Abstract
This study examined the effects of an intervention to support parents and promote skill development in newly diagnosed toddlers with ASD. Participants included 50 children with ASD under 3 and their parents who were randomly assigned to participate in a 6-month intervention, Family Implemented TEACCH for Toddlers (FITT) or 6 months of community services as usual. FITT included 90-min in-home sessions (n = 20) and parent group sessions (n = 4). Results revealed significant treatment effects on parent stress and well-being, with families in the FITT group showing decreased stress and improved well-being over time. While no treatment effects were found for global child measures, there were significant treatment effects on social communication skills.
Similar content being viewed by others
References
Abidin, R. R. (1995). Parenting stress index (3rd ed.). Odessa, FL: Psychological Assessment Resource.
Baker-Ericzén, M. J., Brookman-Frazee, L., & Stahmer, A. (2005). Stress levels and adaptability in parents of toddlers with and without autism spectrum disorders. Research and Practice for Persons with Severe Disabilities, 30(4), 194–204. doi:10.2511/rpsd.30.4.194.
Beck, A., Hastings, R. P., Daley, D., & Stevenson, J. (2004). Pro-social behaviour and behaviour problems independently predict maternal stress. Journal of Intellectual and Developmental Disability, 29(4), 339–349.
Boyd, B. A. (2002). Examining the relationship between stress and lack of social support in mothers of children with autism. Focus on Autism and Other Developmental Disabilities, 17(4), 208–215. doi:10.1177/10883576020170040301.
Brereton, A., & Tonge, B. J. (2005). Preschoolers with autism: An education and skills training programme for parents. London: Jessica Kingsley Publishers.
Carr, T., Shih, W., Lawton, K., Lord, C., King, B., & Kasari, C. (2015). The relationship between treatment attendance, adherence, and outcome in a caregiver-mediated intervention for low-resourced families of young children with autism spectrum disorder. Autism. doi:10.1177/1362361315598634.
Carter, A. S., de Martínez-Pedraza, F. L., & Gray, S. A. O. (2009). Stability and individual change in depressive symptoms among mothers raising young children with ASD: Maternal and child correlates. Journal of Clinical Psychology, 65(12), 1270–1280. doi:10.1002/jclp.20634.
Carter, A. S., Messinger, D. S., Stone, W. L., Celimli, S., Nahmias, A. S., & Yoder, P. (2011). A randomized controlled trial of Hanen’s ‘More Than Words’ in toddlers with early autism symptoms. Journal of Child Psychology and Psychiatry, 52(7), 741–752. doi:10.1111/j.1469-7610.2011.02395.x.
Contopoulos-Ioannidis, D. G., Karvouni, A., Kouri, I., & Ioannidis, J. P. A. (2009). Reporting and interpretation of SF-36 outcomes in randomised trials: Systematic review. British Medical Journal, 338(7687), 1–8. doi:10.1136/bmj.a3006.
Cripe, J. W., & Venn, M. L. (1997). Family-guided routines for early intervention services. Young Exceptional Children, 1(1), 18–26.
Estes, A., Munson, J., Rogers, S. J., Greenson, J., Winter, J., & Dawson, G. (2015). Long-term outcomes of early intervention in 6-year-old children with autism spectrum disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 54(7), 580–587. doi:10.1016/j.jaac.2015.04.005.
Estes, A., Vismara, L., Mercado, C., Fitzpatrick, A., Elder, L., Greenson, J., & Rogers, S. (2014). The impact of parent-delivered intervention on parents of very young children with autism. Journal of Autism and Developmental Disorders, 44(2), 353–365. doi:10.1007/s10803-013-1874-z.
Green, J., Charman, T., McConachie, H., Aldred, C., Slonims, V., Howlin, P., & Pickles, A. (2010). Parent-mediated communication-focused treatment in children with autism (PACT): A randomised controlled trial. Lancet, 375(9732), 2152–2160. doi:10.1016/S0140-6736(10)60587-9.
Hutman, T., Siller, M., & Sigman, M. (2009). Mothers’ narratives regarding their child with autism predict maternal synchronous behavior during play. Journal of Child Psychology and Psychiatry, 50(10), 1255–1263.
Ingersoll, B. (2012). Effect of a focused imitation intervention on social functioning in children with autism. Journal of Autism and Developmental Disorders, 42(8), 1768–1773. doi:10.1007/s10803-011-1423-6.
Kasari, C., Gulsrud, A., Paparella, T., Hellemann, G., & Berry, K. (2015). Randomized comparative efficacy study of parent-mediated interventions for toddlers with autism. Journal of Consulting and Clinical Psychology, 83(3), 554–563. doi:10.1037/a0039080.
Kasari, C., Gulsrud, A. C., Wong, C., Kwon, S., & Locke, J. (2010). Randomized controlled caregiver mediated joint engagement intervention for toddlers with autism. Journal of Autism and Developmental Disorders, 40(9), 1045–1056. doi:10.1007/s10803-010-0955-5.
Lecavalier, L., Leone, S., & Wiltz, J. (2006). The impact of behaviour problems on caregiver stress in young people with autism spectrum disorders. Journal of Intellectual Disability Research, 50(3), 172–183.
