News and Knowledge

In November, OAR’s Board of Directors authorized funding for seven new applied autism research studies in 2020. These new grants, totaling $275,000, bring OAR’s total research funding to more than $4 million since 2002. This is the fifth of seven previews to be featured in The OARacle this year.

Early access to evidence-based intervention leads to best-case long-term outcomes for children with autism spectrum disorder (ASD), with the greatest developmental gains experienced by children who begin intervention before their third birthday, according to research. Unfortunately, parents from underserved communities often have less knowledge about ASD and are less likely to recognize ASD symptoms, resulting in later diagnoses for their children. Language barrier and cultural mismatch can also be challenges for these families.

OAR-funded researcher Robin Dodds, Ph.D., an assistant professor of early childhood special education at California State University, Los Angeles, plans to develop and evaluate a brief online, smart-phone optimized training curriculum, Helping Optimize Language Acquisition (HOLA), to help overcome those challenges. The curriculum will train parents in pivotal response treatment (PRT) strategies in either Spanish or English.

Brief PRT training has been shown to significantly improve joint attention, expressive language, responsivity, and adaptive skills in young children with ASD. The training will be interactive and culturally competent, based on information, lessons, and examples in Using Pivotal Response Treatment to Teach First Words to Children with Autism and Pivotal Response Treatment: Using Motivation as a Pivotal Response.

Methodology

To test the HOLA intervention, Dr. Dodds will recruit 24 parents and their toddlers (ages 16 to 36 months) with elevated risk for ASD from Centro de Niños y Padres, a family-focused program providing early intervention services to children birth to age three, who have or are at risk for a developmental disability. Other sources may include community health centers, family resource centers, and diagnostic clinics.

The HOLA training will make use of adult learning principles and use multiple instruction methods, including presentations, visual representations, game playing, and video to teach the content. To allow for varying levels of literacy, the text will be simplified and supported by visuals.

The HOLA curriculum will be delivered in six brief (20 to 40 minutes) weekly modules (in Spanish or English) that can be accessed for multiple viewings any time of day by computer, tablet, or smart phone:

1. Child Development: autism spectrum disorder
2. Child Choice: getting started, natural environments, favorite things, introduction to HOLA
3. Providing Natural Rewards: defining natural rewards, rewarding attempts, maintenance tasks
4. Providing Clear Opportunities: getting your child’s attention, providing a clear opportunity, responding right away
5. Putting It All Together: reviewing the strategies, teaching in daily routines, celebrating your child
6. Planning for the Future: troubleshooting, task variety, family balance, taking care of yourself

All needed materials will be integrated into the training modules.

Evaluation

Dr. Dodds will evaluate the intervention training based on these components:

• Social communication: Using a recorded play session between the parent and child, the research team will identify the frequency of communicative behavior by the child.
• Parent implementation: Using the recorded play session, the research team will score the number of times parents correctly use each of the five PRT principles (presenting clear opportunities, child choice, immediate contingent responses, natural reinforcers and reinforcing verbal attempts, and correct verbal responses).
• Satisfaction: Parents will complete a survey rating their satisfaction with accessibility, helpfulness, convenience, and thoroughness of the program and materials.
• Parental knowledge of child development: The research team will assess parents’ knowledge of typical and atypical development.

In addition to those primary measures, the team will also:

• Ask parents to report on their children’s language and communication skills, using a standardized communicative development inventory form.
• Screen for the level of stress parents feel.
• Evaluate the levels of empowerment parents experience.
• Ask parents to check off problem behaviors their children exhibit and provide additional qualitative information about their children’s problems and strengths.
• Ask parents to describe their children’s social and emotional development, including self-regulation, communication, autonomy, compliance, adaptive functioning, affect, and interaction with people.

Practical Relevance

Because Latinx children are consistently underdiagnosed and underserved by the ASD community, it is crucial to provide parents with knowledge and strategies to assist their child in developing language. If results are positive, the HOLA bilingual training would be made available via the university’s website free of charge and the availability of the resource would be publicized to national disability and autism organizations and childcare providers.

The modules would also be translated into Chinese, Tagalog, Korean, Armenian, Vietnamese, Farsi, Japanese, and Russian to include the top 10 languages spoken in Los Angeles County.

HOLA will help Latinx parents create rich learning environments for their children in Spanish or English, educate them about child development and the signs of ASD, thereby improving their ability to gain access to diagnostic referrals and quality services.