Factors associated with enrollment into a clinical trial of caregiver-implemented intervention for infants at risk for autism spectrum disorder.
Jessica Bradshaw, Ashley Trumbull, Jennifer Stapel-Wax and 8 others
PMID 32594763WHAT IT FOUND
Families invited to a clinic-based caregiver intervention trial for 12-month-olds were less likely to enroll when mothers worked full time, household income was $60,000-$100,000, or they lived more than 30 miles away.
Infants with higher communication scores were also less likely to enroll.
Key findings
01Among 57 eligible families invited to enroll, 32 enrolled and 25 declined.
02Full-time maternal work was associated with 71% lower odds of enrolling. Household income of $60,000-$100,000 was associated with 85% lower odds than income under $60,000. Living more than 30 miles from the clinic was associated with 88% lower odds than living under 10 miles.
03Higher infant Vineland Communication standard scores were associated with lower odds of enrolling. Enrolled infants averaged 88.1 on this scale, compared with 96.6 for infants who did not enroll. Each one-point higher score was associated with 5% lower odds.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs
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What it does not show
Only 57 eligible families were analyzed, so some factors may have been missed because the sample was small. Most eligible infants were high-risk siblings (47 of 57), so the results may not apply to all infants with red flags. The study did not ask parents directly why they declined, did not measure parental attitudes, and did not measure parental stress or older sibling treatment history. The study did not know whether families who declined sought community early intervention services. It examined enrollment only, not intervention outcomes, and the researchers remained masked to treatment condition. The income finding was not linear: middle-income families had lower odds, but highest-income families did not differ significantly from lowest-income families. The study did not measure parental buy-in, so explanations about burden and consensus are hypotheses.
Declared interests
No conflicts of interest or funding declaration is included in the supplied text. The publication types indicate NIH extramural and non-U.S. government research support.
The easy way to misread this
Do not read this as evidence that caregiver-implemented intervention works or does not work. It only examined which families enrolled in a trial, not child outcomes, and the researchers did not analyze treatment condition.