Lord, C., Rutter, M., DiLavore, P. C., Risi, S., Gotham, K., & Bishop, S. L. (2012). Autism diagnostic observation schedule, 2nd edition (ADOS-2) manual (Part I): Modules 1–4. Torrence, CA: Western Psychological Service.
Mancil, G. R., Conroy, M. A., & Haydon, T. F. (2009). Effects of a modified milieu therapy intervention on the social communicative behaviors of young children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 39(1), 149–163. doi:10.1007/s10803-008-0613-3.
McGee, G. G., Morrier, M. J., & Daly, T. (1999). An incidental teaching approach to early intervention for toddlers with autism. Journal of the Association for Persons with Severe Handicaps, 24(3), 133–146. doi:10.2511/rpsd.24.3.133.
Moh, T. A., & Magiati, I. (2012). Factors associated with parental stress and satisfaction during the process of diagnosis of children with Autism Spectrum Disorders. Research in Autism Spectrum Disorders, 6(1), 293–303. doi:10.1016/j.rasd.2011.05.011.
Mullen, E. M. (1995). Mullen scales of early learning: AGS edition. Circle Pines, MN: American Guidance Service.
Murphy, N. A., Christian, B., Caplin, D. A., & Young, P. C. (2007). The health of caregivers for children with disabilities: Caregiver perspectives. Child: Care, Health and Development, 33(2), 180–187. doi:10.1111/j.1365-2214.2006.00644.x.
National Research Council. (2001). Educating children with autism. Committee on Educational Interventions for Children with Autism. In C. Lord & J. P. McGee (Eds.). Washington, DC: National Academy Press.
North Carolina Rural Center. (2016). The Rural Center. Retrieved from http://www.ncruralcenter.org/.
Oono, I. P., Honey, E. J., & McConachie, H. (2013). Parent-mediated early intervention for young children with autism spectrum disorders (ASD). Cochrane Database Systematic Reviews, 4, CD009774. doi:10.1002/14651858.CD009774.pub2.
Osborne, L. A., McHugh, L., Saunders, J., & Reed, P. (2008). Parenting stress reduces the effectiveness of early teaching interventions for autistic spectrum disorders. Journal of Autism and Developmental Disorders, 38(6), 1092–1103. doi:10.1007/s10803-007-0497-7.
Osborne, L. A., & Reed, P. (2008). Parents’ perceptions of communication with professionals during the diagnosis of autism. Autism, 12(3), 309–324. doi:10.1177/1362361307089517.
Osborne, L. A., & Reed, P. (2010). Stress and self-perceived parenting behaviors of parents of children with autistic spectrum conditions. Research in Autism Spectrum Disorders, 4(3), 405–414. doi:10.1016/j.rasd.2009.10.011.
Ozonoff, S., & Cathcart, K. (1998). Effectiveness of a home program intervention for young children with autism. Journal of Autism and Developmental Disorders, 28(1), 25–32.
Peterson, C. A., Luze, G. J., Eshbaugh, E. M., Jeon, H. J., & Kantz, K. R. (2007). Enhancing parent-child interactions through home visiting: Promising practice or unfulfilled promise? Journal of Early Intervention, 29(2), 119–140.
Reichow, B., Barton, E. E., Boyd, B. A., & Hume, K. (2012). Early intensive behavioral intervention (EIBI) for young children with autism spectrum disorders (ASD). Cochrane Database Systematic Reviews, 10, CD009260. doi:10.1002/14651858.CD009260.pub2.
Rogers, S. J., Estes, A., Lord, C., Vismara, L., Winter, J., Fitzpatrick, A., & Dawson, G. (2012). Effects of a brief Early Start Denver model (ESDM)-based parent intervention on toddlers at risk for autism spectrum disorders: A randomized controlled trial. Journal of the American Academy of Child and Adolescent Psychiatry, 51(10), 1052–1065. doi:10.1016/j.jaac.2012.08.003.
Rush, D., & Sheldon, M. (2011). The early childhood coaching handbook. Baltimore, MD: Brookes Publishing.
Schertz, H. H., Odom, S. L., Baggett, K. M., & Sideris, J. H. (2013). Effects of Joint Attention Mediated Learning for toddlers with autism spectrum disorders: An initial randomized controlled study. Early Childhood Research Quarterly, 28(2), 249–258. doi:10.1016/j.ecresq.2012.06.006.
Schreibman, L., Dawson, G., Stahmer, A. C., Landa, R., Rogers, S. J., McGee, G. G., & Halladay, A. (2015). Naturalistic developmental behavioral interventions: Empirically validated treatments for autism spectrum disorder. Journal of Autism and Developmental Disorders, 45(8), 2411–2428. doi:10.1007/s10803-015-2407-8.
Selby, J. V., Beal, A. C., & Frank, L. (2012). The Patient-Centered Outcomes Research Institute (PCORI) national priorities for research and initial research agenda. Journal of the American Medical Association, 307(15), 1583–1584. doi:10.1001/jama.2012.500.
