The effectiveness of an intensive, parent mediated, multi-component, early intervention for children with autism

Krishnan, Raman; Nesh, Merlin Thanka Jemi Alwin; Russell, Paul Swamidhas Sudhakar; Russell, Sushila; Mammen, Priya

doi:10.1177/0973134220160303

Cited by 9 publications

(5 citation statements)

References 27 publications

(30 reference statements)

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“…Eight studies did assess ASD-related outcomes in children. Three uncontrolled studies from India ( 145 , 146 , 149 ) found that parent-mediated interventions improved ASD symptoms as well as social and language skills, sensory-motor and adaptive skills. One RCT from India and Pakistan ( 71 ) investigated the effectiveness of the Parent-mediated intervention for Autism Spectrum Disorder in South Asia (PASS), which is a program adapted from a program developed in the UK.…”

Section: Resultsmentioning

confidence: 99%

“…One RCT ( 147 ) fulfilled the standards with reservations due to missing information on the randomization procedure and attrition. Four uncontrolled studies (pre-post design) did not meet the standards due to a lack of a control group ( 143 , 145 , 146 , 149 ). According to the WWC standards at least two studies meeting standards without reservations are required for an intervention to be eligible for being considered evidence-based.…”

Section: Resultsmentioning

confidence: 99%

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Effectiveness of interventions for children and adolescents with autism spectrum disorder in high-income vs. lower middle-income countries: An overview of systematic reviews and research papers from LMIC

Pervin

Ahmed²,

Hagmayer³

2022

Front. Psychiatry

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BackgroundThere is a multitude of systematic reviews of interventions for children and adolescents with autism spectrum disorder (ASD). However, most reviews seem to be based on research conducted in High-Income Countries (HIC). Thus, summary findings may not directly apply to Lower Middle-Income Countries (LMIC). Therefore, we conducted a Meta-Review analyzing systematic reviews on the effectiveness of interventions for target outcomes in children and adolescents with ASD to find out whether there are differences in effectiveness between HIC and LMIC and which interventions can be considered evidence-based in LMIC.MethodsElectronic databases (PsycINFO, PubMed, Cochrane database of systematic reviews) were searched for reviews on interventions for ASD in children and adolescents from January 2011 through December 2021, which included studies not coming from HIC. Systematic reviews with qualitative and quantitative syntheses of findings were included. Two investigators independently assessed studies against predetermined inclusion/exclusion criteria and extracted relevant data including quality and evidence assessments. Evidence for different types of interventions in HIC vs. LMIC was planned to be compared, but none of the reviews assessed potential differences. Therefore, a narrative review of the studies from LMIC was conducted including an assessment of quality and evidence.ResultsThirty-five reviews fulfilled the inclusion criteria. Eleven considered findings from HIC and LMIC. Sixty-nine percent included studies with various research designs; 63% provided a qualitative synthesis of findings; 77% percent assessed the quality of studies; 43% systematically assessed the level of evidence across studies. No review compared evidence from HIC and LMIC. A review of the studies from LMIC found some promising results, but the evidence was not sufficient due to a small number of studies, sometimes poor quality, and small sample sizes.ConclusionSystematic reviews on interventions for children and adolescents with ASD did not look for potential differences in the effectiveness of interventions in HIC and LMIC. Overall, there is very little evidence from LMIC. None of the interventions can be considered evidence-based in LMIC. Hence, additional research and mutually agreed methodological standards are needed to provide a more secure basis for evidence-based treatments in LMIC trying to establish evidence-based practices.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Effectiveness of interventions for children and adolescents with autism spectrum disorder in high-income vs. lower middle-income countries: An overview of systematic reviews and research papers from LMIC

Pervin

Ahmed²,

Hagmayer³

2022

Front. Psychiatry

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“…The outcomes for children included improvements in perception, cognitive performance, and verbal skills. 16,20,23 Parent-child communication initiation was seen to improve. 18,21 One of these pre-post intervention studies showed strong effects on adaptive behaviour and behavioural problems as well, with even a reduction in the symptoms as assessed by the childhood Autism rating scale.…”

Section: Child and Adolescent Related Outcomesmentioning

confidence: 96%

“…18,21 One of these pre-post intervention studies showed strong effects on adaptive behaviour and behavioural problems as well, with even a reduction in the symptoms as assessed by the childhood Autism rating scale. 15,16,20,28 Additionally, mothers and facilitators reported positive impacts on child's behaviour. Changes in their children's expressive capabilities, such as beginning to point or use more words, greater comprehension of instructions and social interaction, better self-regulation, and higher engagement in self-help skills, were reported.…”

