Sibling-Mediated Intervention for Autism
Recruiting in Palo Alto (17 mi)
+2 other locations
Age: < 18
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: Arizona State University
Disqualifiers: Aggression, Noncompliance, others
No Placebo Group
Trial Summary
What is the purpose of this trial?Given the increasing prevalence of autism spectrum disorder (ASD), estimated to be 1 in 68 in the United States alone, ASD has become one of the fastest-growing pediatric concerns. The deficits of children with ASD range across social communication and academic skills. One of the effective interventions that have been used commonly for ASD is the model-lead-test, which includes modeling, prompting children to practice target skills together, and providing children with affirmative feedback or error correction. Previous research has demonstrated that the model-lead-test is successful in teaching different skills for individuals with ASD, including functional, social, and academic skills. The vast majority of the studies had researchers, therapists, or teachers implement the intervention. However, there is clear empirical support and implications for interventions mediated by more familiar persons, such as parents and siblings, which may lead to better effects, maintenance, and generalization due to more practice opportunities in the natural environments. Research has supported the effectiveness of using parents or peers as agents to deliver interventions for individuals with ASD, whereas fewer studies explored the use of siblings to deliver or mediate intervention. As typically developing siblings are an essential part of the daily life of children with ASD, it makes logical extensions to have siblings as mediators to deliver interventions.
In the initial findings, the investigators found the typically developing siblings can accurately implement the model-lead-test procedure that improved various skills of their siblings with ASD. This project will extend these findings by examining the efficacy of the sibling-implemented intervention on early literacy (reading) and social reciprocity (conversation and play) of children with ASD as well as the sibling relationship before, during, and after the intervention.
Will I have to stop taking my current medications?
The trial information does not specify whether participants need to stop taking their current medications.
What data supports the effectiveness of the sibling-mediated intervention treatment for autism?
Research shows that sibling-mediated interventions can be effective for children with autism. Studies found that siblings can successfully learn and use techniques to improve social interactions and communication in children with autism, leading to increased imitation, joint engagement, and contextually appropriate statements.
12345Is sibling-mediated intervention for autism safe for participants?
There is no specific safety data available for sibling-mediated interventions for autism, but a review of parent-mediated interventions, which are somewhat similar, found no significant adverse effects, suggesting they are generally safe.
56789How is the sibling-mediated intervention treatment for autism different from other treatments?
The sibling-mediated intervention for autism is unique because it involves training siblings to help their brother or sister with autism improve social skills through imitation and engagement activities. This approach leverages the natural sibling relationship to enhance learning and interaction, which is different from traditional therapies that typically involve only parents or professionals.
125910Eligibility Criteria
This trial is for children with Autism Spectrum Disorder (ASD) who can imitate actions and vocalize, and their typically developing siblings who can read. Both should be able to follow instructions. It's not specified what would exclude someone from this study.Inclusion Criteria
Typically developing children can sound out and blend letters during reading
Both siblings can demonstrate compliance during instruction
Children with ASD can imitate physical actions and repeat vocalizations, answer common questions, label common objects and actions with adjectives
+3 more
Exclusion Criteria
Children with aggression towards their siblings and noncompliance during instruction
Children with ASD who can sound out and blend letters
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Pre-Assessment
Pre-assessments for children with ASD, typically developing siblings, and parents to establish baseline measures
5 days
Multiple visits (in-person and virtual)
Intervention
Sibling-mediated intervention with compliance training and intervention phases focusing on early literacy and social reciprocity
3 months
Ongoing sessions (virtual and in-person)
Posttest/Post-intervention
Post-intervention assessments to evaluate changes in skills and social validity
1 week
Multiple visits (in-person and virtual)
Follow-up
Participants are monitored for changes in sibling relationship, self-efficacy, and other outcomes at 3, 6, and 9 months post-intervention
9 months
3 follow-up visits (virtual)
Participant Groups
The study tests a sibling-mediated intervention where the typically developing sibling uses a model-lead-test approach to improve the ASD child's reading and social skills, as well as their relationship.
