Significant barriers exist to accessing early ASD-specific interventions, including long
wait times due to limited system resources (e.g., insufficient funding to meet caseload,
lack of sufficient skilled workforce), exacerbated by restrictions to in-person care
associated with families' distance from service centres, and now COVID-19 isolation
measures.
In response to system pressures and COVID-19 restrictions, the investigators adapted an
evidence-based in-person program (the Social ABCs) to increase efficiency and access.
Adaptations included (1) abbreviating the duration of the program to 6 (from 12), (2)
developing a group-based delivery approach for didactic content, and (3) providing 1:1
coaching over a virtual platform (Zoom for Healthcare). The program builds on an
evidence-based in-person model that uses direct in-the-moment coaching to help parents
learn skills to support their toddlers' development. The Social ABCs is considered a
naturalistic, developmental, behavioural intervention (NDBI), with a focus on child
motivation, play-based learning, and shared enjoyment between caregiver and child.
This three-year, multi-site project uses a randomized control trial (RCT) design to
evaluate an innovative early intervention program for toddlers with confirmed or
suspected autism spectrum disorders (ASD) or related social communication challenges.
This study will evaluate whether this innovative virtual group-based approach (VG-Social
ABCs) yields child and parent gains compared to an active control condition. The research
team will enroll 120 families, recruited from Ontario, Nova Scotia, and Alberta. Toddlers
(aged 12 - 42 months), with identified social communication concerns (or a confirmed
diagnosis of ASD), and their primary caregiver will be randomized into one of two
conditions: (1) VG-Social ABCs or (2) the active control condition. Families randomized
into the control condition will have the option to receive the VG-Social ABCs training
once their participation in the control phase concludes. Outcome measures include toddler
social communication indices and parent implementation fidelity (both derived from
video-coding), parent-reported self-efficacy and wellbeing, and child-level social
communication outcomes based on parent-report questionnaires.
Analyses will be conducted at the end of the trial. Hypotheses include increased gains
(from Time 0 to Time 1) in parent - and child-related variables for families in the
Treatment condition, compared to Controls. Investigators also anticipate that child- and
parent-related gains will be maintained at Time 2 (i.e., no significant change from Time
- for the Treatment arm.
The research team developed the virtual model in rapid response to the COVID-19 pandemic,
and pilot data shows that this promises to be a powerful way to support families of
toddlers with ASD at a developmental stage when they are most amenable to intervention.
Beyond COVID-related isolation measures, there continues to be a significant need for
increased access to evidence-based early intervention for toddlers with confirmed or
probable autism, as many families are currently waiting on years-long waitlists for
service. The research team hopes to demonstrate the efficacy of this feasible and
resource-efficient intervention to encourage government decision-makers to fund this
program for families, leading to increased access to intervention early in life, and
improved outcomes for toddlers with ASD and their families. This model will also increase
access for families who live in remote and rural regions who often have difficulty
accessing important interventions, both within Canada and beyond.