Preemptive intervention reduces severity of autism Symptoms Before School Age: JAMA

Autism spectrum disorder is emergent in early development but is not typically diagnosed until age 3 years,and current clinical guidelines highlight diagnosis as a catalyst in the clinical pathway to commence therapeutic intervention. However, interventions beginning during the first 2 years of life, when the first signs of atypical development are observed and the brain is rapidly developing, may lead to an even greater impact on developmental outcomes in later childhood.

Andrew et al from University of western Australia hypothesized that use of the iBASIS-VIPP(iBASIS–Video Interaction to Promote Positive Parenting) intervention during infancy would reduce ASD symptom severity and the odds of ASD diagnosis and improve a range of developmental outcomes. The iBASIS-VIPP is a version of the Video Interaction for Promoting Positive Parenting program, and he intervention involved 10 sessions delivered in family homes by a trained therapist over a 5-month period.

In this randomized clinical trial a total of 104 infants were randomized into two groups-one received the iBASIS-VIPP intervention(Group I) and other group received routine care(Group II). Participants were infants aged 9 months-15 months with three of five specified behavoiurs indicative of ASD(Autism Spectrum Disorders) were included. The Autism Diagnostic Observation Schedule, second edition (ADOS-2),was used at the 12-month(baseline) and treatment end-point(approx. age 18 months),2 years and 3 years to measure ASD behaviors.

Key findings of the study were:

-From the analysis researchers found that the iBASIS-VIPP intervention led to a reduction in ASD symptom severity ( 95% CI, − to −0.28; P = .04) at 18 months of age.

-Significant improvement was found in social-emotional reciprocity in the intervention group as compared to routine care group(p-0.02).

-Reduced odds of ASD classification at age 3 years was found in the iBASIS-VIPP group (3 of 45 participants [6.7%]) vs the usual care group (9 of 44 participants [20.5%]; with a significant p value: P = .02).

Authors conclude-"this randomized clinical trial is the first to demonstrate that a preemptive intervention for infants showing early signs of ASD led to a small but enduring reduction in ASD symptom severity and reduced odds of ASD diagnosis in early childhood".

Source:JAMA pediatrics