title: Caregiver-mediated intervention for low-resourced preschoolers with autism: an RCT.
abstract: OBJECTIVE
  To compare 2 short-term, community caregiver training interventions for preschool-aged children with Autism Spectrum Disorder who had low resources. Low resource was defined by the US Department of Housing and Urban Development low-income index or 1 "indicator," (e.g., Medicaid eligibility). Child outcomes focused on joint engagement, joint attention, and play.
  
  
  METHODS
  Participants included 112 families of a child who had Autism Spectrum Disorder who met criteria for being low-resourced and who were randomly assigned to 1 of 2 3-month interventions, group caregiver education or individualized caregiver-mediated intervention (CMM). Children were assessed for social communication skills pre- and post-treatment, and followed up at 3 months.
  
  
  RESULTS
  All children improved in joint engagement and initiating joint attention, with significantly greater improvement by the CMM group. Outcomes on play skills were mixed, with improvement of symbolic play for the CMM group and no change in functional play skills. Joint engagement maintained over time for the CMM group, and initiating joint attention maintained for both groups over time.
  
  
  CONCLUSIONS
  This study is among the first randomized trials comparing 2 active interventions with a large sample of low-resourced families. Results suggest improvements in core autism deficits of joint engagement, joint attention, and symbolic play with relatively brief, caregiver-mediated interventions, but additional support is necessary to maintain and generalize these gains over time.
authors: Human Development & Psychology,Center for Autism Research & Treatment, and ckasari@mednet.ucla.edu.
authors: Connie
authors: C
authors: Kasari
authors: The Ohio State University Nisonger Center, andThe Ohio State University Special Education Department, Columbus, Ohio;
authors: Kathy
authors: K
authors: Lawton
authors: Biostatistics, University of California, Los Angeles, Los Angeles, California;
authors: Wendy
authors: W
authors: Shih
authors: Department of Human Development and Quantitative Methodology, University of Maryland, College Park, Maryland;
authors: Tyson V
authors: TV
authors: Barker
authors: Kennedy Krieger Institute, Baltimore, Maryland;
authors: Rebecca
authors: R
authors: Landa
authors: Weill Cornell Medical Center, New York, New York;
authors: Catherine
authors: C
authors: Lord
authors: Children's Hospital of Seattle, Seattle, Washington; and.
authors: Felice
authors: F
authors: Orlich
authors: Children's Hospital of Seattle, Seattle, Washington; and.
authors: Bryan
authors: B
authors: King
authors: Department of Clinical Sciences, Florida State University, Tallahassee, Florida.
authors: Amy
authors: A
authors: Wetherby
authors: Biostatistics, University of California, Los Angeles, Los Angeles, California;
authors: Damla
authors: D
authors: Senturk
mesh_terms: D017028:Caregivers; D002659:Child Development Disorders, Pervasive / Q000628:therapy*; D002675:Child, Preschool; D018479:Early Intervention, Educational; D005260:Female; D006801:Humans; D008297:Male; D011203:Poverty; D016037:Single-Blind Method; D012959:Socioeconomic Factors
keywords: autism; early intervention; joint attention; parent-child interactions