Early Development Project

Mother and Baby

  *This project is now in the analysis phase and is not currently recruiting participants*

Principal Investigators:

Linda Watson, Ed.D., Associate Professor, Division of Speech and Hearing

Elizabeth Crais, Ph.D., Professor, Division of Speech and Hearing


Co-Principal Investigators:

Grace Baranek, Ph.D., Professor, Division of Occupational Science

Steve Reznick, Ph.D., Professor, Department of Psychology

Lauren Turner Brown, Ph.D., Adjunct Assistant Professor, UNC TEACCH


Recent research on genetics and early development allows for the identification of infants and toddler that may be at risk for later diagnosis of various developmental disabilities including autism.  Early identification then presents opportunities to work with these young children and their families during a critical period of development.

The Early Development Project-2, is a four-year, federally-funded ($2.4 million) grant from the U.S. Department of Education’s Institute of Education Sciences.  It expands the work completed in the Early Development Project-1, funded by Autism Speaks that served as a pilot for EDP-2.  Both projects addressed the issues of early identification and early intervention through two primary aims:

  1. To screen 12-month-old infants in central North Carolina to identify those that may be at high risk for an eventual diagnosis of autism or other developmental disabilities, and
  2. To compare effects of a 6-month parent-mediated, relationship-focused intervention to a community services-referral condition, using a randomized controlled study.

For EDP-1, the catchment area consisted of 3 counties (Wake, Orange, Durham); for EDP-2, that area has been expanded to 6 counties (to also include Alamance, Chatham, and Guilford).  We plan to enroll 116 families in EDP-2.  The initial screening is accomplished at 12 months of age using the First Year Inventory (FYI), a parent report measure developed by our research team at UNC that is mailed each week to families in the catchment area counties. Families are identified based on publicly available birth records, and the FYI is mailed to families in our catchment area who gave birth 12 months before.

The FYI is designed to identify risk factors in two important domains of development:  Social Communication and Sensory-Regulatory functions.  Parents of infants with elevated risk scores in both of these domains are then invited to participate with their child in a comprehensive developmental assessment with our team of assessors.  Assessments take place in our lab, at the offices of two area Children’s Developmental Services Agencies, or at the office of a pediatric speech therapy provider in Greensboro.

Following this assessment, parents receive a written report of the results and are invited to participate in a 6-month early intervention treatment study.  All participating families are referred to standard community-based services.  In addition, half of the families are randomly assigned to participated in the Adapted Responsive Teaching (ART) intervention. ART is a home-based, parent-mediated intervention that is based on a relationship-focused approach.  It is adapted from the Responsive Teaching approach originally developed by Mahoney and MacDonald (2004).  In the ART intervention, skilled therapists assist parents in recognizing pivotal milestones and processes in their infant, and then coach parents on responsive techniques to promote optimal development.  Desired outcomes of ART include changes in cognitive abilities, social-communication, sensory-regulatory functions, and adaptive behavior.  Both groups of families receive a monthly-phone call from our Project Coordinator to discuss how their child is doing, how community services are going (as applicable), and to answer any questions parents might have.

Follow-up assessments are completed with both groups of families, before their child turns 2 years old.  Families receive a second written report with the results.

If you would like to learn more about this research, please contact the Project Coordinator, Ashley Freuler, at afreuler@med.unc.edu