Promotion of sensorimotor and attentional development for infants at elevated likelihood of autism: single case experimental design of novel caregiver implemented NDBI

Abstract

Infants with familial autism are at elevated likelihood for future neurodevelopmental needs, including autism spectrum disorder, attention deficit hyperactivity disorder, and clinically significant cognitive and behavioral challenges. Science is advancing the near-future ability to determine presymptomatic and prodromal periods of neurodevelopmental disabilities in infancy. To meet the needs of these infants and their families, proactive intervention and support models must advance in tandem. The present study investigated a novel, telehealth-based approach to caregiver coaching within a naturalistic and developmental behavioral intervention framework to address behavioral priors of attention and sensorimotor responding with nine infants at elevated likelihood of autism due to family history. We sought to answer a primary research question on the functional relation of the NDBI intervention on proximal infant behaviors related to sensorimotor and attentional responding during three, concurrent multiple baseline designs across infant/caregiver dyads. Secondary questions on the feasibility of the study and pre/post characterization of distal measures of infant development were also included. Based on descriptive analysis of attendance data and visual analysis of SCED data, there was promising feasibility and initial single case experimental design evidence on the idiographic efficacy particularly on motor imitation, although results were variable across participants and targeted responses. Following iterations on the study design, the final procedures in the third multiple baseline design led to the most consistent changes across dyads. Given the known importance on earlier identification of autism spectrum disorder/neurodevelopmental disabilities (ASD/NDD) coupled with the nascent stage of intervention research at prodromal or presymptomatic periods, intervention research needs to develop in lockstep with earlier identification. Flexibility appears to be an important component of the present intervention and other emerging models of infant intervention for families with young children and with multiple children with or at elevated likelihood of ASD/NDD. This study was retrospectively registered at OSF. https://osf.io/6tuyx/overview?view_only=2c85f33fd60b496f86ecb09625e6e4b7 , Clinical Trial Registration: not applicable.