Meeting the Needs of Young Hispanic Autistic Children

NCT ID: NCT06733584

Last Updated: 2025-11-05

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

200 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-09-22

Study Completion Date

2028-01-31

Brief Summary

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Purpose of the Study: The goal of this clinical trial is to find out if a technique called the "mutual gaze procedure" used in a Culturally and Linguistically Responsive adaptation of Pathways Early Intervention (CLR-Pathways) is the key to improving social communication, language, and everyday skills in young (18-42 months) Hispanic autistic children experiencing low income.

What Will Happen: Researchers will compare two versions of CLR-Pathways.

* Version 1: Includes mutual gaze strategies.
* Version 2: Does not include mutual gaze strategies.

What to Expect: Participants will:

* Attend 16 sessions (or 18 weeks if there are cancellations) of Pathways Intervention, each lasting 1.5 hours.
* Come to the clinic for a developmental check-up three times: before starting Pathways, right after completing Pathways, and three months after finishing Pathways.

Detailed Description

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Study Description:

* Participants: 200 Hispanic autistic children experiencing low income and their caregivers will be randomly assigned to one of two groups in parallel:

1. Group 1: CLR-Pathways Intervention with mutual gaze strategies.
2. Group 2: CLR-Pathways Intervention without mutual gaze strategies.
* Intervention Sessions: Participants will attend 16 sessions, each lasting 1.5 hours, over approximately 18 weeks (allowing for possible cancellations) of parent-mediated intervention in their homes or another convenient location.

Assessments: To track progress and evaluate long-term effects, participants will undergo several culturally and linguistically appropriate assessments at three time points:

1. Baseline: Within two weeks before starting the intervention.
2. Post-Intervention: Within two weeks after completing the intervention.
3. Three-Month Follow-Up: 12-15 weeks after completing the intervention.

Each evaluation will take approximately 2-3 hours and will include:

* Child Assessments:

* Autism Diagnostic Observation Schedule, Second Edition (ADOS-2; Lord et al., 2012): Researchers will use the ADOS-2 to assess communication, social interaction, play, and restricted/repetitive behaviors and to confirm a research diagnosis of autism (administered only at baseline)
* Bayley Scales of Infant and Toddler Development, Fourth Edition (Bayley-4; Bayley \& Aylward, 2019): Researchers will use the Bayley-4 to measure cognitive and motor skills (administered only at baseline)
* Preschool Language Scales, Fifth Edition (PLS-5; Zimmerman et al., 2011): Researchers will use the English or Spanish version of the PLS-5 to assess receptive language age (administered only at baseline)
* Communication and Symbolic Behavior Scales-Developmental Profile (CSBS-DP; Wetherby \& Prizant, 2002): Researchers will use the CSBS-DP to evaluate social communication.
* Caregiver Questionnaires:

* PhenX Toolkit Core Measures (PhenX; Hamilton et al., 2011): Researchers will use the PhenX to collect family and child demographic information, including parents' and grandparents' place of birth.
* Vineland Adaptive Behavior Scales, Third Edition (VABS-III; Sparrow et al., 2016): Researchers will use the VABS-III to assess adaptive functioning.
* Post-intervention Social Validity Questionnaire (Rollins et al., 2016): Researchers will use a questionnaire from a previous intervention efficacy study to assess the social validity of the intervention.

The CSBS-DP and VABS-III have been validated as appropriate measures for determining meaningful changes in children with or at high risk for autism, based on previous research.

• Video-Recorded Measures:

* Adult-Child Interactions (ACIs): Twelve-minute recordings will be transcribed and coded for social orienting, the Fluency and Connectedness and Joint Engagement measures of the Joint Engagement Rating Inventory (JERI; Adamson et al., 2020), intentional communication (EC Indicator; Greenwood et al., 2006), and expressive language.
* Parent-Child Interactions (PCIs): Twelve-minute naturalistic recordings will be coded for the Parent Calm Authority and Child Affiliative Obedience measures of the JERI.

Conditions

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Autism

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors

Study Groups

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Culturally and Linguistically Responsive Pathways with a Mutual Gaze Protocol

16 90-minute sessions (or 18 weeks, whichever comes first) of a Culturally and Linguistically Responsive adaptation of the Pathways manualized Naturalistic Developmental Behavioral Intervention (NDBI; research version). Pathways is parent-mediated and uses a coaching model.