2Treatment groups
Experimental Treatment
Active Control
Group I: Sibling-mediated interventionExperimental Treatment1 Intervention
Children with autism will receive explicit instruction from their typically developing siblings
Group II: Treatment as usual/Sibling interactionActive Control1 Intervention
Children with autism will spend time with their typically developing siblings for 20-30 mins at least three times a week
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
Children's Autism CenterRound Rock, TX
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Who Is Running the Clinical Trial?
Arizona State UniversityLead Sponsor
References
Evaluation of a Sibling-Mediated Imitation Intervention for Young Children with Autism. [2023]Parents and peers have been successful at implementing interventions targeting social interactions in children with autism; however, few interventions have trained siblings as treatment providers. This study used a multiple-baseline design across six sibling dyads (four children with autism) to evaluate the efficacy of sibling-implemented reciprocal imitation training. All six typically developing siblings were able to learn and use contingent imitation, four of the six siblings were able to learn and use linguistic mapping, and all six siblings increased their use of at least one component of the imitation training procedure. Three of the four children with autism showed increases in overall imitation and all four showed evidence of increases in joint engagement. Parents and siblings reported high satisfaction with the intervention and ratings by naïve observers indicated significant changes from pre- to post-treatment. These results suggest that sibling-implemented reciprocal imitation training may be a promising intervention for young children with autism.
Behavioral training for siblings of autistic children. [2019]The present study was conducted to investigate the effectiveness of a program designed to teach behavior modification procedures to normal siblings of autistic children. Three sibling pairs participated in a multiple-baseline analysis of the effects of training the normal siblings to use behavior modification procedures to teach their autistic brother or sister a variety of learning tasks. Results indicated that the siblings learned to use the behavioral procedures at a high level of proficiency, they used the procedures in a generalization setting, and there were observed improvements in the behavior of the autistic children. In addition, a social validation assessment of the normal siblings' statements about their autistic sibling indicated a decrease in negative statements and an increase in positive statements after training. These results are discussed in terms of the potential for incorporating siblings into the treatment plan in intervention programs with autistic children.
Sibling-Implemented Script Fading to Promote Play-Based Statements of Children with Autism. [2020]We trained three typically developing children to implement a script-fading procedure with their younger siblings with autism. The number of contextually appropriate statements made by the children with autism increased once treatment was initiated. Participants continued to emit higher levels of contextually appropriate statements after the scripts were completely faded and at a 4- or 11-week follow-up. The typically developing siblings were able to implement the script-fading procedure with high levels of fidelity.
Clinical outcomes of children with ASD - Preliminary findings from a 18 month follow up study. [2021]Parent-mediated intervention for children with Autism Spectrum Disorder (ASD) is a critical component to deliver evidence-based interventions in resource-limited settings. There is a need for methodologically rigorous longitudinal and follow-up studies of children with ASD to understand clinical outcome and developmental trajectories.
Sibling involvement in interventions for individuals with autism spectrum disorders: a systematic review. [2021]Many researchers have studied various interventions for individuals with autism spectrum disorder (ASD). Occasionally, siblings will be included in intervention studies, participating in programs designed to address a number of challenges faced by individuals with ASD. Although sibling involvement in such interventions is not a new phenomenon, there is no consistent method for including siblings in treatment for individuals with ASD. The purpose of this article is to review the existing literature describing sibling involvement in interventions among families of children with ASD, describing patterns of research and targeted outcomes. The authors also identify gaps and areas for future consideration from researchers, clinicians, and families.
Brief report: comparative ABA and DIR trials in twin brothers with autism. [2019]Trial interventions in DIR and ABA with twin brothers with autism were offered to help the parents choose one of the programs for their sons. Pre- and post-test scores on the Communication and Symbolic Behavior Scales (CSBS) revealed a slight gain in the composite score of the ABA child and a slight loss in the score of the DIR child. Contrasted gains and losses occurred in six of the seven CSBS clusters. Results from this pilot research are discussed with additional communication and behavior data from the intervention period. Careful interpretation of CSBS outcomes in counseling parents and graduate students is strongly advised. Continued research in comparative outcomes for intervention programs is strongly encouraged.
