Sibling-Mediated Intervention on Literacy and Reciprocity for Children With Autism

NCT05098392 | Terminated

• 1 other identifier: STUDY00014411
• Study Type: interventional
• Target: 8
• Locations: 2 countries
• Sites: 3

Brief Summary

Given the increasing prevalence of autism spectrum disorder (ASD), estimated to be 1 in 68 in the United States alone, ASD has become one of the fastest-growing pediatric concerns. The deficits of children with ASD range across social communication and academic skills. One of the effective interventions that have been used commonly for ASD is the model-lead-test, which includes modeling, prompting children to practice target skills together, and providing children with affirmative feedback or error correction. Previous research has demonstrated that the model-lead-test is successful in teaching different skills for individuals with ASD, including functional, social, and academic skills. The vast majority of the studies had researchers, therapists, or teachers implement the intervention. However, there is clear empirical support and implications for interventions mediated by more familiar persons, such as parents and siblings, which may lead to better effects, maintenance, and generalization due to more practice opportunities in the natural environments. Research has supported the effectiveness of using parents or peers as agents to deliver interventions for individuals with ASD, whereas fewer studies explored the use of siblings to deliver or mediate intervention. As typically developing siblings are an essential part of the daily life of children with ASD, it makes logical extensions to have siblings as mediators to deliver interventions. In the initial findings, the investigators found the typically developing siblings can accurately implement the model-lead-test procedure that improved various skills of their siblings with ASD. This project will extend these findings by examining the efficacy of the sibling-implemented intervention on early literacy (reading) and social reciprocity (conversation and play) of children with ASD as well as the sibling relationship before, during, and after the intervention.

Conditions

Autism Spectrum Disorder

Outcome Measures

Primary Outcomes (5)

• Change in oral reading accuracy

  Participants in the US will complete DIBELS Grades K-1 Benchmark. Participants in China read pinyin's using a pinyin matrix

  Assessment will begin from the date of randomization, during and after the intervention, and up to 9 months after the intervention for a total of approximately 12 months

• Change in social engagement

  Children will play with their siblings for 15 minutes. The interaction will be coded using the Playground Observation of Peer Engagement (POPE).

  Assessment will begin from the date of randomization, during and after the intervention, and up to 9 months after the intervention for a total of approximately 12 months

• Change in sibling relationship

  Parents will complete the "Sibling Inventory of Behavior" scale. The minimum value of the scale is 32, and the maximum value is 160. The scale measures multiple dimensions of the sibling relationship, including companionship, empathy, teaching, rivalry, conflict, avoidance. Higher values obtained in each of the dimensions mean a higher level of companionship, empathy, teaching, rivalry, conflict, or avoidance from the sibling.

  Assessment will begin from the date of randomization, during and after the intervention, and up to 9 months after the intervention for a total of approximately 12 months

• Change in sibling self-efficacy.

  Typically developing siblings will complete the investigator-created "Children's Self-Efficacy Scale for TD Siblings". The scale is broken down into four sections of four to ten items. Each item is rated from 0 indicating a lack of self-efficacy to 100 indicating confidence. Thus, the minimum score that can be obtained is 0 and the maximum score is 2,700.

  Assessment will begin from the date of randomization, during and after the intervention, and up to 9 months after the intervention for a total of approximately 12 months

• Change in reciprocal conversation

  Children will play with their siblings for 15 minutes. Components in reciprocal conversation, such as answering questions, expansion, and reciprocal question-asking will be coded.

  Assessment will begin from the date of randomization, during and after the intervention, and up to 9 months after the intervention for a total of approximately 12 months

Secondary Outcomes (2)

• Change in oral retell

  Assessment may begin from the date of randomization, after the intervention, and up to 9 months after the intervention for a total of approximately 12 months

• Social validity

  Immediately after the intervention

Study Arms (2)

Treatment as usual/Sibling interaction

NO INTERVENTION

Children with autism will spend time with their typically developing siblings for 20-30 mins at least three times a week

Sibling-mediated intervention

EXPERIMENTAL

Children with autism will receive explicit instruction from their typically developing siblings

Behavioral: Sibling-mediated intervention

Interventions

Sibling-mediated intervention BEHAVIORAL

Typically developing siblings will be trained to use an explicit instruction strategy (model-lead-test) and a checklist to self-monitor their teaching when working with their siblings with ASD on reading and social skills.

