May 01, 2017
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Parent-mediated intervention helps infants at risk for autism

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Parent-mediated intervention within the first year of life may reduce the severity of autism prodromal symptoms and enhance parent-child dyadic social communication over the 3 years following the intervention, according to findings published in Journal of Child Psychology and Psychiatry.

“Advances towards a developmental account of the emergence of autism ... suggest possibilities for intervention in the autism prodrome, targeting either the earliest behavioral symptoms of emerging disorder or those neurocognitive biomarkers that have predictive salience in early development,” Jonathon Green, MD, from the social development research group at the University of Manchester School of Biological Sciences, England, and colleagues wrote. “There is an appealing, but unproven, argument that very early intervention in these emergent trajectories may be especially effective, with added potential to exploit early brain system plasticity to altered environmental input.”

Researchers delivered a parent-mediated social communication intervention to infants aged 9 to 14 months at familial risk of autism. Using an adapted version of the British Autism Study of Infant Siblings-Video Interaction for Promoting Positive Parenting Program (iBASIS-VIPP), they compared 28 infants randomly allocated to this intervention group with 26 infants in the nonintervention group. Therapists delivered a minimum of six home-based visits using video-feedback to help the parents recognize and respond to their child’s individual communication style. They assessed treatment outcomes at 15-month, 27-month and 39-month follow-up.

The results revealed that the families who received the video therapy intervention had improved prodromal symptoms associated with autism compared with those in the nonintervention group. The researchers saw similar results in the effects on proximal intervention targets of parent nondirectness/synchrony (Effect size [ES] = 0.33; 95% CI, 0.04-0.63) and child attentiveness/communication initiation (ES = 0.36; 95% CI, 0.04-0.68). Green and colleagues observed a noticeable positive impact on parent-child interactions. The intervention had no effect on categorical diagnostic outcome or formal language measures.

“We know that similar kinds of intervention later in childhood can show long term effects; here we have shown that beginning intervention of this kind in the first year of life can produce important improvements for the babies over the medium term in development, continuing after the therapy finishes,” Green said in the accompanying press release. “If this intervention continues to show improvements in such larger studies, then the method would have real potential use for families at the point of early concern, or if their child is genetically at risk of developing autism.” – by Savannah Demko

Disclosures: The researchers report no relevant financial disclosures.