A Digital Health Parent-Training Intervention for Children With Social Communication Delays

We will administer a revised Motor Imitation Scale (MIS), a standardized, structured observational measure that assesses a child's ability to imitate familiar and novel motor actions. Children will see 5 actions modeled and then will be prompted to imitate the action using a matching toy. Children are given up to three opportunities to imitate each action. MIS scores range from 0 to 10, with higher scores indicating greater imitation.

The Vineland Scales of Adaptive Behavior-3 (Vineland-3) is a standardized parent interview measuring adaptive functioning. It will be administered to all participants at pre- and post-treatment to evaluate change occurring in adaptive behavior across groups. Previous research has documented that this measure has robust psychometric properties, is sensitive to change in response to early intervention, and captures dimensions that are highly valued by stakeholders. Higher scores in the Vineland indicate more advanced adaptive skills.

The MacArthur Bates Communication Development Inventory (MCDI) is a parent-report measure that assesses nonverbal communication (gestures) and verbal communication (words). The Words and Gestures form will be used. The MCDI is widely used, standardized, and validated. It is particularly well-suited for large-scale research due to ease of administration, strong psychometric properties, and sensitivity to individual differences in early language development. Higher scores indicate greater communication.

The Goal Attainment Scaling (GAS) is used to evaluate a participant's progress toward a specific, individualized goal. It follows standardized procedures that allow outcomes to be measured on a common metric, making it possible to compare intervention-related change across participants with different goals. Scores ranger from -2 to +2, with higher scores indicating better functioning.

Parent gains in knowledge of OPT-In-Early strategies will be assessed with the OPT-In-Early Quiz, a 30-item multiple-choice quiz that assesses knowledge of NDBI content covered in the OPT-In-Early program. Scores will be based on the percentage of questions that parents answer correctly, with higher scores indicating greater knowledge of intervention content.

The Treatment Evaluation Inventory Short-Form is a 9-item questionnaire, in which parents rate their acceptability of an intervention on a 5-point Likert scale. Scores are averaged and higher scores represent greater acceptability of the intervention. Parents randomized to the intervention condition will complete this measure at post-treatment.

Parents randomized to the intervention group will complete time-based ecological momentary assessment (EMA). EMA will be used to obtain parent report about whether they (a) reviewed a module (yes/no); (b) practiced learned skill with their child (yes/no); and (c) the duration spent practicing skills with their child (minutes)

With the author's permission, we are using a revised version of the Yatchmenoff Client Engagement Scale. Specifically, questions will be included to yield a total receptivity scale score and buy-in scale score. Higher scores will indicate greater parent attitudinal receptiveness and engagement with the intervention. Parents randomized to the intervention group will complete this measure at baseline.

The Autism Diagnostic Observation Schedule (ADOS) is a structured, standardized assessment used to evaluate social communication, interaction, play, and restricted or repetitive behaviors associated with Autism Spectrum Disorder. It is widely considered a gold-standard observational measure in both clinical and research settings. We. will administer the ADOS-2 to all children during their baseline visit to assess for autism.