Parent-focused early autism intervention has long-lasting effect
medwireNews: Researchers report sustained benefits almost 6 years after an early intervention for autism that focuses on improving the way parents interact and communicate with their child.
They note that such sustained changes in autism symptoms after early intervention are “something that has previously been regarded as difficult to achieve.”
The relatively low-intensity intervention, parent-mediated social communication therapy for young children with autism (PACT), “is designed to work with parents to reduce autism symptoms through optimising naturalistic parent–child social communication in the home setting,” the research team explains in The Lancet.
It consists of 12, 2-hour long therapy sessions over 6 months followed by monthly support and extension sessions for a further 6 months.
In the initial randomized trial, PACT given at the age of 2 to 4 years was associated with modest gains over standard therapy in 152 children, with comparable Autism Diagnostic Observation Schedule Comparative Severity Scores (ADOS CSSs) of 8.0 and 7.9, respectively.
Among 121 (80%) of these initial participants re-assessed 5.75 years later, at a mean age of 10.5 years, the 59 assigned to PACT had significantly lower ADOS CSS scores than the 62 who received treatment as usual, at 7.3 versus 7.8.
And while the proportion of children with scores in the high symptom severity range had increased in both groups, it was lower for those receiving PACT, at 46% compared with 63% for those receiving usual treatment, reflecting a group difference of 17.2%.
“The results of our investigation show a treatment effect to reduce autism symptom severity at treatment endpoint, which remained almost 6 years later, giving a clear averaged treatment effect over the total period,” say Jonathan Green (University of Manchester, UK) and fellow researchers.
“The effect was apparent across both autism social-communication and repetitive symptom domains.”
The researchers note that parental synchrony waned over the follow-up period, which suggests that the improvements in parent–child social communication made with the initial treatment are “self-sustaining […] independent of the initial parental behavioural change that mediated them.”
According to Jeff Sigafoos and Hannah Waddington, both from the Victoria University of Wellington in New Zealand, the researchers have “made a major contribution to autism research.”
They say in a related comment that further research is now needed to isolate the critical treatment components and mechanisms underlying this sustained effect.
By Lucy Piper
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