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DOCTOR of PHILOSOPHY Using Parent-Mediated Intervention To DOCTOR OF PHILOSOPHY Using Parent-Mediated Intervention to Treat Autism Symptoms in Infants Tanner, Amy Award date: 2020 Awarding institution: Queen's University Belfast Link to publication Terms of use All those accessing thesis content in Queen’s University Belfast Research Portal are subject to the following terms and conditions of use • Copyright is subject to the Copyright, Designs and Patent Act 1988, or as modified by any successor legislation • Copyright and moral rights for thesis content are retained by the author and/or other copyright owners • A copy of a thesis may be downloaded for personal non-commercial research/study without the need for permission or charge • Distribution or reproduction of thesis content in any format is not permitted without the permission of the copyright holder • When citing this work, full bibliographic details should be supplied, including the author, title, awarding institution and date of thesis Take down policy A thesis can be removed from the Research Portal if there has been a breach of copyright, or a similarly robust reason. If you believe this document breaches copyright, or there is sufficient cause to take down, please contact us, citing details. Email: [email protected] Supplementary materials Where possible, we endeavour to provide supplementary materials to theses. This may include video, audio and other types of files. We endeavour to capture all content and upload as part of the Pure record for each thesis. Note, it may not be possible in all instances to convert analogue formats to usable digital formats for some supplementary materials. We exercise best efforts on our behalf and, in such instances, encourage the individual to consult the physical thesis for further information. Download date: 29. Sep. 2021 Running head: USING PARENT-MEDIATED INTERVENTION 1 Using Parent-Mediated Intervention to Treat Autism Symptoms in Infants Amy Everill Tanner, B.A., M.Sc., BCBA A Dissertation submitted to the School of Social Sciences, Education and Social Work Queen’s University Belfast In Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy March, 2020 Running head: USING PARENT-MEDIATED INTERVENTION 2 Abstract Autism Spectrum Disorder (ASD) is a neuro-developmental disorder characterized by persistent and significant impairments with social communication and a tendency to engage in non-functional restricted and repetitive behaviours which begin in early childhood. Due to an increase in prevalence and lack of specialist services, many regions or entire countries are facing bottlenecks throughout the process of early detection, early screening, diagnosis and beginning services, with the average age of diagnosis currently lying between 4 to 5 years of age. This late age of diagnosis and access to services is very worrying, given many early signs are observable by the child’s first birthday and research has consistently reported that the start of intervention is directly linked to long-term outcomes, with a start prior to two years of age demonstrating the greatest potential to reach optimal outcomes. The present thesis addresses the challenges of early detection and early intervention through a four-fold process. First, a systematic literature review was conducted to establish the earliest behavioural manifestations of autism by identifying the earliest symptoms and signs which can then guide future screening and assessment tools. Second, a pilot study was conducted to assess the feasibility and acceptability of using a 12-week parent-mediated intervention model to increase social communicative behaviours while decreasing autism symptoms in ‘at risk’ infants. Third, a main study employing a multiple baseline across participants research design was conducted to assess the efficacy and social validity of the 12-week intervention program through a parent-mediated service model with symptomatic infants. Lastly, the 12-week program was translated into parent-friendly language, providing parents with a step-by-step Running head: USING PARENT-MEDIATED INTERVENTION 3 procedure manual which can be used to complement professional intervention or for parents to use while awaiting a comprehensive diagnosis or start of services. All four components have uniquely contributed to the field of behaviour analysis and especially very early parent-mediated autism intervention, as well as to the broader field of autism detection during infancy. Running head: USING PARENT-MEDIATED INTERVENTION 4 Acknowledgements Throughout the writing of this dissertation and the 4 years doctorate level study through Queen’s University Belfast, I have received an immense amount of support and assistance. I would first like to thank my primary supervisor, Dr. Katerina