October 27, 2016
Kelly C. Bawden, MS, CCC-SLP
A group of researchers in the UK have published a study in The Lancet that indicates significant long-term benefits of parent led social communication intervention for young children with autism. What do these findings mean? Well, a couple of things. First, it is as-good-as-it-gets evidence that intensive, parent-involved early intervention around social communication skills has benefits that last well into a child's future. Second, it suggests that the path a child with ASD will walk is not a fixed one, and that early intervention matters. Third, and maybe most importantly, it indicates that parent involvement can make a huge difference in communication treatment outcomes.
Here's how the study worked:
Participants
The 152 children and parents in this study initially participated in a different study called the Preschool Autism Communication Trial (PACT). According to the authors, "the PACT intervention is a 1 year developmentally focused social communication intervention programme for young children that consists of 12 therapy sessions (each 2 h long) over 6 months, followed by monthly support and extension sessions for a further 6 months, as described previously. Additionally, the parents agree to do 20–30 min per day of planned practice activities with the child."
The participants were between 2- and 4-years old and all had verbal abilities above the 12-month level at the time the original PACT study started. Their average age at the time of this follow-up study was 10 and a half years old.
Method
Children from the original study were re-assessed ~5.75 years after the conclusion of the PACT intervention. The re-assessment used a variety of methods to assess the current severity of autism present in the children as well as their social communication skills. This new study was a "randomized double-blind" study, which means that a) participants were randomly assigned to either get the treatment being studied or to get an alternative treatment, b) the participants didn't know if they were getting the treatment being studied, and c) the evaluators did not know who was getting the treatment. Findings that come out of this type of research are generally considered to be the strongest when compared to findings from other types of research.
Findings and Conclusions
The researchers were able to discern that the children who received the PACT intervention as young children showed significantly improved outcomes when compared to their peers who had received a more "typical" type of intervention. The researchers write, "the results are the first to show long-term symptom reduction after a randomised controlled trial of early intervention in autism spectrum disorder."
My takeaway? As an SLP, I am encouraged by the findings in general, and that they support my gut instincts about the importance of having parents involved in therapy in a meaningful way. As a parent (albeit not a parent of a child on the spectrum), I'm a little worried that parents will take too much of this on and will have another thing to feel guilty about not doing right. And, finally, combining those 2 parts of myself, I think I'll continue my work to be mindful of finding the balance :-)
Citation: Parent-mediated social communication therapy for young children with autism (PACT): long-term follow-up of a randomised controlled trial. Pickles, Andrew et al. Published Online October 25, 2016 http://dx.doi.org/10.1016/ S0140-6736(16)31229-6
