Effects of Technology-Supported Social Communication Baby Navigator Intervention to Improve Outcomes of Toddlers With Communication Delays: Preliminary Study

BACKGROUND AND AIMS:

About one in three children in the U.S. enter kindergarten unprepared to learn and lacking sufficient communication skills. Despite the federal mandate for early intervention (EI), less than 25% of children who will require special education at school age are receiving EI services under three years of age. Lower income, African American, and rural families may receive a diagnosis 1.5 years later. Twenty-five years after Hart and Risley described the 30-million-word gap between children from higher and lower socioeconomic backgrounds, "catching up" earlier is emphasized more than ever, and intervention beginning during infancy or preschool has a greater impact on outcomes for children than providing services at school age. A confluence of empirical research on poverty, environmental risk factors, and brain development shows that early experiences are uniquely powerful in the first years of life with lasting effects on developmental trajectories and significant impact on lifelong well-being, providing further impetus for early detection and intervention.

There is a pressing need to leverage resources by coordinating care provided by the many different agencies serving young children and test new methods to support families as soon as their children begin to show small lags in communication development. The investigators' research has identified robust predictors of later language development that can be identified at 9-18 months of age. Because delays in communication are apparent long before language delays are evident, measures of early-developing social communication skills offer a viable solution for earlier detection of children with language delays and subsequent educational challenges.

The investigators propose studying a new technology-supported intervention for babies with early communication delays-Social Communication "Baby Navigator" Intervention-that builds on the findings of our efficacy trial of the Early Social Interaction (ESI) Model to coach families of toddlers with autism to embed evidence-based intervention strategies in their everyday activities. The content of Baby Navigator is based on responsive parenting research that has a strong evidence-base for children from very low resource settings worldwide and is recommended to improve child health and development by the World Health Organization (WHO). Responsive parenting defined by WHO entails observing the child's cues, such as movements and sounds, interpreting these signals accurately, and acting swiftly, consistently and efficiently to meet the child's needs. Baby Navigator is a web platform with three parent-mediated intervention components using mobile technology: 1) the Social Communication Growth Charts, a self-guided application (app) to explore hundreds of video clips illustrating early milestones with narration on responsive parenting and to chart their child's development; 2) Baby Navigator Class, group weekly online meetings designed as a companion to the Growth Charts to engage parents while learning the milestones and how to support their child's development, and connect with other families; and 3) Mobile Coaching, individual weekly telehealth sessions to coach parents and provide reflective feedback in their everyday activities, adapted from the ESI model.

The investigators will address the following research aims: