Earliest Intervention for Emerging ASD: Innovations in Caregiver-Mediated Approaches | Jessica Brian
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Earliest Intervention for Emerging ASD: Innovations in Caregiver-Mediated Approaches | Jessica Brian


I’m just going to set the stage for you. This is a 3 month old baby, his dad is holding him this way in his arm and they’re looking at each other in the face. So the first thing that you may notice is that this little three-month-old is looking quite intently at his father’s face. You may also notice that he’s smiling. So there’s something about his father’s face that he finds pleasing and he’s smiling to show that We don’t know from the picture, but I can tell you it’s quite likely that his father is also smiling It’s very hard not to smile when your baby smiles at you, so baby smiles have a lot of value for adults. So let’s imagine this scenario playing out in a over the next few seconds. What may happen is the baby’s smile might start to fade a tiny bit. Dad starts thinking, I enjoyed that smile – how am I going to get it back? I’ll do something funny Make a funny sound, make a funny face – baby smiles again, dad gets rewarded, this feels good, I’m going to try it again. Baby smiles again. So now there’s this feedback loop or a sort of reciprocal interaction between Dad and baby where they’re enjoying each other’s company, and they’re having fun together Now dad’s been doing this for a couple of minutes. He wants to take a quick break. – maybe breathe And baby notices hey the game stopped. How do I get this game going again? So this is when babies might start to just lean in a bit lean forward Laugh a little bit, open their eyes a bit wider to keep things going. So that’s sort of creating a social overture. In the next few months of development this baby is going to learn much more sophisticated ways to have to get game started and to show that he wants games to continue. So these are all developmental skills that emerge very early in life within the first year of life and are typically quite well developed by the time a baby is two years of age. What we know from research is that all of these areas have also been found to be areas of concern or difficulty for babies who go on to develop autism spectrum disorder. So what we see in these babies are sometimes reduce time spent looking at caregivers face, reduced smiling, reduced social overtures or initiating interactions and challenges of communication So this brings us to the question if we can identify these concerns very early in development Is there anything we can do to help these kids develop? This question motivated my team to develop a parent mediated intervention for toddlers who are showing early signs of autism spectrum disorder It takes on the developmental and behavioral perspective and we really just work with caregivers to find ways to enhance their babies communication and social affect. I’ll tell you very quickly about some results we follow these babies and look at them over time at three time points. We watch some playing with their caregiver before we do any training. We see them again 12 weeks later, and then we see them again 12 weeks after that. We’ve just completed a randomized control trial where we taught one group of families the social ABCs intervention and we followed controls over the same period of time and what we’re finding is if you look at the blue lines you’ll see that the families who receive the social ABCs intervention training learn the techniques, their babies responded to them at a high level and they had increased initiations or sort of social overtures with their parents. We saw parents smiling more and we saw an association between increased parents smiling and increase baby smiling and increased time spent looking at caregivers faces We spoke to the parents. They didn’t report increased stress from being involved in this intervention, and they reported feeling self-efficacy, empowerment and satisfaction with the program. So really the take-home message for us is that we know that we can detect risk for ASD very early in life and this research shows that we can also implement very low cost interventions low resource interventions that have the potential to have significant impacts for these kids very early in development to set a foundation for their future ongoing development. Thank you so much

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