range 0-6) and words (range (0-6); higher scores indicate greater outcome on all scales | Change from Baseline to 8 weeks post-baseline, and from Baseline to 8 weeks post-intervention | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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infant, play, parents