Quality and Duration of P-Esdm Intervention Mediates the Developmental Outcomes of Toddlers with ASD

Background:

A clinical trial previously published our team indicated that Chinese ASD toddlers receiving 26 weeks of P-ESDM via regular coaching sessions significantly improved their developmental outcomes including social communications than those receiving community interventions.

Objectives:

To further explore how parents’ duration and mastery of P-ESDM could influence the developmental outcomes of toddlers with ASD.

Methods:

We calculated the durations of P-ESDM (≥20hrs/week or ＜20hrs/week) according to the Intervention Record Sheet completed by parents and evaluated their mastery of P-ESDM (master-fidelity score≥3 or loose-fidelity score＜3) based on their fidelity and their self-assessment. Considering the parents who mastered the techniques of ESDM well tended to implement the intervention more frequently, we performed repeated measure ANOVA and post-hoc t-tests comparing the developmental outcomes of ASD toddlers receiving P-ESDM intervention for more or less than 20 hours a week at home, and receiving the intervention by more or less skilled parents.

Results:

1. We perform 2 (Mastery: master, loose)*2 (Duration: ≥20hrs/week, <20hrs/week) repeated measure ANOVA. The results indicated that the interaction between the 2 factors is significant (F=21.135, P=0.019). Then post-hoc t-tests were applied and the results are listed as follows.
2. ASD toddlers receiving P-ESDM intervention for more than 20 hours(n=15) demonstrated greater improvement in general development than those for less than 20(n=8)(ΔGQ: 10.78±12.22 vs. 2.95±4.24，P=0.037), especially in Language domain.
3. ASD toddlers with relatively more-skilled parents(n=14) showed significant improvement in general development than those with less-skilled parents(n=9)(ΔGQ: 11.41±12.43 vs. 2.84±3.97，P=0.029) , especially in Language and Eye-hand coordination domains.

Conclusions:

Our results demonstrated that higher intensity of P-ESDM intervention with more-skilled parents would effectively improve developmental outcomes of toddlers with ASD, even with low-intensity professional coaching. We underscore the importance of regular parent training and actively participating in the early intervention for ASD toddlers in daily life.