Seltzer, M. M., Greenberg, J. S., Hong, J., Smith, L. E., Almeida, D. M., Coe, C., & Stawski, R. S. (2010). Maternal cortisol levels and behavior problems in adolescents and adults with ASD. Journal of Autism and Developmental Disorders, 40(4), 457–469. doi:10.1007/s10803-009-0887-0.
Stahmer, A. C. (2007). The basic structure of community early intervention programs for children with autism: Provider descriptions. Journal of Autism and Developmental Disorders, 37(7), 1344–1354. doi:10.1007/s10803-006-0284-x.
Stahmer, A. C., Collings, N. M., & Palinkas, L. A. (2005). Early intervention practices for children with autism: Descriptions from community providers. Focus Autism Other Developmental Disabilities, 20(2), 66–79. doi:10.1177/10883576050200020301.
Stahmer, A. C., & Mandell, D. S. (2007). State infant/toddler program policies for eligibility and services provision for young children with autism. Administration and Policy in Mental Health, 34(1), 29–37. doi:10.1007/s10488-006-0060-4.
Stahmer, A. C., & Pellecchia, M. (2015). Moving towards a more ecologically valid model of parent-implemented interventions in autism. Autism, 19(3), 259–261.
Stone, W. L., Coonrod, E. E., Pozdol, S. L., & Turner, L. M. (2003). The Parent Interview for Autism-Clinical Version (PIA-CV): A measure of behavioral change for young children with autism. Autism, 7(1), 9–30. doi:10.1177/1362361303007001017.
Stone, W. L., & Hogan, K. L. (1993). A structured parent interview for identifying young children with autism. Journal of Autism and Developmental Disorders, 23(4), 639–652. doi:10.1007/BF01046106.
Valicenti-McDermott, M., Lawson, K., Hottinger, K., Seijo, R., Schechtman, M., Shulman, L., & Shinnar, S. (2015). Parental stress in families of children with autism and other developmental disabilities. Journal of Child Neurology, 30(13), 1728–1735. doi:10.1177/0883073815579705.
Ware, J. E., Kosinski, M., & Keller, S. D. (1994). SF-36 Physical and Mental Health Summary Scales: A users’ manual. Boston: The Health Institute.
Ware, J. E., & Sherbourne, C. D. (1992). The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Medical Care, 30(6), 473–483.
Welterlin, A., Turner-Brown, L. M., Harris, S., Mesibov, G., & Delmolino, L. (2012). The home TEACCHing program for toddlers with autism. Journal of Autism and Developmental Disorders, 42(9), 1827–1835. doi:10.1007/s10803-011-1419-2.
Wetherby, A. M., Guthrie, W., Woods, J., Schatschneider, C., Holland, R. D., Morgan, L., & Lord, C. (2014). Parent-implemented social intervention for toddlers with autism: An RCT. Pediatrics, 134(6), 1084–1093. doi:10.1542/peds.2014-0757.
Wong, C., Odom, S. L., Hume, K. A., Cox, A. W., Fettig, A., Kucharczyk, S., & Schultz, T. R. (2015). Evidence-based practices for children, youth, and young adults with autism spectrum disorder: A comprehensive review. Journal of Autism and Developmental Disorders, 45(7), 1951–1966. doi:10.1007/s10803-014-2351-z.
Woods, J. J., & Brown, J. A. (2011). Integrating family capacity-building and child outcomes to support social communication development in young children with autism spectrum disorder. Topics in Language Disorders, 31(3), 235–246. doi:10.1097/TLD.0b013e318227fde4.
Zaidman-Zait, A., Mirenda, P., Duku, E., Szatmari, P., Georgiades, S., Volden, J., et al. (2014). Examination of bidirectional relationships between parent stress and two types of problem behavior in children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 44(8), 1908–1917. doi:10.1007/s10803-014-2064-3.
Acknowledgments
We are grateful to the families who generously participated in this study and would like to acknowledge the valuable contribution of Samantha Scott, Cassidy Arnold, Laurie Moses, and Amanda Benson to the project. This research was supported in part by grants from the Department of Health and Human Services Maternal Child Health Bureau (R40MC22648) and by the NICHD IDDRC (U54 HD079124).
Author's contributions
LTB, KH, and BAB conceived of the study, participated in its design and coordination and drafted the manuscript; KK performed the statistical analysis and participated in the interpretation of the data. All authors read and approved the final manuscript.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
Lauren Turner-Brown, Kara Hume, Brian Boyd and Kirsten Kainz declares that they have no conflict of interest.
Ethical Approval
All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed Consent
All research activities were approved by our institution’s IRB prior to enrolling participants. Informed consent was obtained from families prior to participation in any research activities.
Rights and permissions
About this article
Cite this article
Turner-Brown, L., Hume, K., Boyd, B.A. et al. Preliminary Efficacy of Family Implemented TEACCH for Toddlers: Effects on Parents and Their Toddlers with Autism Spectrum Disorder. J Autism Dev Disord 49, 2685–2698 (2019). https://doi.org/10.1007/s10803-016-2812-7
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10803-016-2812-7