Sibling-Mediated Intervention for Autism

No longer recruiting at 2 trial locations

Overseen By Katie Castro

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: Arizona State University

Disqualifiers: Aggression, Noncompliance, others

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

Compensation: Varies

Number of Visits: 3

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores whether siblings can effectively teach social and reading skills to children with autism through a sibling-mediated intervention. It examines how interactions with typically developing siblings might enhance early literacy and social skills like conversation and play. The trial consists of two parts: one where siblings actively teach using specific methods and another where siblings simply spend time together. Families with children who have autism, who can imitate actions and answer questions, and siblings who can read simple words might be a good fit. This opportunity could enhance sibling relationships and support skill development in children with autism. As an unphased study, this trial offers families a unique chance to contribute to research that could improve sibling relationships and skill development in children with autism.

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

What prior data suggests that this sibling-mediated intervention is safe for children with autism?

Research shows that sibling involvement can safely and effectively support children with autism. Studies indicate that when siblings teach, they positively influence their brother's or sister's social and communication skills. Although specific safety data for these methods is lacking, they emphasize family involvement, which is generally well-received and considered low risk. Siblings, familiar and part of everyday life, can offer more practice opportunities in natural settings. This approach has improved various skills in children with autism, with no major safety concerns reported. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the sibling-mediated intervention for autism because it leverages family dynamics in a new and potentially impactful way. Unlike standard treatments that often involve professionals working directly with children, this approach empowers typically developing siblings to provide structured support and learning opportunities. This method not only fosters a supportive family environment but also aims to enhance social and communication skills in a natural setting, which could lead to more effective and sustainable improvements.

What evidence suggests that the sibling-mediated intervention is effective for autism?

Research shows that when siblings help teach children with autism, it can improve their social and communication skills. In this trial, one group of participants will receive a sibling-mediated intervention, where typically developing siblings provide explicit instruction to children with autism. A review of different studies has found that this method has a moderate impact, making a noticeable difference. Parents and siblings generally express high satisfaction with these programs, and experts have observed significant positive changes after the treatment. Evidence also suggests that these sibling-led activities enhance social skills, which are often challenging for children with autism. Early results specifically show that siblings can successfully use a step-by-step teaching method, leading to skill improvement in children with autism. ^{1 3 6 7 8}

Who Is on the Research Team?

Chengan Yuan, PhD

Principal Investigator

Arizona State University

Erin Rotheram-Fuller, PhD

Principal Investigator

Arizona State University

Juliet Hart Bartnett, PhD

Principal Investigator

Arizona State University

Are You a Good Fit for This Trial?

This trial is for children with Autism Spectrum Disorder (ASD) who can imitate actions and vocalize, and their typically developing siblings who can read. Both should be able to follow instructions. It's not specified what would exclude someone from this study.

Inclusion Criteria

Typically developing children can sound out and blend letters during reading

Both siblings can demonstrate compliance during instruction

Children with ASD can imitate physical actions and repeat vocalizations, answer common questions, label common objects and actions with adjectives

Exclusion Criteria

Children with aggression towards their siblings and noncompliance during instruction

Children with ASD who can sound out and blend letters

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Pre-Assessment

Pre-assessments for children with ASD, typically developing siblings, and parents to establish baseline measures

5 days

Multiple visits (in-person and virtual)

Intervention

Sibling-mediated intervention with compliance training and intervention phases focusing on early literacy and social reciprocity

3 months

Ongoing sessions (virtual and in-person)

Posttest/Post-intervention

Post-intervention assessments to evaluate changes in skills and social validity

1 week

Multiple visits (in-person and virtual)

Follow-up

Participants are monitored for changes in sibling relationship, self-efficacy, and other outcomes at 3, 6, and 9 months post-intervention

9 months

3 follow-up visits (virtual)

What Are the Treatments Tested in This Trial?

