Explore the vast range of titles available.

Psychometric properties and initial validity of the Brief Observation of Social Communication Change (BOSCC), a measure of treatment-response for social-communication behaviors, are described. The BOSCC coding scheme is applied to 177 video observations of 56 young children with ASD and minimal language abilities. The BOSCC has high to excellent inter-rater and test–retest reliability and shows convergent validity with measures of language and communication skills. The BOSCC Core total demonstrates statistically significant amounts of change over time compared to a no change alternative while the ADOS CSS over the same period of time did not. This work is a first step in the development of a novel outcome measure for social-communication behaviors with applications to clinical trials and longitudinal studies.

This dissertation focuses on the design and implementation of an early intervention protocol—the Early Social Interaction-Community Outreach Project (ESI-CO)—for families with limited education and limited income. The project was modified from an existing parent-mediated intervention, the Early Social Interaction Project (Wetherby & Woods, 2006), to increase participation from a population that historically has been underserved, and to place greater emphasis on the influences of family environment and experiences of caregivers of children with ASD. Specific aims of the project were to 1) apply empirically supported methods for promoting treatment attendance, adherence, and retention in the specified population; and 2) provide preliminary outcome data that includes descriptive, quantitative, and qualitative analyses of the experiences of participating families. Participants were 14 families from the Southeast Michigan region. Families received 24 in-home treatment sessions over the course of 5 months with an additional 3 months of resource support. Data were collected and analyzed using a mixed-methods approach. A single-subject multiple baseline design was used to measure caregivers' acquisition of strategies to facilitate their child's social engagement and communication, while additional data were collected qualitatively to assess caregivers' satisfaction with the intervention. Eight families completed the intervention, yielding an attrition rate of 38%. This rate was higher than most other reported autism interventions, but lower than what is typically reported in research with low-income populations. Data are presented on the first four families to complete the intervention. Caregivers demonstrated acquisition of treatment strategies with generalization of skills to activities and families were assisted in identifying and enrolling in community autism resources. Overall, caregivers reported positive experiences with the intervention. The ESI-CO study yields promising results in promoting positive change in families from underserved populations. Future directions will include the recruitment of a larger sample and modifications to the research and intervention design to afford the examination of mediating and moderating factors affecting caregiver and child outcome. Results from the project will contribute to the development of treatment services that are accessible and appropriate for families from diverse socioeconomic backgrounds.