A hybrid type I randomized effectiveness-implementation trial of a Naturalistic Developmental Behavioral Intervention in the Part C early intervention system: study protocol

Abstract Background Participation in Naturalistic Developmental Behavioral Interventions (NDBI) is associated with significant improvements in functioning for toddlers with, and showing early signs of, autism spectrum disorder. The Part C Early Intervention (EI) system, which is publicly funded and...

Full description

Saved in:
Bibliographic Details
Main Authors: Allison L. Wainer, Sarah R. Edmunds, Alice S. Carter, Wendy L. Stone, R. Christopher Sheldrick, Sarabeth Broder-Fingert, Yael S. Stern, Ellie Harrington, Lisa V. Ibanez, Brooke Ingersoll
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Pediatrics
Subjects:
Online Access:https://doi.org/10.1186/s12887-025-05587-8
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849734844353871872
author Allison L. Wainer
Sarah R. Edmunds
Alice S. Carter
Wendy L. Stone
R. Christopher Sheldrick
Sarabeth Broder-Fingert
Yael S. Stern
Ellie Harrington
Lisa V. Ibanez
Brooke Ingersoll
author_facet Allison L. Wainer
Sarah R. Edmunds
Alice S. Carter
Wendy L. Stone
R. Christopher Sheldrick
Sarabeth Broder-Fingert
Yael S. Stern
Ellie Harrington
Lisa V. Ibanez
Brooke Ingersoll
author_sort Allison L. Wainer
collection DOAJ
description Abstract Background Participation in Naturalistic Developmental Behavioral Interventions (NDBI) is associated with significant improvements in functioning for toddlers with, and showing early signs of, autism spectrum disorder. The Part C Early Intervention (EI) system, which is publicly funded and available in all U.S. states, offers an optimal infrastructure through which toddlers can receive NDBIs. This study seeks to assess the effectiveness and fit of one NDBI, Caregiver Implemented Reciprocal Imitation Teaching (CI-RIT), within the Part C EI system. Methods This hybrid type 1 effectiveness/implementation trial uses a multi-site randomized control design to simultaneously test effectiveness and collect implementation data on CI-RIT in the Part C EI system across four states: Illinois, Massachusetts, Michigan and Washington. Participants include EI providers (target n = 160) who are randomized to either CI-RIT or treatment as usual (TAU), and child/caregiver dyads on their caseloads (target n = 440). Primary effectiveness outcomes focus on (1) child social communication, joint attention, motor imitation; and (2) caregiver responsivity, implementation fidelity of RIT, and self-efficacy, which are all measured at baseline and then 4-months and 9-months after baseline. Implementation outcomes include CI-RIT modifications, treatment acceptability, fidelity of CI-RIT coaching, and RIT session completion. Discussion This study represents a critical effort to transport an evidence-based NDBI, CI-RIT, into a national service delivery setting, the Part C EI system. The large, multi-site nature of the trial provides the opportunity to address critical questions about training and intervention effectiveness, which will, in turn, optimize and support CI-RIT implementation at scale. Trial registration The trial protocol is registered at ClinicalTrials.gov (NCT05114538; Registration date: 10/28/2021).