Dounavi, whose encouragement, technical knowledge and thorough feedback has been invaluable in the creation of a meaningful and important research undertaking. Over the last four years I have grown so much as a researcher and clinician under her supervision. I am forever grateful and indebted for her patience and kindness with me. I would also like to thank my secondary supervisor, Dr. Karola Dillenburger who initially inspired me to apply to the doctorate program and was instrumental with guiding my initial research proposal to support my application. I would like to acknowledge my fellow doctorate students and my colleagues who contributed many hours of reviewing literature and scoring intervention videos in order to obtain interobserver agreement scores to support my research. I would love to thank my colleague Chantelle who I have had the pleasure of working alongside for the past 7 years. She goes above and beyond with every child and has taken on the brunt of our caseload over the past four years while I focused more heavily on my studies. I would also love to thank my next door neighbour Chris who has a limitless ability to make me laugh even through the most overwhelming times. And to my dear friend Tobias whose words of encouragement kept my motivated and charging ahead. Lastly, I would love to thank my incredible family for a lifetime of support and encouragement and my dog, Ace, the greatest companion I’ve ever known, who has never left my side throughout the entire writing process. Running head: USING PARENT-MEDIATED INTERVENTION 5 Research Outputs Publications: Tanner, A., Dounavi, K. (2020). Maximizing the Potential for Infants At-Risk for Autism Spectrum Disorder through a Parent-Mediated Verbal Behaviour Intervention. European Journal of Behaviour Analysis. https://doi.org/10.1080/15021149.2020.1731259 Publications: Under Review Tanner, A., Dounavi, K. (2020). The Emergence of Autism Symptoms Prior to 18- Months of Age: A Systematic Literature Review. Tanner, A., Dounavi, K. (2020). Using Parent-Mediated Intervention to treat Autism symptoms in Infancy: A pilot study. Conferences Tanner, A., & Dounavi, K. (2019). Pre-diagnostic autism intervention for infants and toddlers. Keynote address at 4th National Conference of Hellenic Society for Behaviour Analysis, Panteion University of Social and Political Sciences, Athens, Greece. Tanner, A., & Dounavi, K. (2018). Treating autism symptoms in infancy through parent-mediated intervention. Paper presented at 9th Conference of the European Association for Behaviour Analysis, Würzburg, Germany. Tanner, A., & Dounavi, K. (2017). Treating High-Risk Infants using Parent Mediated Intervention. Paper presented at Applied Behaviour Analysis – International Conference, Paris, France. Tanner, A., & Dounavi, K. (2016). Using Parent-Mediated Intervention to Treat Autism Running head: USING PARENT-MEDIATED INTERVENTION 6 Symptoms in Infants and Young Toddlers. Paper presented at 8th Conference of the European Association for Behaviour Analysis, Sicily, Italy. Tanner, A., & Dounavi, K. (2016). Treatment outcomes of a 10hr per week Interdisciplinary Early Intervention Model. Poster presented at the International Meeting for Autism Research, Baltimore, USA. Tanner, A., & Dounavi, K. (2016). Using Parent-Mediated Intervention to Treat Autism Symptoms in Infants. Paper presented at the Annual British Columbia Conference for Applied Behaviour Analysis, Vancouver, Canada. Tanner, A., & Dounavi, K. (2015). Early Detection for Autism and the use of Naturalistic Developmental Behavioural Intervention to Treat Autism Symptoms in High Risk Infants. Applied Behaviour Analysis International Conference, Kyoto, Japan. Media PhD Research featured on Canadian Provincial and National News as its own segment. BC researchers studying benefits of early help for children with autism (April, 2016) https://globalnews.ca/news/2650248/early-intervention-the-key-for- children-with-autism/ Provided autism expert commentary for Provincial Autism news story . Running head: USING PARENT-MEDIATED INTERVENTION 7 A teacher locked a 6-year-old with autism in a storage room, and that’s ‘traumatizing’https://globalnews.ca/news/3480207/boy-autism-storage-room- nanaimo/ Provided autism expert commentary for Thousands of BC children waiting for autism assessment on Provincial News (Oct 2018). https://globalnews.ca/news/4552537/thousands-of-b-c-children-waiting-for- autism-assessment/ Workshops Tanner, A., & Dounavi, K. (2019). Maximizing the Potential for Infants At-Risk for Autism Spectrum Disorder through a Parent-Mediated Verbal Behaviour Intervention, Seminamhoo Behaviour Analysts, Inc. Tanner, A., & Dounavi, K. (2018). Teaching Infants and Toddlers showing signs of Autism using a Verbal Behaviour Approach, Queen’s
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