4.5 Article

Randomised trial of a parent-mediated intervention for infants at high risk for autism: longitudinal outcomes to age 3 years

期刊

JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY
卷 58, 期 12, 页码 1330-1340

出版社

WILEY
DOI: 10.1111/jcpp.12728

关键词

Pre-emptive intervention; prevention trials; autism; autism spectrum disorder; high-risk siblings; parent-mediated intervention

资金

  1. BASIS funding consortium [7267]
  2. Waterloo Foundation
  3. Autism Speaks US
  4. UK Medical Research Council [G0701484, MR/K021389/1]
  5. NIHR Biomedical Research Centre for Mental Health at the South London and Maudsley NHS Foundation Trust and King's College London
  6. Sir Henry Wellcome Postdoctoral Fellowship
  7. Autistica [7267] Funding Source: researchfish
  8. Medical Research Council [G0701484, MR/K021389/1] Funding Source: researchfish
  9. MRC [G0701484, MR/K021389/1] Funding Source: UKRI

向作者/读者索取更多资源

Background: There has been increasing interest in the potential for pre-emptive interventions in the prodrome of autism, but little investigation as to their effect. Methods:A two-site, two-arm assessor-blinded randomised controlled trial (RCT) of a 12-session parent-mediated social communication intervention delivered between 9 and 14months of age (Intervention in the British Autism Study of Infant Siblings-Video Interaction for Promoting Positive Parenting), against no intervention. Fifty-four infants (28 intervention, 26 nonintervention) at familial risk of autism but not otherwise selected for developmental atypicality were assessed at 9-month baseline, 15-month treatment endpoint, and 27- and 39-month follow-up. Primary outcome: severity of autism prodromal symptoms, blind-rated on Autism Observation Schedule for Infants or Autism Diagnostic Observation Schedule 2nd Edition across the four assessment points. Secondary outcomes: blind-rated parent-child interaction and child language; nonblind parent-rated communication and socialisation. Prespecified intention-to-treat analysis combined estimates from repeated measures within correlated regressions to estimate the overall effect of the infancy intervention over time. Results: Effect estimates in favour of intervention on autism prodromal symptoms, maximal at 27months, had confidence intervals (CIs) at each separate time point including the null, but showed a significant overall effect over the course of the intervention and follow-up period (effect size [ES]=0.32; 95% CI 0.04, 0.60; p=.026). Effects on proximal intervention targets of parent nondirectiveness/synchrony (ES=0.33; CI 0.04, 0.63; p=.013) and child attentiveness/communication initiation (ES=0.36; 95% CI 0.04, 0.68; p=.015) showed similar results. There was no effect on categorical diagnostic outcome or formal language measures. Conclusions: Follow-up to 3years of the first RCT of a very early social communication intervention for infants at familial risk of developing autism has shown a treatment effect, extending 24months after intervention end, to reduce the overall severity of autism prodromal symptoms and enhance parent-child dyadic social communication over this period. We highlight the value of extended follow-up and repeat assessment for early intervention trials.

作者

我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。

评论

主要评分

4.5
评分不足

次要评分

新颖性
-
重要性
-
科学严谨性
-
评价这篇论文

推荐

Article Psychology, Developmental

Parent, Teacher and Observational Reports of Emotional and Behavioral Problems in Young Autistic Children

Melanie Palmer, Joanne Tarver, Virginia Carter Leno, Juan Paris Perez, Margot Frayne, Vicky Slonims, Andrew Pickles, Stephen Scott, Tony Charman, Emily Simonoff

Summary: Emotional and behavioral problems are common in young autistic children. There are discrepancies between parents and teachers in reporting these problems. Parenting stress and verbal ability are associated with more parent-reported problems. Autistic children with minimal verbal ability display more challenging behaviors.

JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS (2023)

Article Psychology, Developmental

World Health Organisation-Caregiver Skills Training (WHO-CST) Program: Feasibility of Delivery by Non-Specialist Providers in Real-world Urban Settings in India

Koyeli Sengupta, Henal Shah, Subharati Ghosh, Disha Sanghvi, Sanchita Mahadik, Allauki Dani, Oshin Deshmukh, Laura Pacione, Pamela Dixon, Erica Salomone, Chiara Servili

Summary: This study evaluated the feasibility and effects of the World Health Organization-Caregiver Skills Training Program in urban India. The program showed promising results in improving caregiver skills and knowledge, reducing stress, and enhancing child developmental outcomes.

JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS (2023)

Article Psychology, Developmental

Psychiatric conditions in autistic adolescents: longitudinal stability from childhood and associated risk factors

Matthew J. Hollocks, Virginia Carter Leno, Susie Chandler, Pippa White, Isabel Yorke, Tony Charman, Andrew Pickles, Gillian Baird, Emily Simonoff

Summary: Autistic individuals have high rates of co-occurring psychiatric diagnoses, particularly emotional and behavioral disorders, which show significant stability from childhood to adolescence. ADHD, on the other hand, has more variability in diagnostic outcomes, with many adolescents transitioning across diagnostic thresholds.

