In a pilot study, researchers have demonstrated the practicality and benefits of using the Internet to teach parents how to use early intervention techniques for autism spectrum disorder (ASD). The program combines live, remote coaching with online learning materials.
Psychologist Allison Wainer conducted the study as part of her Autism Speaks Weatherstone Predoctoral Fellowship. She did so under the mentorship of Autism Speaks-funded researcher Brooke Ingersoll, at Michigan State University.
At the end of the program, most of the participating parents were effectively applying the therapy techniques they’d learned, and most of their children were showing improvements in their imitation skills – the program’s goal. Imitation is a foundation skill for more advanced social interactions and communication.
“Given the enormous need of families affected by ASD, we need to consider options for families who don’t have close access to a behavioral therapist,” comments Alycia Halladay, Autism Speaks senior director for clinical and environmental sciences. “This is a promising approach to improve services for those who can’t otherwise receive them and to enhance other therapies and services.” (Halladay was not involved in the research.)
Reaching out to distant families
Working from their base at Michigan State University, the researchers enrolled five families hundreds of miles away in Ontario, Canada. The families comprised a diverse group. Four were immigrants to North America, and three spoke a foreign language in the home in addition to English. Their children with autism ranged in age from 2.5 to just under 5 years when the study started.
The families and researchers communicated using Skype, a free, password-protected, video-conferencing program. First, the researchers used the link to observe the parents and children playing. This allowed them to take a baseline measure of the children’s abilities and how their parents interacted with them.
Next, the parents completed four self-guided, web-based lessons introducing Reciprocal Imitation Training. RIT encourages imitation through play. In earlier research supported by Autism Speaks, Dr. Ingersoll demonstrated RIT’s effectiveness in improving social engagement. The parents also had the option of watching longer video clips of therapists and parents using RIT with children who had autism.
At the end of the self-taught portion of the program, the researchers again assessed parent interactions and child behavior through video conferencing. All the parents showed improvements in using RIT techniques, and four of the five children showed improvement in imitation skills.
The researchers – all trained child psychologists – then provided three, thirty-minute coaching sessions to each family. Using the live, Internet video link, the coaches provided feedback and suggestions as they watched the parents apply the intervention techniques. Parents could likewise ask questions of their coaches.
At the conclusion of these sessions, four out of five parents were delivering the therapy techniques accurately and consistently. All the children had improved in imitation skills – with the improvement being significant in four of the five children.
“Our findings are important for showing that web-based programs that combine self-directed learning with online coaching have the potential to increase access to effective interventions,” Wainer says. “This is particularly important for addressing the needs of families on lengthy wait lists for behavioral therapy and those living in remote areas with few services.”
With the success of the pilot study, the team hopes to test the program with more families to confirm its benefits.
“This isn’t a cure for the great unmet need for autism services,” Wainer says. Rather, the remote coaching is meant to get parents started with autism intervention and/or supplement the professional services they are receiving.
“Without Autism Speaks and the Dennis Weatherstone Predoctoral Fellowship, this research would not have been possible,” Wainer adds. “I want to personally thank the entire Autism Speaks community.”
Learn more about the Autism Speaks Weatherstone Predoctoral Fellowship program here.
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