Milieu Teaching-AV for Autism

(MT-AV Pilot Trial)

Overseen By Jacob I Feldman, PhD, CCC-SLP

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: Vanderbilt University Medical Center

Disqualifiers: Neurological history, Genetic condition, Pre-term birth, Vision impairment, Hearing loss

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: Up to 20 weeks

8 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a new method called Milieu Teaching-AV, which uses audiovisual speech cues to help infants with older siblings who have autism learn language. Researchers aim to determine if parents find this approach easy and acceptable to use at home, and if they implement the strategies taught. Good candidates for this trial are families with infants from English-speaking homes where an older sibling has been diagnosed with autism. As an unphased trial, this study offers families the chance to contribute to innovative research that could improve language learning strategies for infants at risk.

Do I need to stop my current medications for this trial?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that this method is safe for infants with autistic older siblings?

Studies have shown that Milieu Teaching-AV, a language intervention, is generally well-tolerated by children with autism. Research on similar methods, such as enhanced milieu teaching, has found no significant negative effects reported by parents or caregivers, suggesting the approach is safe for home use. Parents and caregivers find the strategies easy to use and acceptable, supporting its safety. Although this specific study doesn't provide detailed safety data, previous research on similar methods indicates it is likely safe for participants. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Milieu Teaching-AV is unique because it uses a structured approach to enhance communication skills in children with autism by integrating audiovisual elements into teaching. Unlike traditional behavioral therapies that might rely solely on one-on-one interaction or visual aids, this method combines both to create a more engaging learning environment. Researchers are excited about this approach because it could potentially accelerate learning and improve communication outcomes by catering to the diverse sensory preferences of children with autism. This tailored approach might offer a more personalized and effective way to support communication development, setting it apart from existing therapies.

What evidence suggests that Milieu Teaching-AV might be an effective treatment for autism?

Research has shown that Milieu Teaching-AV, which participants in this trial will receive, can improve communication skills in children with autism. Studies have found that milieu strategies help young children with autism communicate more effectively. One study demonstrated that using an iPad to show videos helped a child with autism learn basic skills. Additionally, technology-based methods have aided vocabulary growth in children with autism. These findings suggest that Milieu Teaching-AV could benefit infants at high risk for autism or language development issues. ^{5 6 7 8 9}

Are You a Good Fit for This Trial?

This trial is for infants with older siblings diagnosed with autism, as they have a higher chance of being diagnosed with autism or developmental language disorder (DLD). The study focuses on the caregivers' ability to implement a new language intervention at home and their acceptance of this method.

Inclusion Criteria

My household speaks only English.

My older sibling has been diagnosed with autism.

Exclusion Criteria

I have a diagnosed genetic condition.

Pre-term birth (gestation < 37 weeks)

I have a history of neurological problems.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Baseline

Business as usual baseline sessions conducted before intervention

Up to 20 weeks

Multiple sessions

Treatment

Participants receive Milieu Teaching-AV intervention

Up to 20 weeks

Staggered entry into experimental condition

Follow-up

Participants are monitored for caregiver strategy use and infant engagement

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Milieu Teaching-AV

Trial Overview The Milieu Teaching-AV approach is being tested. It's an innovative language intervention that encourages infants to pay attention to audiovisual speech cues. The study will assess how well caregivers can use this strategy during interactions with their infants.

How Is the Trial Designed?

Group I: Milieu Teaching-AV Experimental Treatment 1 Intervention

Following baseline sessions, there will be staggered entry into the experimental condition.

Group II: Business as usual baseline Active Control 1 Intervention

The first several sessions will be conducted in a business-as-usual baseline condition; these sessions will then be compared to the Milieu Teaching-AV condition. Entry into the Milieu Teaching-AV condition will be staggered across participants to ensure that observed changes are not due to other factors (e.g., history, maturation).

Who Is Running the Clinical Trial?

Vanderbilt University Medical Center

Lead Sponsor

Trials

922

Recruited

939,000+

National Institute on Deafness and Other Communication Disorders (NIDCD)

Collaborator

Trials

377

Recruited

190,000+

Published Research Related to This Trial

The study investigated the effectiveness of combining visual activity schedules with embedded video models on an iPad to help high school students with autism transition between tasks, showing positive results.

Students were able to independently transition between activities and demonstrated high rates of generalization to new tasks even after the video models were removed, indicating the efficacy of this combined approach.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Talking Picture Schedules: Embedding Video Models into Visual Activity Schedules to Increase Independence for Students with ASD. Spriggs, AD., Knight, V., Sherrow, L.[2018]

University students trained with a revised self-instructional manual for discrete-trials teaching (DTT) significantly improved their teaching performance from 52% to 88% accuracy after training, demonstrating the manual's effectiveness.

