Feasibility and acceptability of a caregiver-mediated early support program, delivered online, for infants at elevated familial likelihood for autism: A feasibility randomized controlled trial.
You can run a short, high-quality parent coaching program on Zoom for families of babies at high autism likelihood and keep both fidelity and parent satisfaction above a large share.
01Research in Context
What this study did
Researchers tested LiL' STEPS, a 12-week online coaching program for parents of 9-15-month-old babies who have an older sibling with autism.
Families in India joined live Zoom sessions and watched short videos that showed how to respond when their baby babbled, pointed, or looked at them.
The team asked: can we recruit families, keep them engaged, and hit a large share fidelity without ever meeting in person?
What they found
Four new families signed up each month and only meaningful improvementped out, showing the program is doable.
Every parent said they liked the course and a large share would tell a friend to join.
Coaches scored a large share fidelity on average, proving the Zoom model works.
How this fits with other research
Simacek et al. (2020) looked at 22 telehealth parent-training studies and said the field is growing fast; LiL' STEPS adds fresh infant data to that map.
Solomon et al. (2007) ran an in-home program years ago and also saw happy parents, but LiL' STEPS shows you can get the same smile scores through a screen.
Gerow et al. (2021) coached parents online for daily-living skills in older kids and hit high fidelity too, so the online model now spans from infancy to elementary age.
Why it matters
If you serve rural, military, or COVID-cautious families, you can start an evidence-based social-communication program tomorrow without renting an office.
Use short parent videos, live Zoom feedback, and simple checklists to keep fidelity above a large share.
The low dropout rate means you bill fewer missed sessions and families finish what they start.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Email each parent a two-minute clip that shows waiting, then responding, after the baby points and vocalizes; ask them to practice twice today and note the times.
02At a glance
03Original abstract
Preliminary evidence indicates potential benefit of providing caregiver-mediated intervention, prior to diagnosis, for infants at elevated familial likelihood for autism and related developmental delays including language delay (EL-A). However, delivering such interventions online and in low-resource settings like India has not been reported. This study aimed to evaluate the feasibility and acceptability of delivering a novel manualized caregiver-mediated early support program, the "LiL' STEPS," online in India, for EL-A infants. LiL' STEPS stands for Language development & Intervention Lab's (LiL') Supporting Early social-communication and language by Promoting caregiver Sensitive responsiveness (STEPS). The program comprised 14 sessions with a focus on social-communication and language, conducted over 12-weeks using demonstration and video feedback. Families of 36 EL-A infants aged 9 to 15-months participated in this feasibility randomized controlled trial (RCT). Families were randomized in a 2:1 ratio (n = 24 LiL' STEPS and n = 12 care as usual groups). Information on feasibility and acceptability was collated following a mixed methods approach from caregiver interviews, fidelity forms, session notes, and study register. Findings indicated the LiL' STEPS study trial as feasible and acceptable with recruitment rate of 4 per month, 100% willingness for randomization, 8.3% attrition, and 3.03% loss of blinding. Interventionist and caregiver fidelity was maintained above 80%. Despite challenges like interruptions during sessions, 100% families found the program acceptable and satisfactory, 86% said they would recommend the program to others, and 71% preferred online modality. Caregivers' perspectives on beneficial components and experience attending the program have been described. Accordingly, recommendations for future definitive RCTs have been presented.
Autism research : official journal of the International Society for Autism Research, 2024 · doi:10.1002/aur.3217