EUROPEAN CHILD & ADOLESCENT PSYCHIATRY (2023)

Article Psychology, Clinical

Assessing the feasibility of a web-based outcome measurement system in child and adolescent mental health services - myHealthE a randomised controlled feasibility pilot study

Anna C. Morris, Zina Ibrahim, Margaret Heslin, Omer S. Moghraby, Argyris Stringaris, Ian M. Grant, Lukasz Zalewski, Megan Pritchard, Robert Stewart, Matthew Hotopf, Andrew Pickles, Richard J. B. Dobson, Emily Simonoff, Johnny Downs

Summary: This study assesses the potential of the MHE system in improving the completion of PROMs. The results indicate that the use of MHE significantly increases the completion rates of questionnaires compared to paper-based methods. Caregivers express satisfaction with the MHE system and highlight its numerous benefits.

CHILD AND ADOLESCENT MENTAL HEALTH (2023)

Article Psychiatry

The Link Between Autism and Sex-Related Neuroanatomy, and Associated Cognition and Gene Expression

Dorothea L. Floris, Han Peng, Varun Warrier, Michael V. Lombardo, Charlotte M. Pretzsch, Clara Moreau, Alex Tsompanidis, Weikang Gong, Maarten Mennes, Alberto Llera, Daan van Rooij, Marianne Oldehinkel, Natalie J. Forde, Tony Charman, Julian Tillmann, Tobias Banaschewski, Carolin Moessnang, Sarah Durston, Rosemary J. Holt, Christine Ecker, Flavio Dell'Acqua, Eva Loth, Thomas Bourgeron, Declan G. M. Murphy, Andre F. Marquand, Meng-Chuan Lai, Jan K. Buitelaar, Simon Baron-Cohen, Christian F. Beckmann

Summary: Using deep learning on brain images, the authors found that both autistic males and females tend to have neuroanatomy more similar to males, as well as social cognitive features and gene expression patterns associated with male characteristics. These neurophenotypes provide important insights into the biological mechanisms underlying autism.

AMERICAN JOURNAL OF PSYCHIATRY (2023)

Article Behavioral Sciences

How do autistic people fare in adult life and can we predict it from childhood?

Gordon Forbes, Rachel Kent, Tony Charman, Gillian Baird, Andrew Pickles, Emily Simonoff

Summary: This study examines the outcomes of social, mental health, and quality of life in early adulthood for autistic individuals and identifies childhood predictors for these outcomes. The findings suggest that young autistic adults face challenges in various areas of life, but may fare relatively well in terms of mental health or quality of life.

AUTISM RESEARCH (2023)

Article Behavioral Sciences

Continuity of temperament subgroup classifications from infancy to toddlerhood in the context of early autism traits

Lacey Chetcuti, Mirko Uljarevic, Kandice J. J. Varcin, Maryam Boutrus, Stefanie Dimov, Sarah Pillar, Josephine Barbaro, Cheryl Dissanayake, Jonathan Green, Andrew J. O. Whitehouse, Kristelle Hudry

Summary: A longitudinal study investigates the continuity of temperament subgroup classifications and their associations with behavioral/clinical phenotypic features from infancy to toddlerhood, finding that temperament subgroup classifications might represent a reliable indicator of autism characteristics and social-emotional functioning in infants/toddlers with autism traits.

AUTISM RESEARCH (2023)

Article Psychology, Developmental

Acceptability and feasibility of a parent-mediated social-communication therapy for young autistic children in Brazil: A qualitative implementation study of Paediatric Autism Communication Therapy

Priscilla Brandi Gomes Godoy, Lorna McWilliams, Leticia Rodrigues da Silveira, Mirian de Cesaro Revers Biasao, Fernanda Speggiorin Pereira Alarcao, Leonardo Seda, Renata Generoso Campoli, Holan Liang, Gauri Divan, Kathy Leadbitter, Jonathan Green, Elizabeth Shephard

Summary: Effective support for autistic individuals is lacking in Brazil. Few centres offer services and those that do are limited in therapeutic options and geographical location. Paediatric Autism Communication Therapy is a low-intensity, evidence-based parent-mediated social-communication intervention that may be useful for this scenario.

AUTISM (2023)

Article Psychology, Developmental

Mediation of 6-year mid-childhood follow-up outcomes after pre-school social communication (PACT) therapy for autistic children: randomised controlled trial

Sophie Carruthers, Andrew Pickles, Tony Charman, Helen McConachie, Ann Le Couteur, Vicky Slonims, Patricia Howlin, Rachel Collum, Erica Salomone, Hannah Tobin, Isobel Gammer, Jessica Maxwell, Catherine Aldred, Jeremy Parr, Kathy Leadbitter, Jonathan Green

Summary: This study investigates the mechanism by which the parent-mediated Paediatric Autism Communication Therapy (PACT) intervention achieves sustained effects on autistic child outcomes. It finds that increased communication initiation between the autistic child and their caregiver is largely responsible for the long-term effects on behavior and adaptive outcomes.

JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY (2023)

Article Psychology, Developmental

Infant sleep predicts trajectories of social attention and later autism traits

Jannath K. Begum-Ali, Louisa Gosse, Luke Mason, Greg Pasco, Tony H. Charman, Mark Johnson, Emily J. H. Jones

Summary: Children with neurodevelopmental disorders, such as ASD and ADHD, frequently experience sleep disturbances. A study conducted on infants with family history of ASD and/or ADHD revealed that infants with first-degree relatives with ASD showed poorer night sleep quality at 14 months. Poor infant sleep quality was associated with later ASD diagnosis, decreased cognitive ability, increased ASD symptoms, and developing social attention.

JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY (2023)

Article Psychology, Developmental

Parent-Child Interactions May Help to Explain Relations Between Parent Characteristics and Clinically Observed Child Autistic Behaviours

Antonina Loncarevic, Murray T. Maybery, Josephine Barbaro, Cheryl Dissanayake, Jonathan Green, Kristelle Hudry, Teresa Iacono, Vicky Slonims, Kandice J. Varcin, Ming Wai Wan, John Wray, Andrew J. O. Whitehouse

Summary: This study found that in families with infants showing early signs of autism, the associations between parent characteristics (psychological distress; aloofness) and child autistic behaviors may be mediated by the child's inattentiveness or negative affect during interactions. These findings have important implications for developing and implementing interventions targeting the synchrony of parent-child interaction to support children's social communication development.

JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS (2023)

Article Psychology, Developmental

Using the Infant Sibling-Design to Explore Associations Between Autism and ADHD Traits in Probands and Temperament in the Younger Siblings

Linn Andersson Konke, Terje Falck-Ytter, Emily J. H. Jones, Amy Goodwin, Karin Brocki

Summary: The current study used the infant sibling design to investigate whether proband traits of autism and ADHD can provide information about their infant siblings' temperament. Parent ratings of autistic traits and ADHD traits were used in older siblings diagnosed with autism, and their infant siblings' temperament traits at 9 months of age were examined. Specific associations were found across siblings, with proband autistic traits related to low levels of approach in infant siblings, and proband ADHD traits related to high levels of infant activity. These findings suggest that inherited liability may influence early emerging behaviors in infant siblings.

JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS (2023)

Article Psychology, Developmental

Factors associated with mental health symptoms among UK autistic children and young people and their parents during the COVID-19 pandemic

Melanie Palmer, Susie Chandler, Virginia Carter Leno, Farah Mgaieth, Isabel Yorke, Matthew Hollocks, Andrew Pickles, Vicky Slonims, Stephen Scott, Tony Charman, Emily Simonoff

Summary: This study investigates the role of pre-existing and pandemic-related factors in the mental health symptoms of autistic youth and their parents during the COVID-19 pandemic. The findings suggest that more engagement and enjoyment in education and outdoor activities are associated with better mental health for both children and parents during the pandemic. Pre-existing attention deficit hyperactivity disorder (ADHD) symptoms in children are linked to more behavioral and ADHD symptoms during the pandemic, while pre-existing parental mental health problems are associated with more mental health symptoms in parents during the pandemic.

AUTISM (2023)

Article Psychology, Developmental

Evaluation of an adapted virtual training for master trainers of the WHO Caregiver Skills Training Program during the COVID-19 pandemic

Alaa T. Ibrahim, Afiqah Yusuf, Hannah Pickard, Pamela Dixon, Andy Shih, Stephanie Shire, Andrew Pickles, Mayada Elsabbagh

Summary: The COVID-19 pandemic has created significant barriers to training by limiting in-person professional activities, resulting in the emergence of remote training. In this study, a remote training approach was developed and evaluated for master trainers of the Caregiver Skills Training Program. Despite the pandemic preventing practice with children, participants were able to reliably identify program strategies through video recordings. These findings highlight the feasibility and value of remote training approaches in implementing interventions.

AUTISM (2023)

Article Psychology, Clinical

Debate: Neurodiversity, autism and healthcare

Jonathan Green

Summary: We are currently experiencing significant changes in our understanding of autism and how to respond to it, particularly in terms of clinical services. Clinicians in child development and child mental health services often face overwhelming demand and confusion, as referrals for neurodevelopmental conditions, especially autism, have increased in recent years. This has led to longer wait times, sometimes spanning a child's entire life. The lack of effective interventions further complicates efforts to develop response strategies to meet user frustration, resulting in a multitude of local approaches and initiatives. This article addresses these clinical and related issues by discussing different uses of the term autism, its relationship to intellectual disability, and proposing a new conceptualization of autism as emergent and transactional. The author suggests that this perspective can bridge the gap between neurodiversity and clinical perspectives and provides a rational and evidence-based care pathway.

CHILD AND ADOLESCENT MENTAL HEALTH (2023)

暂无数据