Section: Child and Adolescent Related Outcomesmentioning

confidence: 99%

A systematic review on parent mediated intervention programmes for children with autism spectrum disorders in Indi

Kalorath

Menon

Jayan

2022

Int J Community Med Public Health

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The relevance of identifying effective interventions and rehabilitation of children with autism spectrum disorders (ASD) increases day by day due to the growth, especially in India. One strategy which has been found to be effective to meet the requirements of children and adolescents with ASD is parent-mediated programmes. However, since most studies of this kind have been undertaken in high-income nations, the present research will explore the effect of parent-mediated intervention programmes in India, a country with a high incidence of developmental disabilities. A fast systematic review employing databases such as PUBMED, psycINFO, Medline, Web of science, and Google Scholar was conducted to assess Indian research on PMI for children with ASD published before February 2022. Studies that were included in the review covered research involving those between the ages of 1 and 18 who were diagnosed with ASD. The 354 research papers were collected, and 11 studies satisfied the criteria for inclusion, including randomised controlled trials and pre-and post-intervention studies. The current research reviewed the articles in terms of the efficacy of parent-mediated interventions (PMI) and their feasibility and acceptability. Studies show that PMI helps improve interactions between parents and children as well as children's social, communication, motor, and cognitive skills. They also help parents learn more about how to teach their children and improve their children's language and academic skills. The overall conclusion of the systematic review was that PMI helps improve parent and child skills.

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“…Of the 13 studies reviewed by Kalorath et al ( 9 ), eight focus on children under 6 years of age (the others include children up to age 9 or 10). Of these, only three report on models that are exclusively caregiver-mediated and relatively resource-efficient ( 6 , 11 , 12 ); others describe programs that involve a therapist-delivered component ( 13 ), are longer in duration and/or more intensive [i.e., ( 14 ): 19-month model ( 15 ), and ( 16 ): daily intervention for 3 months], or programs that focus on behaviour reduction ( 17 ) or parent psychoeducation ( 18 ) rather than direct caregiver coaching to promote the child's developmental progress.…”

Section: Introductionmentioning

confidence: 99%

Transporting and implementing a caregiver-mediated intervention for toddlers with autism in Goa, India: evidence from the social ABCs

Brian,

Dowds,

Bernardi

et al. 2024

Front. Rehabil. Sci.

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IntroductionAutism is a global health priority with an urgent need for evidence-based, resource-efficient, scalable supports that are feasible for implementation in low- and middle-income countries (LMICs). Initiating supports in the toddler years has potential to significantly impact child and family outcomes. The current paper describes the feasibility and outcomes associated with a Canadian-developed caregiver-mediated intervention for toddlers (the Social ABCs), delivered through a clinical service in Goa, India.MethodsClinical staff at the Sethu Centre for Child Development and Family Guidance in Goa, India, were trained by the Canadian program development team and delivered the program to families seen through their clinic. Using a retrospective chart review, we gathered information about participating families and used a pre-post design to examine change over time.ResultsSixty-four families were enrolled (toddler mean age = 28.5 months; range: 19–35), of whom 55 (85.94%) completed the program. Video-coded data revealed that parents learned the strategies (implementation fidelity increased from M = 45.42% to 76.77%, p < .001, with over 90% of caregivers attaining at least 70% fidelity). Toddler responsivity to their caregivers (M = 7.00% vs. 46.58%) and initiations per minute (M = 1.16 vs. 3.49) increased significantly, p's < .001. Parents also reported significant improvements in child behaviour/skills (p < .001), and a non-significant trend toward reduced parenting stress (p = .056).DiscussionFindings corroborate the emerging evidence supporting the use of caregiver-mediated models in LMICs, adding evidence that such supports can be provided in the very early years (i.e., under three years of age) when learning may be optimized.

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The effectiveness of an intensive, parent mediated, multi-component, early intervention for children with autism

Cited by 9 publications

References 27 publications

Effectiveness of interventions for children and adolescents with autism spectrum disorder in high-income vs. lower middle-income countries: An overview of systematic reviews and research papers from LMIC

Effectiveness of interventions for children and adolescents with autism spectrum disorder in high-income vs. lower middle-income countries: An overview of systematic reviews and research papers from LMIC

A systematic review on parent mediated intervention programmes for children with autism spectrum disorders in Indi

Transporting and implementing a caregiver-mediated intervention for toddlers with autism in Goa, India: evidence from the social ABCs

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