International Meeting for Autism Research: First Year Intervention for Infants at Risk for Autism Initial Feasibility and Acceptance

First Year Intervention for Infants at Risk for Autism Initial Feasibility and Acceptance

Thursday, May 20, 2010
Franklin Hall B Level 4 (Philadelphia Marriott Downtown)
3:00 PM
S. Ahmed , Child and Adolescent Psychiatry, The University of Manchester, Manchester, United Kingdom
M. W. Wan , Child and Adolescent Psychiatry, The University of Manchester, Manchester, United Kingdom
M. Elsabbagh , Centre for Brain and Cognitive Development, Birkbeck, University of London, London, United Kingdom
M. H. Johnson , Centre for Brain and Cognitive Development, Birkbeck, University of London, London, United Kingdom
J. Green , Child and Adolescent Psychiatry, The University of Manchester, Manchester, United Kingdom
.. The BASIS Team* , BASIS, United Kingdom
Background: Studies of high risk infants (A-sibs) show estimated recurrence rates of 5-30% for the broader autism phenotype. Prospective studies are elucidating emerging behavioural1 and brain function atypicalities2 in the latter part of the first year in infancy. The “interactive specialisation” (IS) model3 within cognitive neuroscience suggests that the “social brain” develops through an active process of postnatal interaction with the environment. Our group has found evidence of perturbation of parent-infant in relation to these early atypicalities4. It has been argued that intervention in infancy carries promise of altering the early trajectory of autism5.
These considerations have led us to undertake a parent-mediated intervention to enhance the social interactive environment for A-sibs from 10-14 months. This is only the second study internationally to initiate an intervention prior to 12 months. Review of acceptability and feasibility of such an intervention is therefore crucial.
Objectives: To report on the initial feasibility and acceptability to parents of the parent-mediated video-aided home based intervention from 10-14 months.
Methods: Siblings of autism probands are recruited within the context of British Autism Study of Infant Siblings (BASIS); a UK collaborative research network.
The intervention design derives from a combination of developmental theory and the best current evidence for effective interventions for parent-child interaction in typically developing infants at high and low risk, as well as in pre-schoolers with autism.  Video-aided techniques are used to enhance parent-infant interaction.
Results: Detailed interviews have been conducted with participating parents and questionnaires filled out before and after the intervention. These assessments ascertain:
·        parental expectations of and attitudes towards an intervention of this nature
·        acceptability of the sessions with respect to content, duration, frequency
·        acceptability of the home practice expected
·        wider impact of intervention on parental attitudes and family factors
The qualitative data from the first families to take part in the intervention will be described.
Conclusions: Early findings from the pilot study reported here give insight into parental acceptance and feasibility of parent-mediated intervention with infants at high risk of autism.
References
1. Zwaigenbaum L et al 2005 International J of Developmental Neuroscience 23, 143-152
2. Elsabbagh, M. and M.H. Johnson, Infancy and autism: progress, prospects, and challenges, in Progress in Brain Research, v.H. C. and Rosander, Editors. In press, Elsevier. p. 355-383.
3. Johnson, M.H., Functional brain development in humans. Nature Reviews Neuroscience, 2001. 2(7): p. 475-483
4. Wan, M.W., J. Green, M. Elsabbagh, and M.H. Johnson, Mother-infant interactions in high-risk infant siblings of children with autism., in International Meeting for Autism Research. 2008: London, UK
5. Dawson G. (2008). Early behavioural intervention, brain plasticity, and the prevention of autistic spectrum disorder. Development and Psychopathology 20 (2008), 775–803

*The BASIS Team in alphabetical order: S. Baron-Cohena, P. Boltonb, T. Charmanc, J. Fernandesd, L. Tuckerd

aUniversity of Cambridge, bInstitute of Psychiatry, cInstitute of Education, dBirkbeck, University of London

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