Group Type EXPERIMENTAL

Culturally and Linguistically Responsive Pathways Parent-Mediated Intervention

Intervention Type BEHAVIORAL

Pathways-trained bilingual research clinicians will conduct 90-minute weekly coaching sessions with caregivers in the family's home or other convenient location. Caregivers will receive a written and audio version of the program manual which has been adapted to be culturally and linguistically responsive to the Hispanic community. Sessions will review information about social communication, infusing mutual gaze in social sensory routines, and using naturalistic developmental behavioral strategies. Interventionists will demonstrate intervention strategies and provide caregivers with feedback and self-reflection.

Culturally and Linguistically Responsive Pathways without Mutual Gaze Protocol

16 90-minute sessions (or 18 weeks, whichever comes first) of a Culturally and Linguistically Responsive adaptation of the Pathways manualized Naturalistic Developmental Behavioral Intervention (NDBI; research version) without the Mutual Gaze Protocol. Pathways is parent-mediated and uses a coaching model.

Group Type ACTIVE_COMPARATOR

Culturally and Linguistically Responsive Pathways Parent-Mediated Intervention without Mutual Gaze

Intervention Type BEHAVIORAL

Pathways-trained bilingual research clinicians will conduct 90-minute weekly coaching sessions with caregivers in the family's home or other convenient location. Caregivers will receive a written and audio version of the program manual which has been adapted to be culturally and linguistically responsive to the Hispanic community. Sessions will review information about social communication, social sensory routines, and using naturalistic developmental behavioral strategies. Interventionists will demonstrate intervention strategies and provide caregivers with feedback and self-reflection.

Interventions

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Culturally and Linguistically Responsive Pathways Parent-Mediated Intervention without Mutual Gaze

Pathways-trained bilingual research clinicians will conduct 90-minute weekly coaching sessions with caregivers in the family's home or other convenient location. Caregivers will receive a written and audio version of the program manual which has been adapted to be culturally and linguistically responsive to the Hispanic community. Sessions will review information about social communication, social sensory routines, and using naturalistic developmental behavioral strategies. Interventionists will demonstrate intervention strategies and provide caregivers with feedback and self-reflection.

Intervention Type BEHAVIORAL

Culturally and Linguistically Responsive Pathways Parent-Mediated Intervention

Pathways-trained bilingual research clinicians will conduct 90-minute weekly coaching sessions with caregivers in the family's home or other convenient location. Caregivers will receive a written and audio version of the program manual which has been adapted to be culturally and linguistically responsive to the Hispanic community. Sessions will review information about social communication, infusing mutual gaze in social sensory routines, and using naturalistic developmental behavioral strategies. Interventionists will demonstrate intervention strategies and provide caregivers with feedback and self-reflection.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Children must be from a Hispanic family experiencing low income, defined as having an income-to-needs ratio of \< 200% of the federal poverty level, determined by their household size
* Children must be between 18-42 months old at the start of the study
* Children must have no other known neurological or genetic concerns or disorders determined by parent report
* Children must receive a Calibrated Severity Score (CSS) of 4 or higher on the Autism Diagnostic Observational Schedule-2 (ADOS-2) administered by a qualified bilingual assessment associate
* Families must have a primary home language of English and/or Spanish

Exclusion Criteria

* Children who are from a family that is not Hispanic and/or does not have an income-to-needs ratio of \< 200% of the federal poverty level, determined by their household size
* Children younger than 18 months or older than 42 months at the start of the study
* Children whose parents report they have any other known neurological or genetic concerns or disorders
* Children who receive a Calibrated Severity Score (CSS) lower than 4 on the ADOS-2
* Families who do not have English or Spanish as a primary home language
Minimum Eligible Age

18 Months

Maximum Eligible Age

42 Months

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Congressionally Directed Medical Research Programs

FED

Sponsor Role collaborator

Catholic Charities

OTHER

Sponsor Role collaborator

University of Kansas

OTHER

Sponsor Role collaborator

The University of Texas at Dallas

OTHER

Sponsor Role lead

Responsible Party

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Pamela Rollins

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Pamela Rollins, EdD

Role: PRINCIPAL_INVESTIGATOR

University of Texas at Dallas

Locations

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University of Kansas

Lawrence, Kansas, United States

Site Status ACTIVE_NOT_RECRUITING

Catholic Charities of Dallas

Dallas, Texas, United States

Site Status RECRUITING

University of Texas at Dallas

Richardson, Texas, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Pamela Rollins, EdD

Role: CONTACT

972-883-3153

Erin E Kosloski, BA

Role: CONTACT

Facility Contacts

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Ana Schaller, PhD

Role: primary

214-337-0175

Pamela Rollins, EdD

Role: primary

972-883-3153

Erin E Kosloski, BA

Role: backup

References

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Rollins PR, Campbell M, Hoffman RT, Self K. A community-based early intervention program for toddlers with autism spectrum disorders. Autism. 2016 Feb;20(2):219-32. doi: 10.1177/1362361315577217. Epub 2015 Apr 23.

