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      Telehealth for Expanding the Reach of Early Autism Training to Parents

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          Abstract

          Although there is consensus that parents should be involved in interventions designed for young children with autism spectrum disorder (ASD), parent participation alone does not ensure consistent, generalized gains in children's development. Barriers such as costly intervention, time-intensive sessions, and family life may prevent parents from using the intervention at home. Telehealth integrates communication technologies to provide health-related services at a distance. A 12 one-hour per week parent intervention program was tested using telehealth delivery with nine families with ASD. The goal was to examine its feasibility and acceptance for promoting child learning throughout families' daily play and caretaking interactions at home. Parents became skilled at using teachable moments to promote children's spontaneous language and imitation skills and were pleased with the support and ease of telehealth learning. Preliminary results suggest the potential of technology for helping parents understand and use early intervention practices more often in their daily interactions with children.

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          Most cited references63

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          Randomized Controlled Caregiver Mediated Joint Engagement Intervention for Toddlers with Autism

          This study aimed to determine if a joint attention intervention would result in greater joint engagement between caregivers and toddlers with autism. The intervention consisted of 24 caregiver-mediated sessions with follow-up 1 year later. Compared to caregivers and toddlers randomized to the waitlist control group the immediate treatment (IT) group made significant improvements in targeted areas of joint engagement. The IT group demonstrated significant improvements with medium to large effect sizes in their responsiveness to joint attention and their diversity of functional play acts after the intervention with maintenance of these skills 1 year post-intervention. These are among the first randomized controlled data to suggest that short-term parent-mediated interventions can have important effects on core impairments in toddlers with autism. Clinical Trials #: NCT00065910.
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            Mullen scales of early learning

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              Collateral effects of parent training on family interactions.

              Recent research suggests that using naturalistic teaching paradigms leads to therapeutic gains in clinic settings for children with autism and related disorders. More recent studies are demonstrating that implementing these strategies within a parent training format may produce collateral effects in other areas of family life. The present experiment assessed collateral effects of two very different parent training paradigms during unstructured dinnertime interactions in the family setting. One paradigm focused on teaching individual target behaviors (ITB) serially, and the other focused on a recently developed naturalistic paradigm that teaches the pivotal responses (PRT) of motivation and responsivity to multiple cues. Two groups of families were randomly assigned to each of the parent training conditions. Pretraining and post-parent-training videotapes of dinnertime interactions were scored in a random order across four interactional scales (level of happiness, interest, stress, and style of communication). Results obtained for the four interactional scales showed that the families in both conditions initially scored in the neutral range, and the ITB training paradigm produced no significant influence on the interactions from pretraining to posttraining. In contrast, however the PRT parent training paradigm resulted in the families showing positive interactions on all four scales, with the parent-child interactions rated as happier, the parents more interested in the interaction, the interaction less stressful, and the communication style as more positive.
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                Author and article information

                Journal
                Autism Res Treat
                Autism Res Treat
                AURT
                Autism Research and Treatment
                Hindawi Publishing Corporation
                2090-1925
                2090-1933
                2012
                22 November 2012
                : 2012
                : 121878
                Affiliations
                Department of Psychiatry and Behavioral Sciences, Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California, Davis 2825 50th Street, Sacramento, CA 95817, USA
                Author notes

                Academic Editor: Aubyn Stahmer

                Article
                10.1155/2012/121878
                3512210
                23227334
                3df55747-eda9-46e8-8f01-2fe5ef7fac51
                Copyright © 2012 Laurie A. Vismara et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 25 April 2012
                : 9 October 2012
                Categories
                Research Article

                Neurology
                Neurology

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