# Promoting Transactional Supports to Optimize Social Communication Outcomes for Infants and their Families

> **NIH NIH P50** · EMORY UNIVERSITY · 2020 · $370,635

## Abstract

PROJECT SUMMARY 
The overarching goal of this treatment project is to document the efficacy of very early transactional supports 
that parents can learn to change developmental trajectories and optimize outcomes of their child using a 2-stage 
sequential multiple assignment randomized trial (SMART) design to develop an adaptive intervention. All 
parent-infant dyads in the Emory ACE will be invited at 6 months of age from the pool of 250 high and low risk siblings 
and will be randomly assigned at Stage 1 to the Social Communication Growth Charts (SCGC) that uses an 
innovative web-based technology to teach parents early social communication milestones and how to support 
their child’s very early development or Usual Care to compare efficacy of the SCGC on parent contingent 
responsiveness and child developmental trajectories. Familes of children who show early signs of ASD at 12 
months of age based on tailoring variables using parent report and observational measures will be re-randomized 
to Stage 2 to compare the efficacy of a parent-implemented (P-I) condition of a naturalistic developmental 
behavioral intervention (NDBI) based on the Early Social Interaction model1 to a clinician-implemented (C-I) 
condition NDBI based on a hybrid model from 12 to 21 months of age. Outcome measures of social 
communication, autism symptoms, social visual engagement, developmental level, and adaptive behavior will 
be gathered every 6 months from 6 to 30 months of age to measure treatment effects. Measures of parent 
transactional support and child active engagement will be collected quarterly from 9 to 30 months of age to 
examine growth trajectories during the Stage 1 and 2 conditions and at follow-up at 21 and 30 months after 
intervention. The expected impact of this study will have the following important implications: 1) maximize the 
use of technology to teach all parents how to support their infant’s development early to optimize opportunities 
for learning and recognize as early as possible if their child is not meeting developmental milestones and may 
need intervention; 2) document improved outcomes for very young children with early signs of ASD receiving a 
manualized, evidence-based NDBI intervention that is cost-efficient and feasible for community-based 
implementation; and 3) substantiate that these adaptive interventions implemented by parents beginning at 6 
months of age lead to better child outcomes, providing evidence that very early detection of autism is crucial to 
improve developmental outcomes.

## Key facts

- **NIH application ID:** 10005484
- **Project number:** 5P50MH100029-09
- **Recipient organization:** EMORY UNIVERSITY
- **Principal Investigator:** AMY M WETHERBY
- **Activity code:** P50 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $370,635
- **Award type:** 5
- **Project period:** 2012-09-04 → 2022-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10005484

## Citation

> US National Institutes of Health, RePORTER application 10005484, Promoting Transactional Supports to Optimize Social Communication Outcomes for Infants and their Families (5P50MH100029-09). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10005484. Licensed CC0.

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