Changing developmental trajectories (Wetherby et al., 2018)

<div><div><b>Purpose:</b> The need for community-viable, evidence-based intervention strategies for toddlers with autism spectrum disorder (ASD) is a national priority. The purpose of this research forum article is to identify gaps in intervention research and needs in community practice for toddlers with ASD, incorporate published findings from a randomized controlled trial (RCT) of the Early Social Interaction (ESI) model (Wetherby et al., 2014) to illustrate community-based intervention, report new findings on child active engagement from the ESI RCT, and offer solutions to bridge the research-to-community practice gap.</div><div><b>Method:</b> Research findings were reviewed to identify gaps in the evidence base for toddlers with ASD. Published and new findings from the multisite ESI RCT compared the effects of two different ESI conditions for 82 toddlers with ASD to teach parents how to support active engagement in natural environments.</div><div><b>Results:</b> The RCT of the ESI model was the only parent-implemented intervention that reported differential treatment effects on standardized measures of child outcomes, including social communication, developmental level, and adaptive behavior. A new measure of active engagement in the natural environment was found to be sensitive to change in 3 months for young toddlers with ASD and to predict outcomes on the standardized measures of child outcomes. Strategies for utilizing the Autism Navigator collection of web-based courses and tools using extensive video footage for families and professional development are offered for scaling up in community settings to change developmental trajectories of toddlers with ASD.</div><div><b>Conclusions: </b>Current health care and education systems are challenged to provide intervention of adequate intensity for toddlers with ASD. The use of innovative technology can increase acceleration of access to evidence-based early intervention for toddlers with ASD that addresses health disparities, enables immediate response as soon as ASD is suspected, and rapidly bridges the research-to-practice gap.</div><div><br></div><div><b>Publisher Note:</b> This article is part of the Research Forum: Advances in Autism Research: From Learning Mechanisms to Novel Interventions.</div><div><br></div><div>Wetherby, A. M., Woods, J., Guthrie, W., Delehanty, A., Brown, J. A., Morgan, L., . . . Lord, C. (2018). Changing developmental trajectories of toddlers with autism spectrum disorder: Strategies for bridging research to community practice. <i>Journal of Speech, Language, and Hearing Research, 61</i>(11), 2615–2628. https://doi.org/10.1044/2018_JSLHR-L-RSAUT-18-0028</div></div>