‘Coaching’ parents found to halt two thirds of autism cases in trial
TWO thirds of autism cases could be prevented among at-risk babies using a simple video intervention that helps teach parents how to communicate with their child, research suggests.
Scientists in the UK and Australia found that they could reduce the proportion of at-risk children being diagnosed with autism at age three from 20.5 per cent, to 6.7 per cent.
The intervention involved filming babies as they tried to interact with a parent, often using unconventional means – such as avoiding eye contact.
The footage was then analysed by a therapist who explained how the child was trying to communicate, so that the parent could respond. When caregivers fail to respond to such communication, it can damage the child’s brain development, leading to long-term difficulties in social interactions.
Prof Jonathan Green, of Manchester University, said: “Autism is a condition that we know is present from birth, in fact before birth. In the first couple of years you don’t see autism fully emerge, but you see signs, and we make a diagnosis around three.
“Early caregiver interactions are crucial to the brain and social development and we think in the autistic brain, parents and babies, through no fault of their own, get a bit out of sync, leaving parents highly perplexed about how to communicate with their babies.
“What is missing in autism therapy is work at the early stage before diagnosis when all the crucial developmental processes are happening.”
The four-year clinical trial followed 89 babies aged nine to 14 months deemed to be at risk of an autism diagnosis. Over a period of five months, half the families received the video intervention, while a control group received current best practice treatment.
The team said that the therapy did not actually involve the child at all, but rather worked with parents to help them understand their child. Babies initially learn how to communicate with their parents, and that ability then gets generalised to other people. But if there is little interaction early on, it prevents the skill being learnt, making social behaviour harder in later life.
Tests showed that scores of “social emotional reciprocity” – the back andforth interaction between parents – was far higher in children who underwent the intervention, compared with children who did not.
Repetitive movements associated with autism were also reduced in the intervention group which experts said showed the therapy was having a “cascade effect” which went beyond social benefits.
Prof Green added: “For the children who had had therapy as usual, just over 20 per cent of them went on to develop autism, which is roughly what we would expect. In the therapy intervention group it was 6.7 per cent.
“That is a really big, big difference. This is the first evidence worldwide that a pre-emptive intervention can reduce autism. It shifts the focus of therapy from after diagnosis to before diagnosis. There are a lot of babies who could benefit from this.”
Prof Andrew Whitehouse, of the University of Western Australia, added: “The clinical impact that could be immediate is really gobsmacking.”
About 700,000 people are living with autism in Britain, and 10,000 babies are born with the condition each year. The research, published in the journal Jama Paediatrics, was welcomed by autism charities.
Dr James Cusack, of the charity Autistica, said: “We think today’s work is important. It suggests that the Government and health services need to think differently about how they support children.” The team will be testing the children again at the age of six or seven to see if the benefits of intervention last.