A Pilot Evaluation of the Baby Social ABCs Caregiver-Mediated Intervention for 6-15-month-olds with Early Signs of Autism – Feasibility, Acceptability, and Preliminary Evidence

Erin Dowds^1*Stacey MacWilliam²Abbie Solish¹Samara Osten¹Lonnie Zwaigenbaum³Isabel Smith²Jessica Brian^1*

• ¹Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
• ²IWK Health Centre, Halifax, Canada
• ³Glenrose Rehabilitation Hospital, Edmonton, Canada

Background: Autism spectrum disorder (autism) is a neurodevelopmental condition with a high prevalence of about 1 in 50 children. Early intervention can promote long-term health outcomes. Caregiver-mediated interventions (CMIs) are evidence-based and appropriate for toddlers with autism or early social communication challenges. The Social ABCs, one such CMI, is supported by robust evidence. Originally developed for toddlers (12 - 42 months), it shows potential for supporting social-communication development even earlier (i.e., for infants) with early signs of autism. The current project adapted the toddler Social ABCs for use with infants (aged 6-15 months) showing early signs of autism or with a confirmed diagnosis. This paper describes the development, acceptability, feasibility and preliminary outcomes for the Baby Social ABCs. Methods: Nine infants (aged 6 to 14 months) participated. Families either self-referred or were referred by community clinicians and were eligible based on age and clinician and/or parent concerns about social communication and/or behavioural differences. Each infant, and one of their primary caregivers, participated in a 12-week intervention, the Baby Social ABCs online via Zoom for Healthcare. Results: Caregiver implementation fidelity increased significantly, along with infant responsivity and social communication behaviours (social orienting, shared smiling, gesturing). Caregivers reported high satisfaction with the coaching approach, session structure, and curriculum. Discussion: This pilot study demonstrated the feasibility and acceptability of the Baby Social ABCs as a novel CMI for infants with signs of emerging autism and shows promising effects on caregivers' fidelity and infants' social communication and engagement. Future research should consider the optimal timing (or personalized "fit") for families to access such supports, to better understand the type and intensity of pre-diagnostic care that best meets' families' diverse needs.