Parent Coaching Could Cut Diagnosis of Autism by Two-Thirds

A new study published in the Journal of the American Medical Association Pediatrics (JAMA Pediatrics) finds that therapeutic interventions with parents of infants showing signs of autism at 12 months significantly reduces the probability of the child getting a diagnosis of autistic spectrum disorder (ASD) by age 3. The title of the study is Effect of Preemptive Intervention on Developmental Outcomes Among Infants Showing Early Signs of Autism.

The study was a randomized clinical trial of 104 infants who were screened for early signs of autistic spectrum disorder. Some of the signs used to assess the risk of autism were: the infant’s reduced use of eye contact in face-to-face interactions, reduced ability to follow a parent’s gaze, reduced reciprocal social smile, reduced response to social talk from a parent, reduced affective response to touch, delays in producing sounds and words, reduced babbling, and atypical motor mannerisms like hand flapping.

Fifty infants received a preemptive intervention called iBASIS-VIPP in addition to standard care. This therapy supports social communication skills in the first years of life with the aim of removing barriers to communication in the long term. Fifty-three of the infants received standard care only without any preemptive interventions. The two groups had similar household incomes and similar levels of education among the parents.

A total of 89 participants were reassessed at age 3. The assessment found that while only 3 of 45 (6.7 percent) of the treated children were given a diagnosis of ASD, 9 of the 44 (20.5 percent) of the untreated children were given an ASD diagnosis. The children whose parents did not receive the therapy were thus three times more likely to be diagnosed with ASD.

The interventions for the parents of treated children involved 10 sessions in the family homes by trained therapists over a five-month period. The core aspects of the iBASIS-VIPP therapy included a focus on the communication between parent and baby, the parents’ viewing of videotaped positive interactions between parent and child, assistance with parents’ reflecting on interactions with their babies, and helping parents changing certain negative parent-baby interactions.

Therapists asked the parents to practice the skills they were taught on a daily basis. Parents were trained to become more sensitive to their babies’ social communications and needs. They made more eye contact with the infants and talked with them more than previously. The group of parents who did not receive the therapy had usual community care including a range of health services or no special services.

Clinicians who were not aware of which group of parents and babies received the interventions (blinded) assessed the children at 24 months and 3 years. There was reduced severity of ASD symptoms in the group that received the therapy as well as an increase in sensitive responsiveness by the parents. There were no adverse effects of the therapeutic interventions.

According to the researchers, this is the first study to demonstrate that therapy for the parent-baby dyad led to reduced odds of an ASD diagnosis in early childhood. As for the limitations of the study, the authors acknowledge that a small proportion of the children might change diagnostic categories if reassessed at later times. The authors also acknowledge that follow-ups of the children in later childhood will be important to determine whether the interventions had long-term clinical significance.