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Interest in toys predicts effectiveness of Hanen’s More than Words in toddlers with early autism symptoms

March 31, 2011 3 comments

As part of the Autism Speaks funded Toddler Treatment Network, a multi-site randomized clinical trial was conducted to examine the efficacy of Hanen’s “More Than Words” intervention (Carter, Messinger, Stone, Celimli, Nahmias, & Yoder, 2011).  This is a very important funding initiative, as very few studies provide empirical validation for autism-specific interventions with toddlers who are evidencing symptoms consistent with ASD.  Parents of 62 (51 boys and 11 girls) toddlers with symptoms consistent with an autism spectrum disorder (ASD) between 14- to 23- months of age were enrolled in Boston, Miami, and Nashville.  Hanen’s “More Than Words” was selected for study because there was some previous experimental support for its effectiveness, it is developmentally appropriate for parents raising toddlers, and it is a short-term, relatively low-cost intervention.

This study provided some evidence that parents were able to learn and use new parenting strategies, such as practicing taking turns, encouraging eye contact and modeling simple sentences from the child’s perspective.  However, Hanen’s “More Than Words” was not effective for all children. This is not surprising, given that there is great variability among toddlers with ASD.  Toddlers who played with a limited number of toys prior to beginning Hanen’s “More Than Words” intervention showed more improvement in their social-communication skills following the intervention than those only receiving other community-based treatments. Specifically, they showed more instances of making eye contact, pointing to or reaching for objects of interest and showing or giving the experimenter a toy.  These effects lasted for at least four months after the intervention ended.  Importantly, there was evidence that these children showed gains that were observed in interactions with both parents and an unfamiliar adult as well as based on their parents’ responses to questionnaires.

This report adds to our emerging knowledge about which interventions work for which children with ASD.  It also adds to our understanding of how to match children to interventions that can optimize their development and not waste time enrolling them in treatments that are not well-suited for them.

Co-authors are Alice Carter, professor of psychology at the University of Massachusetts Boston; Paul Yoder, professor of special education at Vanderbilt University; Daniel Messinger, associate professor of psychology at the University of Miami; Wendy Stone, professor of psychology and Director of the University of Washington’s Autism Center; Seniz Celimli, postdoctoral researcher at the University of Miami; and Allison Nahmias, a psychology graduate student at the University of Pennsylvania.  For more information, contact Carter at alice.carter@umb.edu, Stone at stonew@uw.edu, Yoder at paul.yoder@vanderbilt.edu or Messinger at dmessinger@miami.edu.

Carter, A. S., Messinger, D. S., Stone, W. L., Celimli, S., Nahmias, A. S. and Yoder, P. , A randomized controlled trial of Hanen’s ‘More Than Words’ in toddlers with early autism symptoms. Journal of Child Psychology and Psychiatry, no. doi: 10.1111/j.1469-7610.2011.02395.x

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