Interventions

• Sibling-mediated intervention

Trial Overview The study tests a sibling-mediated intervention where the typically developing sibling uses a model-lead-test approach to improve the ASD child's reading and social skills, as well as their relationship.

How Is the Trial Designed?

Group I: Sibling-mediated intervention Experimental Treatment 1 Intervention

Children with autism will receive explicit instruction from their typically developing siblings

Group II: Treatment as usual/Sibling interaction Active Control 1 Intervention

Children with autism will spend time with their typically developing siblings for 20-30 mins at least three times a week

Who Is Running the Clinical Trial?

Arizona State University

Lead Sponsor

Trials

311

Recruited

109,000+

Published Research Related to This Trial

Interactions between 18-month-old infants and their older siblings with autism spectrum disorder (ASD) showed higher levels of negativity compared to those with typically developing siblings, indicating potential challenges in these early relationships.

Sibling pairs with an older sister exhibited more positive behaviors, suggesting that gender dynamics may influence the quality of sibling interactions, which could impact the developmental trajectories of both siblings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The early development of infant siblings of children with autism spectrum disorder: Characteristics of sibling interactions. Bontinck, C., Warreyn, P., Van der Paelt, S., et al.[2018]

Children with ASD showed significantly more negative interactions when playing with older siblings compared to younger siblings, indicating that sibling age may influence interaction quality.

Parents reported more negative interactions with their children with ASD during play than when these children interacted with younger siblings, suggesting that the dynamics of play differ based on the partner involved.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Social Behaviors of Children with ASD during Play with Siblings and Parents: Parental Perceptions. O'Brien, ZK., Cuskelly, M., Slaughter, V.[2020]

The study involved three sibling pairs and demonstrated that normal siblings of autistic children could effectively learn and apply behavior modification techniques, leading to improved learning outcomes for their autistic siblings.

Post-training assessments showed that the normal siblings made more positive statements and fewer negative statements about their autistic siblings, suggesting enhanced understanding and relationship dynamics.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Behavioral training for siblings of autistic children. Schreibman, L., O'Neill, RE., Koegel, RL.[2019]

In a study of 42 children with Autism Spectrum Disorder (ASD) who received a 3-month parent-mediated intervention, all participants showed significant improvements in symptom severity and adaptive functioning at both 3-month and 18-month follow-ups.

At the 18-month follow-up, 16.7% of the children achieved the 'best possible' outcome, with scores indicating they no longer qualified for an ASD diagnosis, highlighting the effectiveness of early intervention in altering developmental trajectories.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Clinical outcomes of children with ASD - Preliminary findings from a 18 month follow up study. Manohar, H., Kandasamy, P.[2021]

The study involved six sibling pairs, including four children with autism, and demonstrated that siblings can effectively learn and implement reciprocal imitation training, leading to increased engagement and imitation in children with autism.

All siblings reported high satisfaction with the intervention, and objective observations showed significant improvements in the children's social interactions, suggesting that sibling involvement can be a valuable approach in autism interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evaluation of a Sibling-Mediated Imitation Intervention for Young Children with Autism. Walton, KM., Ingersoll, BR.[2023]

Parent-mediated interventions (PMIs) for children with autism spectrum disorders (ASDs) showed a small but clinically relevant improvement in parent-rated adaptive functioning, although the evidence is of low certainty based on a review of 30 randomized controlled trials involving 1,934 participants.

PMIs may help reduce disruptive behavior in children with ASD, with a moderate certainty of evidence indicating a significant effect, but no clear benefits were found for clinician-rated core symptoms or parental well-being.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Parent-Mediated Interventions for Children and Adolescents With Autism Spectrum Disorders: A Systematic Review and Meta-Analysis. Conrad, CE., Rimestad, ML., Rohde, JF., et al.[2021]

In a pilot study involving twin brothers with autism, the child receiving Applied Behavior Analysis (ABA) showed a slight improvement in communication skills, while the child receiving Developmental, Individual-differences, Relationship-based (DIR) intervention experienced a slight decline.