Sibling-mediated intervention

Eligibility Criteria

• Age: 5 Years - 11 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17)

You may qualify if:

• Both siblings can demonstrate compliance during instruction.
• Children with ASD can imitate physical actions and repeat vocalizations, answering common questions, label common objects and actions with adjectives.
• Typically developing children can sound out and blend letters during reading.

You may not qualify if:

• Children with aggression towards their siblings and noncompliance during instruction
• Children with ASD who can sound out and blend letters.

Sponsors & Collaborators

• Arizona State University: lead

Study Sites (3)

Children's Autism Center

Round Rock, Texas, 78664, United States

Location

Best Love Child Development Center

Kunming, Yunnan, China

Location

Clover Children Rehabilitation Kindergarten

Shanghai, China

Location

Related Publications (7)

• Christensen DL, Baio J, Van Naarden Braun K, Bilder D, Charles J, Constantino JN, Daniels J, Durkin MS, Fitzgerald RT, Kurzius-Spencer M, Lee LC, Pettygrove S, Robinson C, Schulz E, Wells C, Wingate MS, Zahorodny W, Yeargin-Allsopp M; Centers for Disease Control and Prevention (CDC). Prevalence and Characteristics of Autism Spectrum Disorder Among Children Aged 8 Years--Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2012. MMWR Surveill Summ. 2016 Apr 1;65(3):1-23. doi: 10.15585/mmwr.ss6503a1.

  PMID: 27031587 BACKGROUND

• Johnny L. Matson, Jonathan Wilkins & Jennifer Macken (2008) The Relationship of Challenging Behaviors to Severity and Symptoms of Autism Spectrum Disorders, Journal of Mental Health Research in Intellectual Disabilities, 2:1, 29-44, DOI: 10.1080/19315860802611415

  BACKGROUND

• Chang YC, Locke J. A systematic review of peer-mediated interventions for children with autism spectrum disorder. Res Autism Spectr Disord. 2016 Jul;27:1-10. doi: 10.1016/j.rasd.2016.03.010. Epub 2016 Mar 26.

  PMID: 27807466 RESULT

• Stadnick NA, Stahmer A, Brookman-Frazee L. Preliminary Effectiveness of Project ImPACT: A Parent-Mediated Intervention for Children with Autism Spectrum Disorder Delivered in a Community Program. J Autism Dev Disord. 2015 Jul;45(7):2092-104. doi: 10.1007/s10803-015-2376-y.

  PMID: 25633920 RESULT

• Kryzak LA, Jones EA. Sibling self-management: Programming for generalization to improve interactions between typically developing siblings and children with autism spectrum disorders. Dev Neurorehabil. 2017 Nov;20(8):525-537. doi: 10.1080/17518423.2017.1289270. Epub 2017 Mar 9.

  PMID: 28277816 RESULT

• Shivers CM, Plavnick JB. Sibling involvement in interventions for individuals with autism spectrum disorders: a systematic review. J Autism Dev Disord. 2015 Mar;45(3):685-96. doi: 10.1007/s10803-014-2222-7.

  PMID: 25178988 RESULT

• Archer AL, Hughes CA. Explicit instruction: Effective and efficient teaching. 2011. Guilford Press,

  RESULT

MeSH Terms

Conditions

Autism Spectrum Disorder

Condition Hierarchy (Ancestors)

Child Development Disorders, Pervasive; Neurodevelopmental Disorders; Mental Disorders

Study Officials

• Chengan Yuan, PhD

  Arizona State University

  PRINCIPAL INVESTIGATOR

• Erin Rotheram-Fuller, PhD

  Arizona State University

  PRINCIPAL INVESTIGATOR

• Juliet Hart Bartnett, PhD

  Arizona State University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: The outcome assessor will not be informed of the group status of the children.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: Children in the US and China will be randomized into the two groups at each location.

Study Record Dates

• First Submitted: October 13, 2021
• First Posted: October 28, 2021
• Study Start: November 2, 2021
• Primary Completion: September 7, 2025
• Study Completion: September 7, 2025
• Last Updated: September 12, 2025

Record last verified: 2025-09

Data Sharing

• IPD Sharing: Will not share

Locations

US (1); CN (2)