Feasibility and acceptability of a caregiver-mediated early support program, delivered online, for infants at elevated familial likelihood for autism: A feasibility randomized controlled trial

IF 5.3 2区 医学 Q1 BEHAVIORAL SCIENCES Autism Research Pub Date : 2024-08-28 DOI:10.1002/aur.3217
Shoba S. Meera, Malavi Srikar, Reny Raju, Divya Swaminathan, Rachel Elizabeth Johnson, Linda R. Watson, Deepa Bhat Nair, John Vijay Sagar Kommu, Jo Chopra-McGowan, Prathyusha P. Vasuki
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Abstract

Preliminary evidence indicates potential benefit of providing caregiver-mediated intervention, prior to diagnosis, for infants at elevated familial likelihood for autism and related developmental delays including language delay (EL-A). However, delivering such interventions online and in low-resource settings like India has not been reported. This study aimed to evaluate the feasibility and acceptability of delivering a novel manualized caregiver-mediated early support program, the “LiL' STEPS,” online in India, for EL-A infants. LiL' STEPS stands for Language development & Intervention Lab's (LiL') Supporting Early social-communication and language by Promoting caregiver Sensitive responsiveness (STEPS). The program comprised 14 sessions with a focus on social-communication and language, conducted over 12-weeks using demonstration and video feedback. Families of 36 EL-A infants aged 9 to 15-months participated in this feasibility randomized controlled trial (RCT). Families were randomized in a 2:1 ratio (n = 24 LiL' STEPS and n = 12 care as usual groups). Information on feasibility and acceptability was collated following a mixed methods approach from caregiver interviews, fidelity forms, session notes, and study register. Findings indicated the LiL' STEPS study trial as feasible and acceptable with recruitment rate of 4 per month, 100% willingness for randomization, 8.3% attrition, and 3.03% loss of blinding. Interventionist and caregiver fidelity was maintained above 80%. Despite challenges like interruptions during sessions, 100% families found the program acceptable and satisfactory, 86% said they would recommend the program to others, and 71% preferred online modality. Caregivers' perspectives on beneficial components and experience attending the program have been described. Accordingly, recommendations for future definitive RCTs have been presented.

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针对自闭症家族遗传几率较高的婴儿,通过网络提供以护理人员为媒介的早期支持计划的可行性和可接受性:可行性随机对照试验。
初步证据表明,在确诊之前,为自闭症及相关发育迟缓(包括语言发育迟缓)家族可能性较高的婴儿提供以照顾者为媒介的干预可能会带来益处(EL-A)。然而,在印度等资源匮乏的环境中通过网络提供此类干预措施的情况尚未见报道。本研究旨在评估在印度针对EL-A婴儿在线提供新颖的、以照顾者为媒介的手动化早期支持计划 "LiL' STEPS "的可行性和可接受性。LiL'STEPS "是语言发展与干预实验室(LiL')"通过促进护理人员的敏感反应(STEPS)来支持早期社会交流和语言 "的缩写。该计划包括 14 个课程,重点是社交沟通和语言,通过示范和视频反馈进行,为期 12 周。36 个 9 至 15 个月大的 EL-A 婴儿家庭参加了这项可行性随机对照试验(RCT)。这些家庭按 2:1 的比例被随机分组(n = 24 个 "LiL' STEPS "组和 n = 12 个 "照常护理 "组)。我们采用混合方法,从护理人员访谈、忠诚度表格、课程笔记和研究登记册中整理了有关可行性和可接受性的信息。研究结果表明,"LiL' STEPS "研究试验具有可行性和可接受性,每月招募 4 人,100% 愿意接受随机分组,8.3% 自然减员,3.03% 失盲。干预人员和护理人员的忠诚度保持在 80% 以上。尽管存在课程中断等挑战,但100%的家庭认为该计划可以接受并令人满意,86%的家庭表示会向他人推荐该计划,71%的家庭更喜欢在线模式。护理人员对该计划的有益内容和参加该计划的经历进行了描述。相应地,还对未来的明确 RCT 提出了建议。
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来源期刊
Autism Research
Autism Research 医学-行为科学
CiteScore
8.00
自引率
8.50%
发文量
187
审稿时长
>12 weeks
期刊介绍: AUTISM RESEARCH will cover the developmental disorders known as Pervasive Developmental Disorders (or autism spectrum disorders – ASDs). The Journal focuses on basic genetic, neurobiological and psychological mechanisms and how these influence developmental processes in ASDs.
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