format Article
id doaj-art-f47df1c99e7b4af8a5717c181b5a2d98
institution DOAJ
issn 1471-2431
language English
publishDate 2025-04-01
publisher BMC
record_format Article
series BMC Pediatrics
spelling doaj-art-f47df1c99e7b4af8a5717c181b5a2d982025-08-20T03:07:41ZengBMCBMC Pediatrics1471-24312025-04-0125111310.1186/s12887-025-05587-8A hybrid type I randomized effectiveness-implementation trial of a Naturalistic Developmental Behavioral Intervention in the Part C early intervention system: study protocolAllison L. Wainer0Sarah R. Edmunds1Alice S. Carter2Wendy L. Stone3R. Christopher Sheldrick4Sarabeth Broder-Fingert5Yael S. Stern6Ellie Harrington7Lisa V. Ibanez8Brooke Ingersoll9Department of Psychiatry and Behavioral Sciences, Rush University Medical CenterDepartment of Psychology, University of South Carolina, Barnwell CollegeDepartment of Psychology, University of Massachusetts BostonDepartment of Psychology, University of WashingtonDepartment of Psychiatry, UMass Chan Medical SchoolDepartment of Pediatrics, UMass Chan Medical SchoolANNA Autism CareANNA Autism CareDepartment of Psychology, University of WashingtonDepartment of Psychology, Michigan State UniversityAbstract Background Participation in Naturalistic Developmental Behavioral Interventions (NDBI) is associated with significant improvements in functioning for toddlers with, and showing early signs of, autism spectrum disorder. The Part C Early Intervention (EI) system, which is publicly funded and available in all U.S. states, offers an optimal infrastructure through which toddlers can receive NDBIs. This study seeks to assess the effectiveness and fit of one NDBI, Caregiver Implemented Reciprocal Imitation Teaching (CI-RIT), within the Part C EI system. Methods This hybrid type 1 effectiveness/implementation trial uses a multi-site randomized control design to simultaneously test effectiveness and collect implementation data on CI-RIT in the Part C EI system across four states: Illinois, Massachusetts, Michigan and Washington. Participants include EI providers (target n = 160) who are randomized to either CI-RIT or treatment as usual (TAU), and child/caregiver dyads on their caseloads (target n = 440). Primary effectiveness outcomes focus on (1) child social communication, joint attention, motor imitation; and (2) caregiver responsivity, implementation fidelity of RIT, and self-efficacy, which are all measured at baseline and then 4-months and 9-months after baseline. Implementation outcomes include CI-RIT modifications, treatment acceptability, fidelity of CI-RIT coaching, and RIT session completion. Discussion This study represents a critical effort to transport an evidence-based NDBI, CI-RIT, into a national service delivery setting, the Part C EI system. The large, multi-site nature of the trial provides the opportunity to address critical questions about training and intervention effectiveness, which will, in turn, optimize and support CI-RIT implementation at scale. Trial registration The trial protocol is registered at ClinicalTrials.gov (NCT05114538; Registration date: 10/28/2021).https://doi.org/10.1186/s12887-025-05587-8Autism spectrum disorderPart C Early InterventionReciprocal Imitation TeachingNaturalistic Developmental Behavioral Intervention
spellingShingle Allison L. Wainer
Sarah R. Edmunds
Alice S. Carter
Wendy L. Stone
R. Christopher Sheldrick
Sarabeth Broder-Fingert
Yael S. Stern
Ellie Harrington
Lisa V. Ibanez
Brooke Ingersoll
A hybrid type I randomized effectiveness-implementation trial of a Naturalistic Developmental Behavioral Intervention in the Part C early intervention system: study protocol
BMC Pediatrics
Autism spectrum disorder
Part C Early Intervention
Reciprocal Imitation Teaching
Naturalistic Developmental Behavioral Intervention
title A hybrid type I randomized effectiveness-implementation trial of a Naturalistic Developmental Behavioral Intervention in the Part C early intervention system: study protocol
title_full A hybrid type I randomized effectiveness-implementation trial of a Naturalistic Developmental Behavioral Intervention in the Part C early intervention system: study protocol