The use of a motivational incentive ($10 for achieving 90% accuracy) likely contributed to the students' engagement and success, as they maintained an average performance of 77% when applying DTT with actual children with autism.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evaluation of a self-instructional manual for conducting discrete-trials teaching with children with autism. Thiessen, C., Fazzio, D., Arnal, L., et al.[2019]

The study demonstrated that an iPad-based video modeling package effectively taught a 5-year-old boy with autism spectrum disorder basic numeracy skills, including identifying and writing Arabic numerals 1-7.

The treatment showed clear improvements in the child's understanding of numerals and their quantities, with evidence of generalization and maintenance of skills over time, suggesting the method's robustness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Using an iPad-based video modelling package to teach numeracy skills to a child with an autism spectrum disorder. Jowett, EL., Moore, DW., Anderson, A.[2019]

An advanced university course in Applied Behaviour Analysis (ABA) for autism was developed for Swedish professionals, utilizing blended-learning technologies and problem-solving exercises to enhance practical skills.

Students reported high satisfaction with the course, believing it would positively impact their professional practice, addressing the global shortage of trained autism intervention professionals.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Using blended and guided technologies in a university course for scientist-practitioners: teaching applied behaviour analysis to autism professionals. Roll-Pettersson, L., Ala'i-Rosales, S.[2009]

The paper compares two key behavioral intervention models for teaching language to children with autism: Applied Verbal Behavior (AVB), which follows Skinner's principles, and Naturalistic Teaching Approaches (NTAs), which focus on strategies in natural settings.

It highlights the importance of understanding both approaches to improve communication and collaboration between professionals, while also discussing common teaching procedures and how they can be integrated for better outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Behavioral language interventions for children with autism: comparing applied verbal behavior and naturalistic teaching approaches. Leblanc, LA., Esch, J., Sidener, TM., et al.[2021]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11854219/

Effectiveness of Intensive Linguistic Intervention in Autism ... The aim of this study was to assess the effectiveness of an individualized and intensive oral language and communication intervention.

2. frontiersin.org frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2024.1370965/full

The use of technology-assisted intervention in vocabulary ... Introduction: Children with autism spectrum disorder may show delays in vocabulary development. Technology-based interventions could facilitate the teaching ...

3. link.springer.com link.springer.com/article/10.1007/s10803-021-05331-y

Effectiveness of Responsivity Intervention Strategies on ... Impact of milieu teaching on communication skills of young children with autism spectrum disorder. Topics in Early Childhood Special ...

4. withpower.com withpower.com/trial/milieu-teaching-av-for-autism-24de0

Milieu Teaching-AV for Autism (MT-AV Pilot Trial) The study demonstrated that an iPad-based video modeling package effectively taught a 5-year-old boy with autism spectrum disorder basic numeracy skills, ...

5. ircommons.uwf.edu ircommons.uwf.edu/esploro/outputs/doctoral/Impact-of-Milieu-Teaching-on-Communication/99380090756006600

Impact of Milieu Teaching on Communication Skills of ... Results indicated that milieu strategies are an effective means of providing communication skills instruction for young children with ASD in an ECSE classroom.

6. mdpi.com mdpi.com/2227-9067/12/2/182

Effectiveness of Intensive Linguistic Intervention in Autism ... Evaluation of the effectiveness of video-modeling for teaching articulation in verbal children with autism spectrum disorder. Rev. Eur. Stud. 2023, 15, 42 ...

7. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/37823798/

Aided Enhanced milieu teaching to develop symbolic and ... The aim of this study was to investigate the efficacy of an intervention that combined aided AAC with a naturalistic intervention - enhanced milieu teaching ( ...

8. researchgate.net researchgate.net/publication/330919629_Enhanced_milieu_teaching_for_children_with_autism_spectrum_disorder_in_South_Africa

(PDF) Enhanced milieu teaching for children with autism ... This multiple baseline study examined the effects of therapist-implemented enhanced milieu teaching (EMT) on the diversity and frequency of spoken language of ...

9. dc.etsu.edu dc.etsu.edu/cgi/viewcontent.cgi?referer=&httpsredir=1&article=3108&context=etd

Educational Interventions for Children with Autism Spectrum ... Data were collected through interviews with a purposeful sample of 7 parents of 6 children with autism spectrum disorders, 8 special education teachers, and 6 ...