Parent-Mediated Interventions for Children and Adolescents With Autism Spectrum Disorders: A Systematic Review and Meta-Analysis. [2021]There has been increasing interest in parent-mediated interventions (PMIs) for children with autism spectrum disorders (ASDs). The objective of this systematic review and meta-analysis was to examine the effect of PMIs compared to no PMI for children with ASD aged 2-17 years. The primary outcome was adaptive functioning rated by a parent or clinician. The secondary outcomes were long-term adaptive functioning rated by the parents, adverse events, core symptoms of ASD, disruptive behavior, parental well-being, quality of life of the child rated by the parents and anxiety. The MEDLINE, PsycInfo, Embase, and CINAHL databases were searched in March 2020. The Cochrane Risk of Bias Tool was used to rate the individual studies, and the certainty in the evidence was evaluated using GRADE. We identified 30 relevant randomized controlled trials (RCTs), including 1,934 participants. A clinically relevant effect of PMIs on parent-rated adaptive functioning was found with a low certainty of evidence [Standard mean difference (SMD): 0.28 (95% CI: -0.01, 0.57)] on Vineland Adaptive Behavior Scales (VABS), whereas no clinically relevant effect was seen for clinician-rated functional level, with a very low certainty of evidence [SMD on Clinical Global Impressions (CGI)-severity scale: SMD -0.45 [95% CI: -0.87, -0.03)]. PMIs may slightly improve clinician-rated autism core symptoms [SMD: -0.35 (95% CI: -0.71, 0.02)]. Additionally, no effect of PMIs on parent-rated core symptoms of ASD, parental well-being or adverse effects was identified, all with a low certainty of evidence. There was a moderate certainty of evidence for a clinically relevant effect on disruptive behavior [SMD: 0.55 (95% Cl: 0.36, 0.74)]. The certainty in the evidence was downgraded due to serious risk of bias, lack of blinding, and serious risk of imprecision due to few participants included in meta-analyses. The present findings suggest that clinicians may consider introducing PMIs to children with ASD, but more high-quality RCTs are needed because the effects are not well-established, and the results are likely to change with future studies. The protocol for the systematic review is registered at the Danish Health Authority website (www.sst.dk).
Self-reported behaviour problems and sibling relationship quality by siblings of children with autism spectrum disorder. [2022]There are few published research studies in which siblings of children with autism spectrum disorder (ASD) provide self-reports about their own behavioural and emotional problems and their sibling relationships. Reliance on parent reports may lead to incomplete conclusions about the experiences of siblings themselves.
The early development of infant siblings of children with autism spectrum disorder: Characteristics of sibling interactions. [2018]Although sibling interactions play an important role in children's early development, they are rarely studied in very young children with an older brother or sister with autism spectrum disorder (ASD). This study used a naturalistic, observational method to compare interactions between 18-month-old infants and their older sibling with ASD (n = 22) with a control group of 18-month-old infants and their typically developing (TD) older sibling (n = 29). In addition, role (a)symmetry and the influence of gender were evaluated. Sibling interactions in ASD-dyads were characterized by higher levels of negativity. Although somewhat less pronounced in ASD-dyads, role asymmetry was present in both groups, with the older child taking the dominant position. Finally, siblings pairs with an older sister were characterized by more positive behaviours. Since differences in sibling interactions may alter the developmental trajectories of both siblings, these early relationships should be taken into account in future ASD research and interventions.
Social Behaviors of Children with ASD during Play with Siblings and Parents: Parental Perceptions. [2020]Both siblings and parents are important interactional partners for children with ASD, but we know little about whether these interactions differ between these two groups, or between older and younger siblings.