title_fullStr A hybrid type I randomized effectiveness-implementation trial of a Naturalistic Developmental Behavioral Intervention in the Part C early intervention system: study protocol
title_full_unstemmed A hybrid type I randomized effectiveness-implementation trial of a Naturalistic Developmental Behavioral Intervention in the Part C early intervention system: study protocol
title_short A hybrid type I randomized effectiveness-implementation trial of a Naturalistic Developmental Behavioral Intervention in the Part C early intervention system: study protocol
title_sort hybrid type i randomized effectiveness implementation trial of a naturalistic developmental behavioral intervention in the part c early intervention system study protocol
topic Autism spectrum disorder
Part C Early Intervention
Reciprocal Imitation Teaching
Naturalistic Developmental Behavioral Intervention
url https://doi.org/10.1186/s12887-025-05587-8
work_keys_str_mv AT allisonlwainer ahybridtypeirandomizedeffectivenessimplementationtrialofanaturalisticdevelopmentalbehavioralinterventioninthepartcearlyinterventionsystemstudyprotocol
AT sarahredmunds ahybridtypeirandomizedeffectivenessimplementationtrialofanaturalisticdevelopmentalbehavioralinterventioninthepartcearlyinterventionsystemstudyprotocol
AT alicescarter ahybridtypeirandomizedeffectivenessimplementationtrialofanaturalisticdevelopmentalbehavioralinterventioninthepartcearlyinterventionsystemstudyprotocol
AT wendylstone ahybridtypeirandomizedeffectivenessimplementationtrialofanaturalisticdevelopmentalbehavioralinterventioninthepartcearlyinterventionsystemstudyprotocol
AT rchristophersheldrick ahybridtypeirandomizedeffectivenessimplementationtrialofanaturalisticdevelopmentalbehavioralinterventioninthepartcearlyinterventionsystemstudyprotocol
AT sarabethbroderfingert ahybridtypeirandomizedeffectivenessimplementationtrialofanaturalisticdevelopmentalbehavioralinterventioninthepartcearlyinterventionsystemstudyprotocol
AT yaelsstern ahybridtypeirandomizedeffectivenessimplementationtrialofanaturalisticdevelopmentalbehavioralinterventioninthepartcearlyinterventionsystemstudyprotocol
AT ellieharrington ahybridtypeirandomizedeffectivenessimplementationtrialofanaturalisticdevelopmentalbehavioralinterventioninthepartcearlyinterventionsystemstudyprotocol
AT lisavibanez ahybridtypeirandomizedeffectivenessimplementationtrialofanaturalisticdevelopmentalbehavioralinterventioninthepartcearlyinterventionsystemstudyprotocol
AT brookeingersoll ahybridtypeirandomizedeffectivenessimplementationtrialofanaturalisticdevelopmentalbehavioralinterventioninthepartcearlyinterventionsystemstudyprotocol
AT allisonlwainer hybridtypeirandomizedeffectivenessimplementationtrialofanaturalisticdevelopmentalbehavioralinterventioninthepartcearlyinterventionsystemstudyprotocol
AT sarahredmunds hybridtypeirandomizedeffectivenessimplementationtrialofanaturalisticdevelopmentalbehavioralinterventioninthepartcearlyinterventionsystemstudyprotocol
AT alicescarter hybridtypeirandomizedeffectivenessimplementationtrialofanaturalisticdevelopmentalbehavioralinterventioninthepartcearlyinterventionsystemstudyprotocol
AT wendylstone hybridtypeirandomizedeffectivenessimplementationtrialofanaturalisticdevelopmentalbehavioralinterventioninthepartcearlyinterventionsystemstudyprotocol
AT rchristophersheldrick hybridtypeirandomizedeffectivenessimplementationtrialofanaturalisticdevelopmentalbehavioralinterventioninthepartcearlyinterventionsystemstudyprotocol
AT sarabethbroderfingert hybridtypeirandomizedeffectivenessimplementationtrialofanaturalisticdevelopmentalbehavioralinterventioninthepartcearlyinterventionsystemstudyprotocol
AT yaelsstern hybridtypeirandomizedeffectivenessimplementationtrialofanaturalisticdevelopmentalbehavioralinterventioninthepartcearlyinterventionsystemstudyprotocol
AT ellieharrington hybridtypeirandomizedeffectivenessimplementationtrialofanaturalisticdevelopmentalbehavioralinterventioninthepartcearlyinterventionsystemstudyprotocol
AT lisavibanez hybridtypeirandomizedeffectivenessimplementationtrialofanaturalisticdevelopmentalbehavioralinterventioninthepartcearlyinterventionsystemstudyprotocol
AT brookeingersoll hybridtypeirandomizedeffectivenessimplementationtrialofanaturalisticdevelopmentalbehavioralinterventioninthepartcearlyinterventionsystemstudyprotocol