Simple strategies used by parents lead to improvements in one-year-olds at risk for autism spectrum disorder

Parents using these strategies, known as Adapted Responsive Teaching (ART), reported significant improvements in their child’s sensory responsiveness, communication and socialization.

Playing face-to-face, and imitating the child’s actions and vocalizations are key strategies that support social interaction. Photo courtesy of UNC PEARLS.
When caregivers follow the child’s lead and take turns, children often stayed engaged in joint activities for a longer time. Photo courtesy of UNC PEARLS.

Media contact: Tom Hughes, 984-974-1151,

Tuesday, February 3, 2015

A new study by University of North Carolina at Chapel Hill researchers finds that a collection of simple strategies used by parents can lead to significant improvements in one-year-olds at risk for autism spectrum disorder (ASD).

In the study, published in Autism Research and Treatment, a group of UNC faculty from the departments of Allied Health Sciences, Psychiatry and Psychology followed 18 families with a one-year-old child at risk for ASD. They compared the effects of a parent-coaching, home-based intervention called “Adapted Responsive Teaching” (ART) versus referral to early intervention and monitoring.

“We identified families with one-year-old infants in a community sample who were at-risk for ASD, and successfully recruited them into our intervention study prior to an age where full-blown autism symptoms are typically evident.  For many families, we facilitated access to early intervention and improved their child’s outcomes.”  said Grace Baranek, PhD, lead author of the study and an autism researcher with the Program for Early Autism, Research, Leadership and Service (PEARLS) in the Department of Allied Health Sciences at the UNC School of Medicine.

Here is one example of how ART is sometimes used. Some one-year-olds at risk for ASD do not respond when someone else tries to get their attention by calling their name or by showing them something interesting, and they may not play  “back-and-forth” social interaction games such as peek-a-boo.  In such a situation the parent, working with an ART interventionist, begins to imitate the child’s actions and communications. The child then begins to interact with the parent to see if the parent will imitate him or her again. As the intervention continues, the parent is able keep the child engaged in “back-and-forth” social interactions for several exchanges at a time.

“ ‘Imitate your child’ is just one example of an ART intervention strategy that is targeted to address one of 12 pivotal behaviors in our study,” Baranek said. “Each child has different strengths and weaknesses, so the intervention is individualized to the needs of the child, and necessarily varies across families.”

“This is one of the most rewarding interventions I’ve ever used,” said Linn Wakeford, the Intervention Coordinator for the study. “It’s amazing to watch parents learn to engage their children more fully in play and social interactions, and in turn, to see the children flourish in response to these strategies!”

Co-authors of the study are Linda Watson, Lauren Turner-Brown, Samuel Field, Elizabeth Crais, Linn Wakeford, Lauren Little and J. Steven Reznick. All are researchers with PEARLS.

Autism Speaks and The Ireland Family Foundation provided funding for the study.

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