Intervention Fails to Reduce Autism Symptom

Medical News: Intervention Fails to Reduce Autism Symptoms - in Pediatrics, Autism from MedPage Today

A social communication intervention for children with autism improved parent-child interactions but failed to reduce the severity of autism symptoms, a British randomized trial found. Children who received the intervention had a reduction in symptom severity of 3.9 points during 13 months, while those who had treatment as usual showed a reduction of 2.9 points, for a between-group effect size of −0.24 (95% CI −0.59 to 0.11), according to Jonathan Green, FRCPsych, of the University of Manchester, and colleagues.

The Preschool Autism Communication Trial (PACT) explored whether children with autism would respond with enhanced social and communication skills if parents adapted their interactions to the child's impairments. It was the largest autism trial of its kind.


What does this mean?: Communication-focused intervention did not reduce autism symptom severity, but did improve parent-child social interaction.

"On the basis of our findings, we cannot recommend the addition of this PACT intervention to treatment as usual for the purpose of reduction in autism symptoms," the researchers stated.

"The intervention does, however, significantly alter parent-child dyadic social communication in ways that are associated with subsequent positive child outcomes in longitudinal studies of autism, and are likely to be also positive for parents themselves," they said.

Small studies, including a randomized pilot trial, have shown benefits for direct communication interventions, but effects on core autism symptoms have not been assessed. So while programs might be advertising that they are shown to be "effective" you really need to ask what that means. A social-communications based intervention for a young child with moderate to severe autism might related better with his or her parents after intervention, but there may be no changes in the core behaviours of concern with autism (repetitive behaviours, lack of social interaction, difficulty with changes etc.).

Many parents chose these interventions because they are more "humane" or socially acceptable to them than ABA (Applied Behaviour Analysis) programs, which they see as "robotic." And when engaged in the program they may feel, and experience, more positive relationship with their child. But there is simply no support for these interventions changing autism specific symptoms.

Autism, however, is a spectrum, and high functioning children, children diagnoses with Asperger's, and young adolescents often need social based interventions (such as Michelle Winner's "Social Thinking" program." One of the difficulties with autism research, and reporting it to the public, is that "autism" can mean very different things to different people, and the range of symptoms is so varied. When programs promote their particular intervention method they often promote it based upon outcome factors that are far removed from the symptoms of greatest concern to parents or teachers. Often it's best to ask for the research in hard copy and finding a professional to review it with you. Wasting time (and money) on such a serious developmental disorder is a mistake. The NIH in the US does list programs that have been shown to be effective, and that is a good place to start.


My web page lists a number of resources you can make use of yourself in dealing with Autism Spectrum Disorder and Asperger's, as well as many other learning disabilities. Please visit it at www.socialcognitivetherapy.com, or one of my other sites at: Psychology Today, AAMFT, PSYRIS or my professional site or www.adhdhelp.ca.

Autism assessment and treatment services are offered for individuals, couples, families, children, adolescents and adults in the Burnaby, Vancouver, Coquitlam, Port Moody, New Westminster and Maple Ridge areas of the lower mainland. This includes neuro-developmental assessments, psycho-education assessments, autism assessments as well as behavioural and cognitive behaviour therapy. I also provide diagnostic assessments for autism and Asperger's Disorder in my Burnaby office.

Dr. Jim Roche
Registered Psychologist, British Columbia 01610
778.998-7975
www.relatedminds.com