A brief and cost-effective in-home program using video feedback helps parents improve engagement and social behavior in some infants at high risk for autism. The program’s goals are to foster the babies' social development and reduce the likelihood that they develop autism.
The study, funded in part by Autism Speaks, appears online today in Lancet Psychiatry.
"Our findings indicate that using video feedback-based therapy to help parents understand and respond to their infant's individual communication style during the first year of life may be able to modify the emergence of autism-related behaviors and symptoms," says lead author Jonathan Green, of the University of Manchester.
Previous research has found that autism’s earliest red flags – reduced social interest and decreased eye contact – may be present as early as the first year of life. This has opened up research into methods for improving infant engagement and social development and reducing or avoiding the development of autism symptoms.
The 54 infants in the study – ages 7 to 10 months – were considered “high risk” because each had an older brother or sister with autism. Previous research has shown that around a fifth of infants with an older sibling on the spectrum will go on to develop autism themselves. Another 20 to 30 percent of these high-risk babies will have related social and communication challenges that don't rise to the level of an autism diagnosis.
In the study, the researchers randomly assigned parents of 28 of the infants to receive a training program called “Video Interaction for Promoting Positive Parenting.” The other 26 babies received no treatment and served as controls.
Over five months, a therapist made at least six home visits to each family in the treatment group. During the visits, therapists videotaped parents interacting with their babies. They then played back the videos while providing advice on how to better engage the babies in ways that foster social interaction.
At the end of the study, the researchers assessed the behavioral development of the infants in both groups. Overall, the babies in the treatment group showed greater improvement across a wide range of social and communication behaviors including attentiveness to caregivers. However, the difference between groups was not clear and significant in most areas. As children can vary widely in their response to behavioral therapies, this may have been due, in part, to the relatively small number of participants. The study found no differences in language development or attention to language sounds.
The authors conclude that the intervention may have improved infant social development in ways that helped reduce autism risk. At the same time, they agree that larger and longer studies are needed to draw clear conclusions about the method’s effectiveness in preventing or reducing autism symptoms.
“This study adds to a growing body of research exploring how we can use parents effectively as therapists for children at high risk for or diagnosed with autism,” comments developmental pediatrician Paul Wang, Autism Speaks head of medical research. “Given the mixed results, it may be that parents need more intensive and comprehensive training to become truly effective therapists.”
In addition to funding from Autism Speaks, the study was supported by Autistica, ICAP plc, the Waterloo Foundation, the UK Medical Research Council and the UK Economic and Social Research Council.
The study’s authors are part of the British Autism Study of Infant Siblings (BASIS) team, which is affiliated with the Autism Speaks Baby Siblings Research Consortium.
“Families participating in ‘baby sibs’ studies such as this continue to provide us with valuable insights into autism’s earliest beginnings and how we can best foster early development to improve outcomes,” says Andy Shih, Autism Speaks' senior vice president for scientific affairs. “We are so thankful for their collaboration in this important work.”
You can read the full study here.
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