A randomized controlled trial was conducted to evaluate effects of the Joint Attention Mediated Learning (JAML) intervention. Toddlers with autism spectrum disorders (ASD) aged 16-30 months (n = 144) were randomized to intervention and community control conditions. Parents, who participated in 32 weekly home-based sessions, followed a mediated learning process to target preverbal social communication outcomes (social visual synchrony, reciprocity, and responding and initiating forms of joint attention) throughout daily interactions. The analysis found post-intervention effects for all outcomes, with all except initiating joint attention sustaining 6 months post-intervention. Findings support the value of very early intervention targeting explicitly social functions of preverbal communication and of promoting active engagement in the learning process for both toddlers and parents.
In great demand are efficient mechanisms for delivery of evidence-based interventions for promoting social-emotional development and early positive behavior of all children, and especially for those with or at risk for disabilities. The rise of Internet use has created potentially new avenues for intervention delivery, which, when paired with the many recent advances in computer networking and multimedia technology, is fueling this demand. This article describes the development of an Internet-based, computer-delivered parent-training intervention, Infant Net, with infants at risk for poor social-emotional outcomes. Results of a randomized control trial of the Infant Net intervention with 40 parent-infant dyads showed significant increase, reflecting a medium to large effect size, in infant social engagement and engagement with the environment for infants in the intervention group as compared to the control group. Implications are discussed with regard to future research.
This study examined the efficacy of a multimodule parenting intervention, “My Baby & Me,” that began prenatally and continued until children reached 2.5 years of age. The intervention targeted specific parenting skills designed to alter trajectories of maternal and child development. Of 361 high-risk mothers (193 adolescents, 168 adults) enrolled across 4 states, half were randomly assigned to the high-intensity (HI) home visitation coaching program (55 sessions), and half to a low-intensity (LI) condition that included monthly phone calls from a coach, printed informational materials, and community resource referrals. Videotaped observations of mother–child play were coded at 5 time points for multiple maternal and child behaviors and skills. Compared to mothers in the LI group, mothers in the HI group showed higher levels of contingent responsiveness, higher quality verbal stimulation, and more verbal scaffolding by 30 months, with higher levels of warmth and greater decreases in physical intrusiveness and negativity when their children were 24 months. By 30 months, children in the HI group showed more rapid increases and higher levels of engagement with the environment, expressive language skills, and social engagement, as well as more complex toy play and fewer problem behaviors than those in the LI group. Gains in maternal responsive behaviors mediated the effects of the intervention on child outcomes. Results were comparable for adolescent and adult mothers. A strong theoretical framework, consistent focus on maternal responsiveness, high dosage, and trusting relationships with coaches are thought to explain the positive outcomes.
Early parenting home-visiting interventions have been found to be highly effective in promoting child development. Yet, there are many obstacles in the implementation of home-visiting programs, including travel and access to trained providers. Internet-based interventions can reach many parents of infants to overcome these barriers. The objective of this randomized control trial was to evaluate the impact of the Internet-adaptation of the Play and Learning Strategies (PALS) program, a preventive intervention program to strengthen effective parenting practices that promote early language, cognitive, and social development. others in low-income environments (N = 164) of infants were randomized to either (a) an Internet-facilitated PALS parenting intervention or (b) an Internet-facilitated attention control condition. Measures included direct observations of maternal behavior with her infant, questionnaires about maternal functioning and parenting knowledge, and real-time program usage. Experimental participants demonstrated significantly greater increases in parenting knowledge and observed language-supportive parenting behaviors with a correlated positive change in infant language behaviors. Effects were pronounced when participants received a greater dosage of the intervention. Results suggest that the Internet-based translation of the PALS program is effective as a remotely delivered intervention for economically disadvantaged families to strengthen early parenting behaviors that promote infant social communication and child language development.
This study evaluated the effectiveness of an intervention designed to improve early parenting by increasing understanding of infant developmental needs and promoting maternal responsiveness as indicated by increased positive behavior support for infants and decreased psychological control. At-risk mothers were randomly assigned to control or treatment conditions, the latter consisting of training in parental responsiveness, developmental knowledge, and loving touch. Following the intervention, treatment mothers reduced their controlling tendencies; they were less rigid, less intrusive, and more flexible than control mothers. Treatment mothers provided more parental support indicated by higher quality verbalizations, more demonstrative teaching, and lower role-reversal tendencies. Editors' Strategic Implications: Further replication will be necessary, but the results for the "My Baby and Me" program are promising. The authors provide crucial information for parent educators about the pairing of basic knowledge transfer with the active engagement of parents with their infants in practicing new parenting skills.
There are major obstacles to the effective delivery of mental health services to poor families, particularly for those families in rural areas. The rise of Internet use, however, has created potentially new avenues for service delivery, which, when paired with the many recent advances in computer networking and multimedia technology, is fueling a demand for Internet delivery of mental-health services. We report on the adaptation of a parenting program for delivery via the Internet, enhanced with participant-created videos of parent-infant interactions and weekly staff contact, which enable distal treatment providers to give feedback and make decisions informed by direct behavioral assessment. This Internet-based, parent-education intervention has the potential to promote healthy and protective parent-infant interactions in families who might not otherwise receive needed mental health services.Child maltreatment is one of our nation's most significant public-health problems (National Center for Injury Prevention and Control, 2004). Though it is difficult to arrive at firm prevalence rates, the Department of Health and Human Services [DHHS] (2005) indicates that in 2005 (the most recent year for which National Child Abuse and Neglect Data System summary statistics are available), 899,000 children in the U.S. and its territories were victims of abuse or neglect. This statistic very likely under-estimates the true prevalence rate (DHHS, 2005; Goldman, Salus, Wolcott, & Kennedy, 2003). Infants and young children are particularly vulnerable. Children under 3 years of age are the most frequent victims of substantiated maltreatment (Goldman, et al.;Wu et al., 2004), and over 40% of maltreatment-related fatalities
Technology advances increasingly allow for access to remotely delivered interventions designed to promote early parenting practices that protect against child maltreatment. Among low-income families, at somewhat elevated risk for child maltreatment, there is some evidence that parents do engage in and benefit from remote-coaching interventions. However, little is known about the effectiveness of such programs to engage and benefit families at high risk for child maltreatment due to multiple stressors associated with poverty. To address this limitation, we examined engagement and outcomes among mothers at heightened risk for child abuse, who were enrolled in a randomized controlled, intent-to-treat trial of an Internet adaptation of an evidence-based infant parenting intervention. We found that engagement patterns were similar between higher and lower risk groups. Moreover, an intervention dose by condition effect was found for increased positive parent behavior and reduced child abuse potential.
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