Effectiveness of Early Intervention in an Underserved Population

Families of racial/ethnic minority, lower levels of education, and those who live in
non-metropolitan areas have been found to experience greater limitations in accessing
services for Autism Spectrum Disorder (ASD) (Thomas, Ellis, McLaurin, Daniels, & Morrissey,
2007). Black and Hispanic children have been found to have lower odds of having a documented
ASD classification than white children (Mandell, Wiggins, Arnstein Carpenter, Daniels, Durkin
et al., 2009) and of those children who do receive an ASD diagnosis, many of them are not
diagnosed in early childhood. The age of first ASD diagnosis received has been found to be
significantly higher for African American and Latino children compared to white children
(Mandell, Listerud, Levy, & Pinto-Martin, 2002). For these reasons, it is important that the
effectiveness of intensive early intervention for children with ASD is examined across
varying cultural and socioeconomic backgrounds.

This project is directed by Dr. Catherine Lord at the University of Michigan, in
collaboration with Dr. Amy Wetherby at Florida State University to test the applicability of
a modified caregiver-implemented autism intervention (Modified Early Social Interaction; ESI)
to a deliberately recruited low-income, underserved population. UM will recruit 28 children
and FSU will recruit 16 children diagnosed with ASD who are between 24 and 42 months of age
over a period of 3 years, totaling 44 caregiver-child dyads. This study will utilize a
multiple baseline single-subject research design. Dyads will complete 1 month of weekly
1-hour baseline observations followed by three months of the modified ESI intervention. Child
and family characteristics predicting response to intervention will be identified and
findings will contribute to the development of autism interventions serving families from
diverse backgrounds.

Inclusion Criteria:

- caregiver(s) with less than a 4-year college degree

- family income equal to or below 2x the federal poverty line

- English as the predominantly-spoken language.

- child received diagnosis of autism spectrum disorder before treatment

- child is between 24 and 42 months at the start of treatment

- child has normal hearing and adequate motor control to make simple actions (giving,
reaching)

- family agrees to 2-4 weeks of weekly 1-hour observations, 3 months of 2 intervention
sessions per week, and 3 months of 1 intervention session per month.

- family agrees to pre-treatment, post-treatment, and follow-up evaluation and
videotaping of intervention sessions and weekly video check during the treatment.

Exclusion Criteria:

-Must meet eligibility requirements stated above.