Journal of Autism and Developmental Disorders

, Volume 47, Issue 11, pp 3520–3540 | Cite as

Parent-Mediated Intervention for One-Year-Olds Screened as At-Risk for Autism Spectrum Disorder: A Randomized Controlled Trial

  • Linda R. WatsonEmail author
  • Elizabeth R. Crais
  • Grace T. Baranek
  • Lauren Turner-Brown
  • John Sideris
  • Linn Wakeford
  • Jessica Kinard
  • J. Steven Reznick
  • Katrina L. Martin
  • Sallie W. Nowell
Original Paper


Theoretically, interventions initiated with at-risk infants prior to the point in time a definitive autism spectrum disorder (ASD) diagnosis can be made will improve outcomes. Pursuing this idea, we tested the efficacy of a parent-mediated early intervention called Adapted Responsive Teaching (ART) via a randomized controlled trial with 87 one-year-olds identified by community screening with the First Year Inventory as at-risk of later ASD diagnoses. We found minimal evidence for main effects of ART on child outcomes. However, ART group parents showed significantly greater increases in responsiveness to their infants than control group parents. Further, significant indirect (mediation) effects of assignment group on multiple child outcomes through changes in parent responsiveness supported our theory of change.


Infants Autism spectrum disorder Screening Prodromal Intervention Responsiveness 



The research reported here was supported by a grant from the Institute of Education Sciences, U.S. Department of Education (Grant # R324A100305) to the University of North Carolina at Chapel Hill. The opinions expressed are those of the authors and do not represent views of the Institute or the U.S. Department of Education. We gratefully acknowledge the invaluable contributions of our project staff and of the families who participated in this study. We miss the creativity, insightfulness, collegiality, and friendship of Dr. J. Steven Reznick, who was such an inspiring collaborator in this research. Portions of the research reported in this manuscript have been presented previously at the 2015 International Meeting for Autism Research (Salt Lake City, UT), the 2015 Institute of Education Sciences Principal Investigators Meeting (Washington, DC), and the 2016 Conference on Research Innovations in Early Intervention (San Diego, CA).

Author Contributions

LRW served as principal investigator for the study, participating in study conceptualization, design and coordination; data acquisition, analysis, and interpretation; and drafting the manuscript. ERC served as co-principal investigator, with contributions to study conceptualization, design and coordination; assessor training, data acquisition and interpretation; and drafting the manuscript. GTB participated in study conceptualization and design; assessor training and data interpretation; and drafting the manuscript. LTB participated in study conceptualization and design; assessor training, coordination, and supervision; data acquisition and interpretation; and drafting the manuscript. JS participated in the design of the study, performed statistical analyses, and contributed to drafting the manuscript. LW participated in interventionist training, coordination, and supervision; served as an interventionist; and participated in data acquisition and interpretation. JK coordinated data acquisition for parent interaction variables and contributed to data interpretation and drafting the manuscript. JSR contributed to the conceptualization and design of the study, recruitment of the sample, and data interpretation. KLM participated in data acquisition and interpretation. SWN contributed to project coordination, data interpretation, and drafting the manuscript. All authors read and approved the final manuscript.

Compliance with Ethical Standards

Conflict of interest

Some of the authors of this paper have intellectual property rights related to several of the instruments used in the study. Baranek, Watson, Crais, and Reznick (now deceased) are co-authors of the First Year Inventory. Baranek is the author of the Sensory Experiences Questionnaire and the Sensory Processing Assessment. Reznick is a co-author of the MacArthur-Bates Communicative Development Inventories. The authors declare they have no financial conflicts of interest.

Ethical Approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Supplementary material

10803_2017_3268_MOESM1_ESM.docx (180 kb)
Supplementary material 1 (DOCX 179 KB)


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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Linda R. Watson
    • 1
    Email author
  • Elizabeth R. Crais
    • 1
  • Grace T. Baranek
    • 1
    • 2
  • Lauren Turner-Brown
    • 1
  • John Sideris
    • 1
    • 2
  • Linn Wakeford
    • 1
  • Jessica Kinard
    • 1
  • J. Steven Reznick
    • 1
  • Katrina L. Martin
    • 1
    • 3
  • Sallie W. Nowell
    • 1
  1. 1.The University of North Carolina at Chapel HillChapel HillUSA
  2. 2.University of Southern CaliforniaLos AngelesUSA
  3. 3.SRI InternationalMenlo ParkUSA

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