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CompletedNCT02272192TADPOLEUpdated Jan 6, 2020

Intervention Effects of Intensity and Delivery Style for Toddlers With Autism

An interventional study of Early Start Denver Model (ESDM) and Early Intensive Behavioral Intervention (EIBI) in Autism Spectrum Disorder, sponsored by University of California, Davis. Completed at 3 sites in United States. Open to participants aged 15 Months to 30 Months. Per ClinicalTrials.gov, last updated 2020-01-06.

Sponsored by University of California, Davis · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
87
Allocation
Randomized
Ages
15 Months to 30 Months
Sex
All
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Study summary

A multi-site randomized study of intensive treatment for toddlers with autism involving a three-site collaborative network plus a data coordinating center to evaluate the effects of intervention intensity and intervention style delivered for 12 months, on the progress of very young children with ASD ages 12-30 months old and their families, and the effect of children's developmental rates and autism severity on their response to intervention.

Read the detailed description

High quality, intensive early intervention is a powerful treatment for ASD, improving IQ and language markedly in randomized controlled clinical trials (RCTs), though little long term follow-up data exists. Few core characteristics that affect child change have been tested. Two potential core characteristics that invoke considerable debate among parents, professionals, and administrators are the delivery style of intervention: play-based versus discrete trial teaching, and the intensity (dosage) of intervention. This ACE treatment network conducted an RCTs to answer the following question: what are the effects of intensity and delivery style on developmental progress of toddlers with ASD?

87 young children with ASD, mean age 23.4 months who live within a specified radius near the university at each site were enrolled in one of three national sites and randomized into one of four cells varying on two dimensions: dosage - 15 or 25 hours per week of 1:1 treatment; and discrete trial teaching or naturalistic developmental-behavioral intervention. Other aspects of intervention held constant were: use of the principles of applied behavior analysis, 1:1 adult:child ratios, parent coaching in the assigned treatment, and treatment location. Developmental progress was measured frequently allowing for growth curve analysis to examine fine-grained differences in groups as well as interactions among major child and family initial variables and these two experimental variables.

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Conditions studied

  • Autism Spectrum Disorder

Keywords

  • autism
  • autism spectrum disorder
  • intensive intervention
  • early intervention
  • Early Start Denver Model
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In context

Autistic Disorder

1,344 studies on the registry are indexed under Autistic Disorder; 334 are open to participants now.

This study's enrollment of 87 is above the median of 45 across 1,044 interventional studies indexed under Autistic Disorder.

Browse Autistic Disorder studies →

Lead sponsor

University of California, Davis is the lead sponsor of 798 studies on the registry; 146 are open to participants now.

Of its 65 completed or terminated interventional studies of FDA-regulated products, 43 (66%) have results posted.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
15 Months to 30 Months
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • 12-30 months of age at time of assessment;
  • ambulatory and without impairments affecting hand use;
  • meets criteria for Autistic Spectrum Disorder on the APA Diagnostic and Statistical Manual, 5th revision criteria and on the Autism Diagnostic Observation Schedule for Toddlers:
  • clinical consensus of ASD diagnosis by 2 independent staff (including a licensed psychologist) based on observation as well as record review;
  • developmental quotient of >35 on Mullen Scales of Early Learning;
  • normal hearing and vision screen;
  • caregiver agreement to comply with all project requirements, including regular videotaping at home with provided equipment.

Exclusion criteria

Exclusion criteria:

  • English not a primary language spoken at home;
  • absence at 2 or more appointments without prior notice during the intake assessment;
  • more than 10 hours per week of 1:1 ABA based treatment;
  • other health or genetic conditions (i.e. fragile X syndrome, seizures, prematurity).
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Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
87 participants (actual)

Study arms

  • Experimental
    ESDM15 hr/week

    Children receive 15 hours a week of 1:1 intervention at home plus parent coaching using the Early Start Denver Model and following its manual

    Behavioral: Early Start Denver Model (ESDM)

  • Experimental
    ESDM 25 hr/week

    Children receive 25 hours a week of 1:1 intervention at home plus parent coaching using the Early Start Denver Model and following its manual

    Behavioral: Early Start Denver Model (ESDM)

  • Experimental
    EIBI 15 hr/week

    Children receive 15 hours per week of 1:1 intervention at home plus parent training using Early Intensive Behavioral Intervention (EIBI) and following the Manual "A Work in Progress"

    Behavioral: Early Intensive Behavioral Intervention (EIBI)

  • Experimental
    EIBI 25 hr/week

    Children receive 25 hours per week of 1:1 intervention at home plus parent training using EIBI and following the Manual "A Work in Progress"

    Behavioral: Early Intensive Behavioral Intervention (EIBI)

Interventions

  • BehavioralEarly Start Denver Model (ESDM)

    The Early Start Denver Model (ESDM) is a comprehensive developmental and behavioral early intervention approach for children with autism, ages 12 to 48 months. The program encompasses a developmental curriculum that defines the skills to be taught at any given time and a set of teaching procedures based in applied behavioral analysis to deliver this content. The teaching format focuses on trained therapists delivering the intervention 1:1 by engaging reciprocally with children in typical toddler activities involving play or daily routines, adding additional structure for children who need it to progress well. Progress data is collected throughout each session and used to make decisions about teaching approaches.

