Randomised trial of a parent-mediated intervention for infants at high risk for autism: longitudinal outcomes to age 3 years
Open accessAbstract
BACKGROUND: There has been increasing interest in the potential for pre-emptive interventions in the prodrome of autism, but little investigation as to their effect. METHODS: A two-site, two-arm assessor-blinded randomised controlled trial (RCT) of a 12-session parent-mediated social communication intervention delivered between 9 and 14 months of age (Intervention in the British Autism Study of Infant Siblings-Video Interaction for Promoting Positive Parenting), against no intervention. Fifty-four infants (28 intervention, 26 nonintervention) at familial risk of autism but not otherwise selected for developmental atypicality were assessed at 9-month baseline, 15-month treatment endpoint, and 27- and 39-month follow-up. PRIMARY OUTCOME: severity of autism prodromal symptoms, blind-rated on Autism Observation Schedule for Infants or Autism Diagnostic Observation Schedule 2nd Edition across the four assessment points. SECONDARY OUTCOMES: blind-rated parent-child interaction and child language; nonblind parent-rated communication and socialisation. Prespecified intention-to-treat analysis combined estimates from repeated measures within correlated regressions to estimate the overall effect of the infancy intervention over time. RESULTS: Effect estimates in favour of intervention on autism prodromal symptoms, maximal at 27 months, had confidence intervals (CIs) at each separate time point including the null, but showed a significant overall effect over the course of the intervention and follow-up period (effect size [ES] = 0.32; 95% CI 0.04, 0.60; p = .026). Effects on proximal intervention targets of parent nondirectiveness/synchrony (ES = 0.33; CI 0.04, 0.63; p = .013) and child attentiveness/communication initiation (ES = 0.36; 95% CI 0.04, 0.68; p = .015) showed similar results. There was no effect on categorical diagnostic outcome or formal language measures. CONCLUSIONS: Follow-up to 3 years of the first RCT of a very early social communication intervention for infants at familial risk of developing autism has shown a treatment effect, extending 24 months after intervention end, to reduce the overall severity of autism prodromal symptoms and enhance parent-child dyadic social communication over this period. We highlight the value of extended follow-up and repeat assessment for early intervention trials.
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If infants show warning signs of autism and intervention is provided, there is an improvement in symptomatology (milder signs of autism and increased social interaction).
“If infants show warning signs of autism and intervention is provided, there is an improvement in symptomatology (milder signs of autism and increased social interaction).”
From Mindfulness Parenting and Childish Play: A Clinical Trial With Parents of Children With Autism Spectrum Disorders (2023) · cites this paper as Green et al., 2017
The Methods state that infants were at familial risk of autism but were not selected for developmental atypicality, so the trial does not establish the claim specifically for infants already showing warning signs. The Results report reduced autism prodromal symptoms and improved child attentiveness and communication initiation over the intervention and follow-up period, though effects at individual time points were uncertain. (LLM, conf=0.89)
Experimental — accuracy not yet measuredThe improvement in symptomatology from early intervention manifests itself even years later.
“This improvement manifests itself even years later (Green et al., 2017).”
From Mindfulness Parenting and Childish Play: A Clinical Trial With Parents of Children With Autism Spectrum Disorders (2023) · cites this paper as Green et al., 2017
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- Authors
- Green, J., Pickles, A., Pasco, G., Bedford, R., Wan, M. W., Elsabbagh, M., Slonims, V., Gliga, T., Jones, E., Cheung, C., Charman, T., Johnson, M., & The British Autism Study of Infant Siblings (BASIS) Team
- Affiliations
- University of Manchester (GB)
- King's College London (GB)
- McGill University (CA)
- Birkbeck, University of London (GB)
- Blind and Sight Impaired Society (GB)
- Corresponding author
- Green, Jonathan
- ORCID
- Venue
- Journal of Child Psychology and Psychiatry
- Publisher
- Wiley
- Published
- 2017-04-10
- Volume
- 58
- Issue
- 12
- Pages
- 1330-1340
- ISSN
- 0021-9630 (ISSN-L)
- 1469-7610
- PMC
- PMC5724485
- OpenAlex
- W2605716357
- Cited by
- 328
- References
- 41
- Citations by year
- 2026: 20 · 2025: 30 · 2024: 26 · 2023: 29 · 2022: 35 · 2021: 47 · 2020: 72 · 2019: 32 · 2018: 28 · 2017: 9
- FWCI
- 22.14
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Child Psychology and Psychiatry (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- BIROn (Birkbeck, University of London) (acceptedVersion)
- UEA Digital Repository (University of East Anglia) (acceptedVersion)
- Institutional Research Information System University of Turin (University of Turin) (submittedVersion, other-oa)
- BOA (University of Milano-Bicocca) (submittedVersion)
- Research Portal (King's College London) (submittedVersion, cc-by)
- Research Explorer (The University of Manchester) (submittedVersion, cc-by)
- Apollo (University of Cambridge) (submittedVersion, cc-by)
- Apollo (cc-by)
- Funders
- Autistica (7267)
- Waterloo Foundation
- Autism Speaks
- Medical Research Council (G0701484, MR/K021389/1)
- King’s College London
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Family and Disability Support Research
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Keywords
- autism spectrum disorder, infant siblings, parent-mediated intervention, early intervention, social communication, parent-child interaction, child language, longitudinal follow-up
- MeSH terms
- Autism Spectrum Disorder, Child, Preschool, Communication, Education, Nonprofessional, Female, Humans, Interpersonal Relations, Language Development, Longitudinal Studies, Male, Parent-Child Relations, Single-Blind Method, Parenting, Outcome Assessment, Health Care, Early Intervention, Educational, Prodromal Symptoms
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