Changing Developmental Trajectories of Toddlers With Autism Spectrum Disorder: Strategies for Bridging Research to Community Practice.
Amy M Wetherby, Juliann Woods, Whitney Guthrie and 6 others
PMID 30418491WHAT IT FOUND
In toddlers with autism, a parent-implemented model combining coaching, routines, communication targets, and instruction produced greater gains in engagement and communication than weekly group support.
The paper did not isolate which parts mattered.
Key findings
01Individual ESI produced greater improvement in active engagement than group ESI, with the difference apparent by 3 months.
02Greater improvement in active engagement was related to higher later scores on social communication, language, adaptive behavior, and autism social affect.
03The ESI trial reported clinician time averaging 2.46 hr per week, compared with 15.2 hr per week in the ESDM study.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
This is a review and secondary report, not the full trial report, so some methods and participant details are summarized from a separate paper. The intervention was a multi-component model, and the paper does not show which component produced the child changes. The comparison with clinician-delivered ESDM is indirect, so sample differences may explain similar effects. Parent-reported daily logs of hours were not verified. The article reports the first 9-month condition and does not present results from the cross-over period. The MAE was developed by the authors and tested in their own trial. Many other parent-implemented interventions had few sessions, short duration, or clinic-only delivery, so child outcome effects were limited.
Declared interests
No separate author conflict-of-interest statement is supplied. Funding came from NIH institutes, Autism Speaks, and the Simons Foundation. The article also stems from an ASHA convention symposium supported by NIDCD. The authors report findings from their own ESI model and trial.
The easy way to misread this
Do not conclude that parent-implemented ESI is proven better than clinician-delivered ESDM or that the claimed weekly engagement was objectively measured. The ESDM comparison was indirect, and the daily logs were parent-reported and not verified.