{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T18:07:29Z","timestamp":1783015649556,"version":"3.54.6"},"reference-count":56,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T00:00:00Z","timestamp":1746144000000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100007857","name":"Intellectual and Developmental Disabilities Research Center","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007857","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000055","name":"National Institute on Deafness and Other Communication Disorders","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000055","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Autism Research"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Randomized controlled trials (RCTs) focused on idiopathic social communication delay (SCD) in the first year of life are rare. We preliminarily tested the efficacy of an 8\u2010week caregiver\u2010implemented intervention for infants with idiopathic SCD. Infants (8\u201312\u2009months) with SCD were block\u2010randomized with caregivers to the Infant Achievements (IA) (<jats:italic>n<\/jats:italic>\u2009=\u200918) or Caregiver Education (CE) (<jats:italic>n<\/jats:italic>\u2009=\u200920) group in this assessor\u2010masked RCT. Assessments were completed at baseline, post\u2010intervention, and 8\u2010week follow\u2010up. IA caregivers received reflective, home\u2010based coaching to implement naturalistic developmental behavioral intervention (NDBI) strategies. Primary outcomes: masked ratings of caregiver implementation fidelity, frequency of infant initiation of joint attention (IJA), and percent of coordination of joint engagement (CJE). Secondary outcomes: masked researcher\u2010administered and scored Mullen Scales of Early Learning (MSEL) language and Visual Reception scaled scores; nonmasked caregiver\u2010reported Communication and Symbolic Behavior Scales Caregiver Questionnaire (CSBS CQ) Social, Speech, and Symbolic composite scores and McArthur\u2010Bates Communication Development Inventories Words Understood and Produced scores. Prespecified analyses followed an intent\u2010to\u2010treat approach using Generalized Linear Mixed Models for non\u2010normally distributed outcomes and linear mixed\u2010effects models for those with normal distributions. Significant group by time effects favored the IA group relative to the CE group on all primary outcomes at post\u2010intervention (<jats:italic>p<\/jats:italic>'s\u2009\u2264\u20090.001), and for caregiver fidelity and IJA, at follow\u2010up (\u2264\u20090.03). Significant IA intervention effects were detected on secondary outcomes of nonverbal cognition (MSEL Visual Reception) and CSBS CQ Speech composite at post\u2010intervention (&lt;\u20090.01) and follow\u2010up (\u2264\u20090.02). IA equips caregivers to learn and generalize the implementation of child\u2010responsive NDBI strategies and propels pre\u2010linguistic social communication advances in SCD infants.<\/jats:p><jats:p>\n<jats:bold>Trial Registration:<\/jats:bold> <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/clinicaltrials.gov\/study\/NCT03404505\">ClinicalTrials.gov<\/jats:ext-link> identifier: NCT03404505.<\/jats:p>","DOI":"10.1002\/aur.70051","type":"journal-article","created":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T12:45:27Z","timestamp":1746189927000},"page":"1104-1116","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Infant Achievements Intervention Improves Caregiver Implementation Fidelity and Infant Social Communication Outcomes: A Preliminary Randomized Clinical Trial"],"prefix":"10.1002","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8894-8995","authenticated-orcid":false,"given":"Rebecca J.","family":"Landa","sequence":"first","affiliation":[{"name":"Center for Autism Services, Science and Innovation Kennedy Krieger Institute  Baltimore USA"},{"name":"Department of Psychiatry and Behavioral Sciences Johns Hopkins University School of Medicine  Baltimore USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Reetzke","sequence":"additional","affiliation":[{"name":"Center for Autism Services, Science and Innovation Kennedy Krieger Institute  Baltimore USA"},{"name":"Department of Psychiatry and Behavioral Sciences Johns Hopkins University School of Medicine  Baltimore USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine Reiner","family":"Hess","sequence":"additional","affiliation":[{"name":"Center for Autism Services, Science and Innovation Kennedy Krieger Institute  Baltimore USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,2]]},"reference":[{"key":"e_1_2_12_2_1","volume-title":"The Joint Engagement Rating Inventory (JERI)","author":"Adamson L. 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