    Also known as: Naturalistic developmental-behavioral intervention (NDBI)

  • BehavioralEarly Intensive Behavioral Intervention (EIBI)

    EIBI is a one-to-one instructional approach based in applied behavior analysis used to teach skills in a planned, controlled, and systematic manner. Each trial or teaching opportunity has a definite beginning and end, thus the descriptor discrete trial. Within DTT, the use of antecedents and consequences is carefully planned and implemented. Positive praise and/or tangible rewards are used to reinforce desired skills or behaviors. Trial by trial data collection is an important part of DTT and supports decision making by providing teachers/practitioners with information about beginning skill level, progress and challenges, skill acquisition and maintenance, and generalization of learned skills or behaviors.

    Also known as: ABA, DTT, Lovaas method

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What researchers measure

Primary outcomes

  1. Expressive Communication Composite Score

    We used Time 4 means and standard deviations (SDs)s from several measures to compute a z score. The mean of a Z score is always 0 and z scores range from -3 to +3. For this composite a higher score reveals more mature developmental skills. Data from the following measures were used in this composite score: a weighted frequency of intentional communication measured within a 15 minute communication sample; number of different root words measured within the communication sample; the expressive language age equivalent score from he Mullen Scales of Early learning (MSEL); the expressive communication age equivalent scores from the Vineland 2 Adaptive Behavior Scale 2(VABS2); the expressive raw score from the MacArthur Bates Communicative Developmental Inventories; the expressive social communication abilities composite score from the PDD Behavior Inventory; and the expressive language raw score from the PDD Behavior Inventory

    Time frame: two years

Secondary outcomes

  1. Autism Severity Composite Score

    To build the composite scores for all the outcome measures, we first examined whether the proposed component variables were correlated (for 2 component variables) or factor loaded (for 3 or more component variables) at or above .3. We used Time 4 means and SD to compute a z score. The mean of a Z score is always 0 and z scores range from -3 to +3. For this composite a higher score reveals more severe symptoms of ASD. . from the following measures were used in this composite score: the calibrated severity score from the Autism Diagnostic Observation Schedule 2 and the expressive receptive social communication composite from the PDD Behavior Inventory

    Time frame: two years

  2. Receptive Language Composite Score

    To build the composite scores for all the outcome measures, we first examined whether the proposed component variables were correlated (for 2 component variables) or factor loaded (for 3 or more component variables) at or above .3. We used Time 4 means and SD to compute a z score. The mean of a Z score is always 0 and z scores range from -3 to +3. For this composite a higher score reveals more mature developmental skills. from the following measures were used in this composite score: receptive language age equivalent score from the MSEL; receptive language age equivalent score from the VABS 2

    Time frame: two years

  3. Nonverbal Development Composite Score

    To build the composite scores for all the outcome measures, we first examined whether the proposed component variables were correlated (for 2 component variables) or factor loaded (for 3 or more component variables) at or above .3. We used Time 4 means and SD to compute a z score. The mean of a Z score is always 0 and z scores range from -3 to +3. For this composite a higher score reveals more mature developmental skills. from the following measures were used in this composite score: 2 scores - the fine motor and the visual reception age equivalency scores - from the MSEL and 3 age equivalency scores from the VABS2 - daily living, motor skills, and socialization

    Time frame: two years

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Study locations

3 sites
  • UC Davis MIND Institute
    Sacramento, California 95817, United States
  • Vanderbilt University
    Nashville, Tennessee 37240, United States
  • University of Washington Autism Center
    Seattle, Washington 98195, United States
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References and documents

Publications

  • Rogers SJ, Yoder P, Estes A, Warren Z, McEachin J, Munson J, Rocha M, Greenson J, Wallace L, Gardner E, Dawson G, Sugar CA, Hellemann G, Whelan F. A Multisite Randomized Controlled Trial Comparing the Effects of Intervention Intensity and Intervention Style on Outcomes for Young Children With Autism. J Am Acad Child Adolesc Psychiatry. 2021 Jun;60(6):710-722. doi: 10.1016/j.jaac.2020.06.013. Epub 2020 Aug 24. PubMed 32853704 ↗

Individual participant data

Plan to share: Yes — All de-identified data will be uploaded into NDAR as soon as primary papers are published. All demographic data are uploaded into NDAR as they are collected.

Supporting information: Study protocol, Sap, Icf, Csr

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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jan 6, 2020, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT02272192
Lead sponsor
University of California, Davis
Collaborators
University of Washington, Vanderbilt University, University of California, Los Angeles
Responsible party
Sponsor
First posted
Oct 22, 2014
Start date
Mar 2013
Primary completion
Jul 1, 2019
Completion
Jul 1, 2019
Last update
Jan 6, 2020

Study contacts

Sally J Rogers, Ph.D.
principal investigator · UC Davis MIND Institute

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Jan 2020. You cannot join it, but the record below documents what was studied.

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