A Randomized, Community-Based Feasibility Trial of Modified ESDM for Toddlers with Suspected Autism.
Pat Mirenda, Paola Colozzo, Veronica Smith and 4 others
PMID 35022943WHAT IT FOUND
Parents coaching toddlers with suspected autism improved their child's understanding of words more than standard community care.
However, there was no significant difference in the number of words children produced or in overall cognitive scores. Parent satisfaction and self-efficacy were higher in the coaching group.
Key findings
01Children in the parent coaching group showed significantly greater gains in words understood compared to the enhanced community treatment group.
02There was no significant difference between groups in the number of words produced by children or in cognitive developmental indices.
03Parents in the coaching group reported significantly higher satisfaction, self-efficacy, and quality of life scores than those in the community treatment group.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study was a feasibility trial with a small final sample (n=49), resulting in low statistical power to detect small to medium effects. The control group (ECT) received 'enhanced' services including the same educational materials as the PC group, which may have diluted the observed differences between groups. Attrition was high (36%), and the final sample was less educated and had lower incomes than the general population, limiting generalizability. Assessors were blind at baseline but not at post-intervention, introducing potential bias in outcome measurement. The study did not measure fidelity of parent implementation, so it is unclear how well parents applied the coaching strategies.
Declared interests
Funded by the Ministry of Children and Family Development, British Columbia. No other conflicts of interest were declared in the provided text.
The easy way to misread this
Do not interpret the lack of significant difference in expressive language or cognitive scores as evidence that parent coaching is ineffective. The study was underpowered due to attrition, and the control group received substantial support (materials and enhanced community services), which likely improved their outcomes and narrowed the gap between groups.