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. 2025 Jun 23.
doi: 10.1007/s10803-025-06928-3. Online ahead of print.

Project ImPACT Reduces Social Hyporesponsiveness and Translates to More Optimal Expressive Language Outcomes in Some Infants at Increased Likelihood of Autism

Jennifer E Markfeld  1   2 , Jacob I Feldman  3   4 , Catherine T Bush  4   5 , Paul J Yoder  5   6 , Tiffany G Woynaroski  3   4   6   7   8
Affiliations

Project ImPACT Reduces Social Hyporesponsiveness and Translates to More Optimal Expressive Language Outcomes in Some Infants at Increased Likelihood of Autism

Jennifer E Markfeld et al. J Autism Dev Disord. .

Abstract

Low responsiveness to sensory stimuli, particularly stimuli that are social in nature (i.e., social hyporesponsiveness), predicts expressive language in autistic children and in infant siblings of autistic children (Sibs-autism), who are at high likelihood for a future diagnosis of autism and developmental language disorder. However, our understanding of whether social hyporesponsiveness can be addressed via early intervention to improve expressive language outcomes of Sibs-autism is limited. This randomized controlled trial investigated whether Project ImPACT, a caregiver-implemented Naturalistic Developmental Behavioral Intervention (NDBI), has an indirect effect on expressive language outcomes by reducing social hyporesponsiveness. Sibs-autism were randomized into a Project ImPACT group (n = 23) for 12 weeks of intervention, or into a non-Project ImPACT control group (n = 23). Social hyporesponsiveness was measured immediately following intervention, and expressive language was measured three months after the end of intervention. Project ImPACT indirectly influenced distal expressive language outcomes through social hyporesponsiveness, but only for infants whose caregivers had high levels of education at study entry. Clinical implications of the results are discussed.

Keywords: Autism; Baby sibs; Language; Preemptive intervention; Prevention; Sensory.

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Conflict of interest statement

Declarations. Competing Interests: Jacob I. Feldman has been paid to provide adaptive horseback riding lessons and has received grant funding from the National Institutes of Health to study the efficacy of interventions geared toward infant siblings of autistic children. Tiffany Woynaroski has previously been paid to provide traditional behavioral, naturalistic developmental behavioral, and developmental interventions to young children on the autism spectrum and has received grant funding from internal and external agencies, including the National Institutes of Health and the Vanderbilt Institute for Clinical and Translational Research, to study the efficacy of various interventions geared toward young children with autism. Tiffany Woynaroski, Jacob I. Feldman, and Catherine T. Bush are employed by the Department of Hearing and Speech Sciences at Vanderbilt University Medical Center, which offers intervention services for autistic children via their outpatient clinics and trains clinical students in the provision of treatments delivered over the course of early childhood. The other authors have declared that no other competing financial or nonfinancial interests existed at the time of publication.

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