Friday, May 21, 2010
Franklin Hall B Level 4 (Philadelphia Marriott Downtown)
3:00 PM
Background: Based on current theories and empirical evidence regarding the transactional effects of biology and environment on neurodevelopment, Dawson (2008) proposed that intervening with infants at risk for autism prior to the emergence of all the diagnostic symptoms could be more efficacious than interventions initiated after diagnosis. To date, however, there is a notable lack of empirical data demonstrating the efficacy of interventions with infants at-risk for autism.
Objectives: To evaluate the potential of a parent-mediated intervention designed for one-year-olds at-risk for autism to (a) improve developmental functioning and (b) ameliorate the severity of symptoms of autism.
Methods: The First Year Inventory, a parent questionnaire designed to identify 12-month-olds who are at risk for an eventual diagnosis of autism, was mailed to families in our catchment area. Parents of infants with scores above the 95th percentile were invited to bring their infants for an extensive developmental assessment. If autism risk indicators were confirmed in the Time 1 assessment, families were invited to enroll in the intervention study. Eligible families who consented to participate were randomly assigned to an experimental intervention called Adapted Responsive Teaching (ART; adapted from Mahoney & MacDonald, 2007) or to a Community Services (CS) group, using a 2:1 randomization ratio. Sixteen families have been enrolled, with 11 assigned to ART and 5 to CS. ART families participated in a 6-month home-based intervention designed to enhance parent responsiveness and promote “pivotal” behaviors in infants in social-communication and sensory-regulatory domains. Children participated in Time 2 assessments after the completion of the ART intervention (at 22-24 months of age).
Results: To date, 7 children have been assessed at Time 2: 5 in the ART group and 2 in the CS group. Children assigned to ART improved on 3 different measures of communication/language functioning: (1) mean standard scores on the Communication and Symbolic Behavior Scales [CSBS] improved from 91 to 102; (2) mean standard scores on the Vineland Communication Scales [VineComm] improved from 93 to 98; and (3) mean scores for spoken words on the MacArthur-Bates Communicative Development Inventories [MCDI] improved from the 27th %ile to the 57th %ile. One child in the CS group showed decreases on all 3 measures (78 to 65 on CSBS; 73 to 64 on VineComm; 10th %ile to 5th %ile on MCDI), whereas the other child in the CS group showed negligible changes (92 to 94 on CSBS; 100 to 94 on VineComm; and 5th %ile to 5th %ile on MCDI). The remaining 9 children will complete Time 2 assessments by March, 2010. Also, planned analyses will examine symptom severity on the Autism Observation Schedule for Infants (Time 1) and the Autism Diagnostic Observation Schedule-Toddler Module (Time 2). Conclusions: Preliminary findings support the promise of parent-mediated early intervention with infants at-risk for autism in improving communication/language functioning. A larger RCT is required to evaluate the efficacy of the treatment and test parent responsiveness as a hypothesized mediator of outcomes.
Objectives: To evaluate the potential of a parent-mediated intervention designed for one-year-olds at-risk for autism to (a) improve developmental functioning and (b) ameliorate the severity of symptoms of autism.
Methods: The First Year Inventory, a parent questionnaire designed to identify 12-month-olds who are at risk for an eventual diagnosis of autism, was mailed to families in our catchment area. Parents of infants with scores above the 95th percentile were invited to bring their infants for an extensive developmental assessment. If autism risk indicators were confirmed in the Time 1 assessment, families were invited to enroll in the intervention study. Eligible families who consented to participate were randomly assigned to an experimental intervention called Adapted Responsive Teaching (ART; adapted from Mahoney & MacDonald, 2007) or to a Community Services (CS) group, using a 2:1 randomization ratio. Sixteen families have been enrolled, with 11 assigned to ART and 5 to CS. ART families participated in a 6-month home-based intervention designed to enhance parent responsiveness and promote “pivotal” behaviors in infants in social-communication and sensory-regulatory domains. Children participated in Time 2 assessments after the completion of the ART intervention (at 22-24 months of age).
Results: To date, 7 children have been assessed at Time 2: 5 in the ART group and 2 in the CS group. Children assigned to ART improved on 3 different measures of communication/language functioning: (1) mean standard scores on the Communication and Symbolic Behavior Scales [CSBS] improved from 91 to 102; (2) mean standard scores on the Vineland Communication Scales [VineComm] improved from 93 to 98; and (3) mean scores for spoken words on the MacArthur-Bates Communicative Development Inventories [MCDI] improved from the 27th %ile to the 57th %ile. One child in the CS group showed decreases on all 3 measures (78 to 65 on CSBS; 73 to 64 on VineComm; 10th %ile to 5th %ile on MCDI), whereas the other child in the CS group showed negligible changes (92 to 94 on CSBS; 100 to 94 on VineComm; and 5th %ile to 5th %ile on MCDI). The remaining 9 children will complete Time 2 assessments by March, 2010. Also, planned analyses will examine symptom severity on the Autism Observation Schedule for Infants (Time 1) and the Autism Diagnostic Observation Schedule-Toddler Module (Time 2). Conclusions: Preliminary findings support the promise of parent-mediated early intervention with infants at-risk for autism in improving communication/language functioning. A larger RCT is required to evaluate the efficacy of the treatment and test parent responsiveness as a hypothesized mediator of outcomes.