Trial of Raupi te Raupo, an early support programme for children with social communication differences.

INTERVENTION: Raupi te Raupo has been developed based on advice and suggestions from an autistic advisory group and a Maori advisory group. The name was generously gifted by Associate Professor Mere Skerrett (Ngai Tahu, Ngati Rakiamoa, Ngati Ruahikihiki, Ngati Mahuta, Ngati Unu, Ngati Maniapoto, Ngati Pikiao, Ngati Te Rangiunuora, Ngati Pukeko). Raupi is about nurturing, taking care of, and cherishing. The wetlands where Raupo (bulrush) grow are the lungs of the land and are essential for survival and wellbeing. Raupo had many traditional uses for Maori including as a covering for poi, in weaving, for canoe sails, and as food. As such, our tomorrow will be filled with a sense of wellbeing when we cherish our youngest ones just as we should cherish raupo. Raupi te Raupo will involve 20 sessions for the main participating whanau/family members over 24 weeks. Following an introductory session, weekly sessions will alternate between discussion and practical sessions. Whanau/families can also choose "additional support people" who will attend one discussion session every si Xweeks. The programme is delivered by trained coaches from a variety of backgrounds, including educational psychology, teaching, and music therapy, and by parents of autistic children. Correct use of Raupi te Raupo techniques during practical and discussion sessions will be monitored using a fidelity checklist. The fortnightly discussion sessions will involve the coach and whanau/family members discussing strategies and reflecting on the most recent practical session. These sessions will last up to 1.5 hours. The child will not be present for these sessions, which will usually take place online via a platform such as Zoom, without the child present. These sessions will involve: (a) checking in at the beg CONDITION: Mental Health ‐ Autistic spectrum disorders social communication differences;signs of autism; ; social communication differences ; signs of autism PRIMARY OUTCOME: Parent Synchrony[Dyadic Communication Measure for Autism Baseline and immediately following support, 24 weeks later] SECONDARY OUTCOME: Child communication with parent[Dyadic Communication Measure for Autism Baseline and immediately following support, 24 weeks later] Child communication with researcher[Eliciting Language Samples for Analysis – Toddler Baseline and immediately following support, 24 weeks later] Child Wellbeing and Quality of Life[KIDSCREEN‐10 Baseline and immediately following support, 24 weeks later] Composite measure of child treatment outcomes related to understanding, communication and interaction, daily routines, support, and wellbeing[Neuro‐Affirming Survey of Outcomes (measure developed for this project) Baseline and immediately following support, 24 weeks later] Composite measure of parent treatment outcomes related to understanding, communication, connecting and interacting, safety, support, and wellbeing.[Neuro‐Affirming Survey of Outcomes (measure developed for this project) Baseline and immediately following support, 24 weeks later] Composite measure of perceptions of the acceptability, appropriateness and feasibility of Raupi te Raupo[Adapted Acceptability, Appropriateness, and Feasibility of Intervention Measure Raupi te Raupo group only, immediately following 24 weeks of support] Family Quality of Life[World Health Organization Quality of Life Assessment‐BREF Baseline and immediately following support, 24 weeks later] Parent positive comments towards their child[Autism‐specific Five‐Minute Speech Sample Baseline and immediately following support, 24 weeks later] Parent Sense of competence[Parent Sense of Competence Scale Baseline and immediately following support, 24 weeks later] Parent Stress[Autism Parent Stress Inde XBaseline and immediately following support, 24 weeks later] INCLUSION CRITERIA: 1. The child is aged between 1 year 0 months and 5 years 0 months at pre‐assessment, 2. The child is showing signs of autism/social communication differences on the Social Attention and Communication Surveillance Tool – Revised (SACS‐R; Barbaro et al., 2022), 3. The child does not have a sibling or twin who is already participating in the study 4. The child does not have a genetic condition which is associated with “autism‐like” characteristics (e.g., Rett Syndrome, Fragile X, 22q deletion), 5. Each participating whanau/family member can commit to 20 sessions of up to one‐and‐a‐half hours across 24 weeks, including alternating fortnightly home‐based sessions with the child present, and fortnightly sessions without the child present either at home, in a clinic, or via Zoom, 6. The primary whanau/family member speaks sufficient English to understand the requirements of the study and to participate in the coaching sessions, 7. The primary whanau