PMID 15482502
Catherine Aldred, Jonathan Green, Catherine Adams, Nov 2004
Background
This study takes place in the UK, and is focused on a social communication intervention against routine care only using randomized control trials (RCTs).
Introduction
Goal: Determine effectiveness of a parent-based social communication intervention against routine care alone in a Randomized Control Trial (RCT).
Methods
The treatment group consisted of children with autism and PDD-NOS. The treatment group consisted of 14 autistic children, 13 boys and 1 girl. The control group consisted of 14 autistic children, 12 boys and 2 girls. Four subgroups were identified within both treatment and control groups. These subgroups were:
• Young High Functioning (24-47 months, ADOS = 11-17)
• Young low Functioning (24-47 months, ADOS = 18-24)
• Older High Functioning (48-71 months, ADOS = 11-17)
• Older Low Functioning (48-71 months, ADOS = 18-24) Staying true to being a randomized control trial, intervention was based on the intention to treat.
The control group received routine care, while the treatment group received both routine care and study intervention. Study intervention treatment consisted of monthly psycho-educational workshop sessions for six months, followed by six additional months of less frequent sessions. Assessment measures used were:
• Autism Diagnostic Interview (ADI) – Used as a baseline assessment for behaviors of autistic children between the age of 4 and 5.
• Autism Diagnostic Observation Schedule (ADOS) – Used at screening to diagnose and measure change in autistic symptoms during treatment.
• Vineland Adaptive Behavior Scales – Indicator of functional skills across a wide range of ages and impairment levels.
• MacArthur Communicative Developmental Inventory – Measured the child’s understanding of expressions, words and gestures
• Parenting Stress Index – Used to record total levels of stress and child difficulty.
• Parent-child Interaction – Standardized rules for consistent and reliable recording of communication acts, asynchronous parental communication, synchronous parental communication, semantic contingency, and shared attention.
Results
Baseline assessments were analyzed using ANCOVA, while post-treatment assessments were analyzed using an analysis of change in standardized measures and video analysis. Reciprocal social interaction showed the most significant treatment effect between the treatment and control groups (F(1, 25) = 10.30; p = 0.004). Based on the MacArthur Inventory, the treatment group made significant gains in expressive language skills (F = 18.5; p < 0.001). Parent synchrony improved in the treatment group and decreased in the control group, and no significant difference was found in the total Parenting Stress Index numbers.
Conclusion
Results support the initial hypothesis that parent-based social communication intervention and routine care are better than routine care alone.
Discussion
Overall, the results look promising for parent-based intervention alongside routine care for future studies and treatments, but the current study's sample size was limited so the results of the study should be retested for reliability.
