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Infant Achievements Intervention Improves Caregiver Implementation Fidelity and Infant Social Communication Outcomes:

Rebecca J Landa1,2, Rachel Reetzke1,2, Christine Reiner Hess1

  • 1Center for Autism Services, Science and Innovation, Kennedy Krieger Institute, Baltimore, USA.

Autism Research : Official Journal of the International Society for Autism Research
|May 3, 2025
PubMed

Insights

Caregiver coaching in naturalistic developmental behavioral interventions (NDBI) significantly improved social communication skills in infants with idiopathic social communication delay (SCD). This early intervention shows promise for advancing pre-linguistic development.

Area of Science:

  • Developmental Psychology
  • Pediatric Communication Disorders
  • Early Intervention

Background:

  • Idiopathic social communication delay (SCD) in infants is challenging due to limited research and early intervention trials.
  • Caregiver involvement is crucial for addressing developmental delays in infants.
  • Early identification and intervention can significantly impact long-term outcomes for children with communication challenges.

Purpose of the Study:

  • To preliminarily test the efficacy of an 8-week caregiver-implemented intervention for infants diagnosed with idiopathic social communication delay (SCD).
  • To evaluate the impact of the Infant Achievements (IA) intervention on infant social communication skills compared to a control group.
  • To assess the role of caregiver coaching in implementing naturalistic developmental behavioral intervention (NDBI) strategies.

Main Methods:

  • An assessor-masked randomized controlled trial (RCT) involving infants aged 8-12 months with idiopathic SCD.
  • Participants were randomized into the Infant Achievements (IA) group (caregiver coaching in NDBI) or a Caregiver Education (CE) control group.
  • Outcomes included caregiver implementation fidelity, infant initiation of joint attention (IJA), coordination of joint engagement (CJE), and standardized developmental assessments.

Main Results:

  • The IA group showed significant improvements in all primary outcomes (fidelity, IJA, CJE) compared to the CE group at post-intervention and follow-up.
  • Secondary outcomes, including nonverbal cognition and speech composite scores, also significantly improved in the IA group.
  • Caregiver coaching effectively equipped caregivers to implement NDBI strategies, leading to enhanced pre-linguistic social communication.

Conclusions:

  • Caregiver-implemented NDBI, delivered through reflective coaching, is effective in promoting social communication development in infants with idiopathic SCD.
  • The Infant Achievements intervention demonstrates potential for improving early social interaction and communication skills.
  • This study highlights the importance of early, caregiver-mediated interventions for infants with social communication delays.

Keywords:
caregivercommunicationdelayinfantsinterventionrandomized controlled trialsocial

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