The development of replicable, cost-effective intensive interventions for the treatment of young children with autistic spectrum disorders (ASD) is a priority for both the health and education systems in this country and internationally. Recent prevalence estimates for ASD range from 4/1000 to 6.5/1000 children. Additionally, there is a national shortage of personnel trained in these approaches even as the number of children identified with ASDs is increasing. The NIH has indicated that early interventions and multi-site randomized clinical trials in autism are each high priorities for research and National Academy of Sciences report emphasizes intensive (25 hours/week, 1:1 or 1:2 teacher:pupil ratios), engaging and comprehensive interventions The combination of high prevalence of children with ASD coupled with the need for intensive intervention means that very substantial resources are required to effectively address autism. Given that most states do not typically provide broad support for intensive interventions, the unmet national need is enormous. Based on the theoretical DIR-framework of Greenspan, we have developed an innovative solution to contribute to addressing this national need. This program is called """"""""The P.L.A.Y. Project"""""""" (Play and Language for Autistic Youngsters) and we have preliminary clinical evidence to show that this parent training model is effective. Early dissemination of the model into community agencies, schools and hospitals has also been successfully accomplished, leading to establishment of an alliance with a major national partner -- Easter Seals. Now we are prepared to organize a rigorous clinical trial. Our hypothesis is that a group randomized, controlled, community-based clinical trial can be organized to test whether a parent-training intervention model can improve functional outcomes for young children with autism. In Phase I we are proposing to pilot the procedures, with guidance from Michigan State University, to be used in the full trial to be conducted in Phase II. Easter Seals will provide the community sites for both Phase I and Phase II. A successful Phase II trial would lay the foundation for broad dissemination. Our long term goal for this project is to disseminate the model widely and to develop strategies for addressing the national need. A successful trial would provide support for efforts to encourage private insurers and government agencies to approve major increases in funding for autism intensive intervention services, resulting in wide dissemination of this model, substantial growth in our business and significant social benefit. ? ? ?
