Randomised trial of a parent-mediated intervention for infants at high risk for autism: Longitudinal outcomes to age 3 years

Green, Jonathan, Pickles, Andrew, Pasco, Greg, Bedford, Rachael, Wan, Ming Wai, Elsabbagh, Mayada, Slonims, Vicky, Jones, Emily, Cheung, Celeste, Charman, Tony, Johnson, Mark and , British Autism Study of Infant Siblings (BASIS) Team (2017) Randomised trial of a parent-mediated intervention for infants at high risk for autism: Longitudinal outcomes to age 3 years. Journal of Child Psychology and Psychiatry, 58 (12). pp. 1330-1340. ISSN 0021-9630

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Abstract

BACKGROUND: There has been increasing interest in the potential for pre-emptive interventions in the prodrome of autism, but little investigation as to their effect. METHODS: A two-site, two-arm assessor-blinded randomised controlled trial (RCT) of a 12-session parent-mediated social communication intervention delivered between 9 and 14 months of age (Intervention in the British Autism Study of Infant Siblings-Video Interaction for Promoting Positive Parenting), against no intervention. Fifty-four infants (28 intervention, 26 nonintervention) at familial risk of autism but not otherwise selected for developmental atypicality were assessed at 9-month baseline, 15-month treatment endpoint, and 27- and 39-month follow-up. PRIMARY OUTCOME: severity of autism prodromal symptoms, blind-rated on Autism Observation Schedule for Infants or Autism Diagnostic Observation Schedule 2nd Edition across the four assessment points. SECONDARY OUTCOMES: blind-rated parent-child interaction and child language; nonblind parent-rated communication and socialisation. Prespecified intention-to-treat analysis combined estimates from repeated measures within correlated regressions to estimate the overall effect of the infancy intervention over time. RESULTS: Effect estimates in favour of intervention on autism prodromal symptoms, maximal at 27 months, had confidence intervals (CIs) at each separate time point including the null, but showed a significant overall effect over the course of the intervention and follow-up period (effect size [ES] = 0.32; 95% CI 0.04, 0.60; p = .026). Effects on proximal intervention targets of parent nondirectiveness/synchrony (ES = 0.33; CI 0.04, 0.63; p = .013) and child attentiveness/communication initiation (ES = 0.36; 95% CI 0.04, 0.68; p = .015) showed similar results. There was no effect on categorical diagnostic outcome or formal language measures. CONCLUSIONS: Follow-up to 3 years of the first RCT of a very early social communication intervention for infants at familial risk of developing autism has shown a treatment effect, extending 24 months after intervention end, to reduce the overall severity of autism prodromal symptoms and enhance parent-child dyadic social communication over this period. We highlight the value of extended follow-up and repeat assessment for early intervention trials.

Item Type: Article
Additional Information: © 2017 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.
Uncontrolled Keywords: prevention & control,child, preschool,communication,methods,education, nonprofessional,female,humans,interpersonal relations,language development,longitudinal studies,male,outcome assessment, health care,parent-child relations,parenting,prodromal symptoms,single-blind method
Faculty \ School: Faculty of Social Sciences > School of Psychology
Depositing User: LivePure Connector
Date Deposited: 12 Jun 2020 00:16
Last Modified: 26 Aug 2020 23:58
URI: https://ueaeprints.uea.ac.uk/id/eprint/75581
DOI: 10.1111/jcpp.12728

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