Reference Type BACKGROUND
PMID: 25907978 (View on PubMed)

Sparrow S. S., Cicchetti D. V., Balla D. A. (2005). Vineland Adaptive Behavior Scales, Second Edition (Vineland-II). San Antonio, TX: Pearson.

Reference Type BACKGROUND

Greenwood CR, Walker D, Buzhardt J, J Howard W, McCune L, Anderson R. Evidence of a Continuum in Foundational Expressive Communication Skills. Early Child Res Q. 2013 Jul 1;28(3):540-554. doi: 10.1016/j.ecresq.2013.02.006.

Reference Type BACKGROUND
PMID: 24882940 (View on PubMed)

Kosloski EE, Patel SD, Rollins PR. The Role of Pathways Early Autism Intervention in Improving Social Skills and Respeto for Young Hispanic Autistic Children. J Autism Dev Disord. 2025 Sep;55(9):3167-3178. doi: 10.1007/s10803-024-06419-x. Epub 2024 Jun 6.

Reference Type BACKGROUND
PMID: 38842669 (View on PubMed)

Hamilton CM, Strader LC, Pratt JG, Maiese D, Hendershot T, Kwok RK, Hammond JA, Huggins W, Jackman D, Pan H, Nettles DS, Beaty TH, Farrer LA, Kraft P, Marazita ML, Ordovas JM, Pato CN, Spitz MR, Wagener D, Williams M, Junkins HA, Harlan WR, Ramos EM, Haines J. The PhenX Toolkit: get the most from your measures. Am J Epidemiol. 2011 Aug 1;174(3):253-60. doi: 10.1093/aje/kwr193. Epub 2011 Jul 11.

Reference Type BACKGROUND
PMID: 21749974 (View on PubMed)

Zimmerman, I. L., Steiner, V. G., & Pond, R. E. (2011). Preschool language scales (5th ed.). Pearson.

Reference Type BACKGROUND

Rollins PR, De Froy AM, Gajardo SA, Brantley S. Pragmatic contributions to early vocabulary and social communication in young autistic children with language and cognitive delays. J Commun Disord. 2022 Sep-Oct;99:106243. doi: 10.1016/j.jcomdis.2022.106243. Epub 2022 Jun 22.

Reference Type BACKGROUND
PMID: 35797775 (View on PubMed)

Rollins PR, De Froy A, Campbell M, Hoffman RT. Mutual Gaze: An Active Ingredient for Social Development in Toddlers with ASD: A Randomized Control Trial. J Autism Dev Disord. 2021 Jun;51(6):1921-1938. doi: 10.1007/s10803-020-04672-4.

Reference Type BACKGROUND
PMID: 32894382 (View on PubMed)

Related Links

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https://sites.gsu.edu/bakeman/files/2024/03/DevLabTechReport25.4-397727a52df21a75.pdf

This is the manual for the Joint Engagement Rating Inventory. \[Adamson, L.B., Bakeman, R., \& Suma, K. (2020). The joint engagement rating inventory. Department of Psychology, Georgia State University.\]

https://www.wpspublish.com/ados-2-autism-diagnostic-observation-schedule-second-edition

This is the link to the Autism Diagnostic Observation Schedule, Second Edition. \[Lord, C., Luyster, R., Gotham, K., \& Guthrie, W. (2012). Autism Diagnostic Observation Schedule (ADOS-2) (2nd ed.). Western Psychological Services.\]

https://www.pearsonassessments.com/store/usassessments/en/Store/Professional-Assessments/Cognition-%26-Neuro/Bayley-Scales-of-Infant-and-Toddler-Development-%7C-Fourth-Edition/p/100001996.html

This is the link to the Bayley Scales of Infant and Toddler Development, Fourth Edition. \[Bayley, N., \& Aylward, G. P. (2019). Bayley Scales of Infant and Toddler Development (4th ed.). Pearson.\]

https://products.brookespublishing.com/Communication-and-Symbolic-Behavior-Scales-Developmental-Profile-CSBS-DP-First-Normed-Edition-P28.aspx

This is a link to the Communication and Symbolic Behavior Scales. \[Wetherby, A., \& Prizant, B. (2002). Communication and Symbolic Behavior Scales- Developmental Profile (1st normed ed.). Paul H. Brookes.\]

Other Identifiers

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HT94252410184 / AR230003

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

UTD IRB-24-306

Identifier Type: -

Identifier Source: org_study_id

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