ASHA journals
2 files

Changing developmental trajectories (Wetherby et al., 2018)

Version 2 2019-10-16, 23:48
Version 1 2018-11-12, 19:08
posted on 2019-10-16, 23:48 authored by Amy M. Wetherby, Juliann Woods, Whitney Guthrie, Abigail Delehanty, Jennifer A. Brown, Lindee Morgan, Renee D. Holland, Christopher Schatschneider, Catherine Lord
Purpose: The need for community-viable, evidence-based intervention strategies for toddlers with autism spectrum disorder (ASD) is a national priority. The purpose of this research forum article is to identify gaps in intervention research and needs in community practice for toddlers with ASD, incorporate published findings from a randomized controlled trial (RCT) of the Early Social Interaction (ESI) model (Wetherby et al., 2014) to illustrate community-based intervention, report new findings on child active engagement from the ESI RCT, and offer solutions to bridge the research-to-community practice gap.
Method: Research findings were reviewed to identify gaps in the evidence base for toddlers with ASD. Published and new findings from the multisite ESI RCT compared the effects of two different ESI conditions for 82 toddlers with ASD to teach parents how to support active engagement in natural environments.
Results: The RCT of the ESI model was the only parent-implemented intervention that reported differential treatment effects on standardized measures of child outcomes, including social communication, developmental level, and adaptive behavior. A new measure of active engagement in the natural environment was found to be sensitive to change in 3 months for young toddlers with ASD and to predict outcomes on the standardized measures of child outcomes. Strategies for utilizing the Autism Navigator collection of web-based courses and tools using extensive video footage for families and professional development are offered for scaling up in community settings to change developmental trajectories of toddlers with ASD.
Conclusions: Current health care and education systems are challenged to provide intervention of adequate intensity for toddlers with ASD. The use of innovative technology can increase acceleration of access to evidence-based early intervention for toddlers with ASD that addresses health disparities, enables immediate response as soon as ASD is suspected, and rapidly bridges the research-to-practice gap.

Publisher Note: This article is part of the Research Forum: Advances in Autism Research: From Learning Mechanisms to Novel Interventions.

Wetherby, A. M., Woods, J., Guthrie, W., Delehanty, A., Brown, J. A., Morgan, L., . . . Lord, C. (2018). Changing developmental trajectories of toddlers with autism spectrum disorder: Strategies for bridging research to community practice. Journal of Speech, Language, and Hearing Research, 61(11), 2615–2628.


This article stems from the 2017 Research Symposium at ASHA Convention, which was supported by the National Institute on Deafness and Other Communication Disorders under Award R13DC003383 (Amy M. Wetherby), the National Institute of Mental Health under Awards R01MH077730 and R01MH078165 (Amy M. Wetherby, Catherine Lord), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development under Award R01HD093055 (Amy M. Wetherby) of the National Institutes of Health. This research was also supported in part by the funding from Autism Speaks (Grant 1791 awarded to Amy M. Wetherby and Catherine Lord; Grant 8551/Dennis Weatherstone Predoctoral Fellowship awarded to Whitney Guthrie) and the Simons Foundation (Catherine Lord).