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Parent-mediated intervention with infants at risk for autism

Dr Kristi Poppi - July 4th 2017

Green et al (2017) have published a 3-year follow-up of their randomized controlled study of an early intervention for infants at familial risk of developing autism. The follow-up shows reduced overall severity of autism prodromal symptoms for those at-risk infants receiving the treatment and enhanced parent-child dyadic social communication over this period.

boy lining up toy cars

The authors original 2013 study had tested the efficacy of a 5-months parent-mediated intervention for 7- to -10 month old infants at high risk for autism (Green et al., 2013). These children were then revisited in 2015 in a study which reported on the 15-month treatment results, demonstrating that this parent-delivered treatment decreased autism related behaviours in infants at risk for autism at age 15 months. (Green et al, 2015)

This recent study extends these previous findings by reporting on a subsequent follow-up of infants to age 27 and 39 months, including prodromal autism-related behaviours and clinical categorical diagnostic outcome. As stated by the authors, the latest study “reports a longitudinal repeated measures analysis that not only highlights the time-paths of the effects of the intervention, giving insight into the possible therapeutic and developmental mechanisms but also increases the statistical power to sharpen effect estimates” (Green et al., 2017).

The original study involved 54 infants (28 intervention, 26 non-intervention) at familial risk of autism, who were identified from the British Autism Study of Infant Siblings. The siblings of children with autism are 20 times more likely than a typical child to be diagnosed with autism.

Those infants receiving the intervention received a 12-session parent-mediated social communication intervention that was delivered between 9 and 14 months of age. The intervention used was the iBASIS-Video Interaction for Promoting Positive Parenting (iBASIS-VIPP), which is a modified version of the VIPP infancy programme (Juffer et al, 2008). During the sessions, parents watched video recordings of themselves interacting with their children and then received feedback in order to adapt better to their infant’s individual communication style. Participating parents practiced their new skills for at least 20 minutes every day. This study is considered the first randomised trial of a precautionary intervention with baby siblings of children with autism. 

When the intervention and non-intervention children were compared at ages 2 and 3 the authors found that the “intervention produced a sustained alteration of subsequent child developmental trajectory; reducing prodromal autism symptoms into the second and third years of life to a total of 24 months following end of intervention”. It should be taken into account that these findings did not reach statistical significance individually, but a combination of the measures over the 3 time points led to the conclusion that the intervention was beneficial for the children. However, further investigation is needed with a larger sample in order to strengthen the results. 

Overall, these are important findings since they support the notion that a parent-mediated intervention can have a sustained positive effect on child dyadic communication and symptom outcomes. 

References:
1. Green J. et al. (2017). Randomised Trial of a Parent-Mediated Intervention for Infants at High Risk for Autism: Longitudinal Outcomes to Age 3 Years. J. Child Psychol. Psychiatry, Epub ahead of print PubMed Open access
2. Green J. et al. (2015). Parent-mediated intervention versus no intervention for infants at high risk of autism: a parallel, single-blind, randomised trial. Lancet Psychiatry, 2 (2), 133-140 PubMed Open access




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Welcome to ourNews, where we keep up-to-date with research and other news related to infant mental health. These articles can be of interest to both parents and professionals.
We are keen to know your views and so please do comment on our articles.
Is there a topic that you would like us to write about? Just send us a message via 'Contact us'.

ourAdvice, our other blog, has brief posts with advice for parents.

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