PMID 12541005
Drew A, Baird G, Baron-Cohen S, Cox A, Slonims V, Wheelwright S, Swettenham J, Berry B, Charman T., Dec 2002
Background
Few studies have been done on preschool-age children with ASD, and even fewer studies have been done using Randomized Control Trials (RCTs). This study takes a parent training group and compares it to a control group.
Introduction
Goal: Examine efficacy of parent-training intervention focused on joint attention and joint action using Randomized Control Trials.
Methods
Participants: The control group was a treatment group consisting of local services only. Twelve children (11 male, 1 female) participated in the parent training group, and twelve children (8 male, 4 female) participated in the local services group. Mean age at the beginning of the study was 22.5 months old. The study lasted for 12.3 months, and age of participants at the time of follow-up was 34.8 months old.
Treatment by the parent training group focused on joint attention routines and consisted of:
• Compliance and behavior training
• Social and communicative competence
• Initiating finger pointing and responding to another’s finger pointing, as well as switching focus of gaze.
• Responding to representational gestures such as waving goodbye.
• Language acquisition through repetition of keywords in different contexts.
• Integration into everyday routines and activities.
• Parent consultations from a speech and language therapist, setting activities based on the child’s cognitive and communicative abilities.
Treatment from the local services control group consisted of a mix of different treatments, with some of the parents actively participating in their child’s treatment while the others received all treatment from an outside therapist. Three of the children participated in 1-on-1 home care with supervision from recognized autism treatment groups. This was not controlled for as the intent of this experiment was to have truly randomized control trials, but results may have been skewed due to small sample size.
Results
Results were analyzed with ANOVA for the initial assessment, and ANCOVA for the follow-up assessment. Both parent training and control groups consisted of 11 out of 12 children being nonverbal pre-treatment. Differences in language comprehension between the two groups had no statistical significance (F[1, 20] = 3.1, p = 0.09, two-tailed) but language comprehension was slightly greater in the parent training group than the control group. Statistically significant results were found between the parent training group and control group in regards to number of words spoken by the child. Seven children in the parent training group went from nonverbal to single-word/phrase speech versus two children in the control group (Fisher exact test, p < 0.05).
Conclusion
Results showed improvements in autistic children's joint attention skills and joint action routines using parent-training intervention with RCTs, but the results were compromised due to difficulties in parental reporting documentation, pre-treatment IQ differences between the treatment and control groups, and lack of regular parental updates on child progress.
Discussion
The RCT design was maintained and upheld throughout the experiment. Limitations of the study include small sample size, poor documentation of parent training, and lack of systemized parent-child interaction. These limitations can be a topic of future studies.