The study highlighted the importance of careful interpretation of the Communication and Symbolic Behavior Scales (CSBS) results when advising parents and students, and it emphasized the need for further research comparing different intervention programs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Brief report: comparative ABA and DIR trials in twin brothers with autism. Hilton, JC., Seal, BC.[2019]

Siblings of children with autism spectrum disorder (ASD) reported only slightly elevated levels of behavioral and emotional problems compared to normative data, with no statistically significant differences, suggesting that their experiences may not be as negatively impacted as previously thought.

The study found that higher behavior problems in the child with ASD were linked to decreased warmth and increased conflict in sibling relationships, indicating that while siblings may not have significant emotional issues, their relationships can be affected by the behavior of the child with ASD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Self-reported behaviour problems and sibling relationship quality by siblings of children with autism spectrum disorder. Hastings, RP., Petalas, MA.[2022]

The script-fading procedure effectively increased the number of contextually appropriate statements made by younger siblings with autism, showing lasting improvements even after the scripts were faded.

Typically developing children successfully implemented the script-fading procedure with high fidelity, indicating that they can be effective facilitators in supporting communication skills in their siblings with autism.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Sibling-Implemented Script Fading to Promote Play-Based Statements of Children with Autism. Akers, JS., Higbee, TS., Pollard, JS., et al.[2020]

There is a lack of consistent methods for including siblings in interventions designed for individuals with autism spectrum disorder (ASD), despite their occasional involvement in treatment programs.

The review highlights the need for more research on sibling participation in ASD interventions, identifying gaps in current studies and suggesting areas for future exploration to improve outcomes for families.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Sibling involvement in interventions for individuals with autism spectrum disorders: a systematic review. Shivers, CM., Plavnick, JB.[2021]

Citations

1. link.springer.com link.springer.com/article/10.1007/s40489-020-00212-z

A Meta-Analysis of Sibling-Mediated Intervention for ... In general, results across the studies show that sibling-mediated intervention has medium effect size and can be used as a method to improve ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC3856875/

Evaluation of a Sibling-Mediated Imitation Intervention for ... Parents and siblings reported high satisfaction with the intervention and ratings by naïve observers indicated significant changes from pre- to post-treatment.

3. uwo.ca uwo.ca/fhs/lwm/teaching/EBP/2019_20/Jensen.pdf

Critical Review: Is sibling-mediated intervention effective in ... Overall, findings indicate that there is suggestive evidence for the effectiveness of sibling-mediated interventions in increasing social skills in children ...

4. researchgate.net researchgate.net/publication/341912216_A_Meta-Analysis_of_Sibling-Mediated_Intervention_for_Brothers_and_Sisters_Who_Have_Autism_Spectrum_Disorder

(PDF) A Meta-Analysis of Sibling-Mediated Intervention for ... Overall, results across several studies reveal that siblings can have positive impacts on social and communication skills in children with autism. However, ...

5. withpower.com withpower.com/trial/phase-autistic-disorder-10-2021-fd645

Sibling-Mediated Intervention for Autism · Info for Participants All siblings reported high satisfaction with the intervention, and objective observations showed significant improvements in the children's social interactions, ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11744003/

Early Recognition and Intervention in SIBlingS at High Risk for ... It has been widely demonstrated that siblings of children with autism spectrum disorder (ASD) have an increased risk of abnormal developmental trajectories.

7. etd.ohiolink.edu etd.ohiolink.edu/acprod/odb_etd/ws/send_file/send?accession=miami1674165786943339&disposition=inline

a meta-analysis of sibling-mediated interventions for youth ... Sibling-mediated interventions have been identified as an effective, family-focused intervention approach for improving social and adaptive skills in youth ...

8. link.springer.com link.springer.com/article/10.1007/s10826-024-02914-y

Sibling-Mediated Early Start Denver Model Support for ... This study evaluated the inclusion of older siblings in the delivery of Early Start Denver Model (ESDM) support to autistic children aged between 3 and 4 years.