Parent-Based Intervention Therapy for Autism Spectrum Disorder

Background:  In India, >10 million children are affected by autism spectrum disorder (ASD). With improvements in diagnosis, the number of cases is expected to greatly increase; however, there continues to be a deficit of professionals in the field of autism intervention. Several studies have shown that a structured intervention for children with ASD at an early stage significantly improves IQ levels, adaptive behavior, and diagnosis of autism compared to children receiving community-based intervention. In this regard, parent-implemented intervention has shown better outcomes for both children and parents compared to other forms of intervention for ASD, and has extended the benefits of intervention to the home environment.

Objectives:  This study aimed to provide timely intervention in children with ASD by training parents to be interventionists themselves.

Methods:  Twenty-three children with ASD (3­–7 years) were first diagnosed using standardized tools, and then, evaluated using the Early Start Denver Model Curriculum Checklist (ESDM) in the areas of communication (receptive and expressive), social skills, and play skills pre-intervention, and the modified Indian version of the MacArther Communicative Development Inventory. A comprehensive intervention plan was then designed to begin from the child’s basal level of functioning, based on the above assessments. This included enhancing the child’s social, communication, and self-help skills through play therapy, language sessions, phonetics and early literacy program, toilet-training program, self-help development program, and sensory program; 3 h/day at the center and at least 2 h/day at home for 5 days, leading to a 25-h structured intervention program weekly. We also focused on sensitizing and empowering parents through weekly presentations and home program to facilitate intervention during child’s daily activities. Plans were reviewed monthly by staff and parents. Evaluation using ESDM checklist was performed after each of the four post-intervention sessions at 6-month intervals.

Results:  Based on our pilot results, most children showed significant improvements in communicative abilities, play, and social skills at the end of 1­–4 intervention sessions (1^st session: n = 17; 2^nd to 4^th session: n = 6) as per the ESDM check-list. By the end of the first intervention session, 12/17, 9/17, and 10/17 children showed improvements in communication, social skills, and play, respectively. Among the 6 kids who have completed all 4 intervention sessions so far, all showed significant improvements in communication, social skills, and play as compared to pre-intervention (p < 0.05).

Conclusions:  Based on our results, we can conclude that our parent-based intervention therapy has successfully enhanced the developmental outcomes for children with ASD. It has made parents more tuned-in to their child’s needs and show child-oriented responses, sensitive to the challenges their child faces, have appropriate expectations from the child, and be more optimistic. Our results support previous research that suggests that close cooperation between parents and professionals as well as parental involvement is key to the success of autism intervention programs. We believe that involving parents/primary caregivers will compensate for the deficit of professionals in the field of autism intervention and help in effective and timely intervention in children with ASD.