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

Trial Summary

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.

How is the Milieu Teaching-AV treatment for autism different from other treatments?

Milieu Teaching-AV is unique because it combines video modeling with visual activity schedules to help individuals with autism transition between tasks independently, which is not commonly seen in other treatments. This approach leverages technology, such as iPads, to embed video models into visual schedules, enhancing the ability to generalize skills across different activities. ^{1 2 3 4 5}

What is the purpose of this trial?

This project will look at whether a novel approach to language intervention that encourages looking to audiovisual speech cues for infants with autistic older siblings (Baby Sibs), who are highly likely be diagnosed with autism or developmental language disorder (DLD). This study will specifically look at (a) whether caregivers find this approach to be easy to implement in their homes, (b) whether they find this approach to be acceptable, and (c) whether caregivers use the taught strategies in interactions with their infants.

Eligibility Criteria

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 older sibling has been diagnosed with autism.

My household speaks only English.

Exclusion Criteria

I have a history of neurological problems.

I have a diagnosed genetic condition.

Pre-term birth (gestation < 37 weeks)

Timeline

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

Treatment Details

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.

Participant Groups

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+

Findings from Research

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]

References

1. United States pubmed.ncbi.nlm.nih.gov

Talking Picture Schedules: Embedding Video Models into Visual Activity Schedules to Increase Independence for Students with ASD. [2018]

2. United States pubmed.ncbi.nlm.nih.gov

Evaluation of a self-instructional manual for conducting discrete-trials teaching with children with autism. [2019]

3. England pubmed.ncbi.nlm.nih.gov

Using an iPad-based video modelling package to teach numeracy skills to a child with an autism spectrum disorder. [2019]

4. England pubmed.ncbi.nlm.nih.gov

Using blended and guided technologies in a university course for scientist-practitioners: teaching applied behaviour analysis to autism professionals. [2009]

5. Switzerland pubmed.ncbi.nlm.nih.gov

Behavioral language interventions for children with autism: comparing applied verbal behavior and naturalistic teaching approaches. [2021]