Intervention for Infants at Risk of Developing Autism: A Case Series
- 2k Downloads
Theory and evidence suggest the potential value of prodromal intervention for infants at risk of developing autism. We report an initial case series (n = 8) of a parent-mediated, video-aided and interaction-focused intervention with infant siblings of autistic probands, beginning at 8–10 months of age. We outline the theory and evidence base behind this model and present data on feasibility, acceptability and measures ranging from parent-infant social interaction, to infant atypical behaviors, attention and cognition. The intervention proves to be both feasible and acceptable to families. Measurement across domains was successful and on larger samples promise to be an effective test of whether such an intervention in infancy will modify emergent atypical developmental trajectories in infants at risk for autism.
KeywordsAutism Intervention Prodromal Infancy Parent–child interaction
We acknowledge with thanks the generous collaboration from the originators of the original VIPP intervention (Femmie Juffer, Marian Bakermans Kranenberg, Marinus van IJzendoorn) that forms the basis of our intervention model. We are grateful for the enormous contributions BASIS families have made towards this study. The research was supported by awards from Autistica, Waterloo Foundation and Central Manchester Foundation NHS Trust to Jonathan Green; from the UK Economic and Social Research Council to Ming Wai Wan and Jonathan Green; Walport Academic Clinical Fellowship to Samina Holsgrove; and from the UK Medical Research Council (G0701484) and the BASIS funding consortium led by Autistica (www.basisnetwork.org) to M.H. Johnson.
- Bedford, R., Elsabbagh, M., Gliga, T., Pickles, A., Senju, A., Charman, T., et al. (2012). Precursors to social and communication difficulties in infants at-risk for autism: Gaze following and attentional engagement. Journal of Autism and Developmental Disorders, 42(10), 2208–2218.PubMedCrossRefGoogle Scholar
- Blazey, K. (2007). Attachment in autism: An investigation into parental sensitivity, mutuality and affect. MPhil dissertation, The University of Manchester, Manchester (UK).Google Scholar
- Dunst, C. J. (1985). Communicative competence and deficits: Effects on early social interactions. In E. T. McDonald & D. L. Gallagher (Eds.), Facilitating social-emotional development in multiply handicapped children (pp. 93–140). Philadelphia: Home of the Merciful Saviour for Crippled Children.Google Scholar
- Elsabbagh, M., Fernandes, J., Webb, S. J., Dawson, G., Charman, T., Johnson, M. H., et al. (in press). Disengagement of Visual Attention in Infancy Is Associated with Emerging Autism in Toddlerhood. Biological Psychiatry. doi: 10.1016/j.biopsych.2012.11.030.
- Goodman, R., Ford, T., Richards, H., Gatward, R., & Meltzer, H. (2000). The development and well-being assessment: Description and initial validation of an integrated assessment of child and adolescent psychopathology. Journal of Child Psychology and Psychiatry, 41, 645–655.PubMedCrossRefGoogle Scholar
- Juffer, F., Bakerman-Kranenburg, M. J., & Van Ijzendoorm, M. J. (2008). Promoting positive parenting: An attachment-based intervention. New York: Taylor Francis Group.Google Scholar
- Matias, C. S. F. (2006). Direct observations of parent-child interaction based on attachment theory. PhD thesis, Institute of Psychiatry, King’s College, London (UK).Google Scholar
- Mullen, E. M. (1995). Mullen scales of early learning. Minnesota: American Guidance Service.Google Scholar
- Ozonoff, S., Young, G. S., Carter, A., Messinger, D., Yirmya, N., Zwaigenbaum, L., et al. (2011). Recurrence risk for autism spectrum disorders: A baby siblings research consortium study. Pediatrics, 128(3), 2010–2825.Google Scholar
- Pickles, A., Charman, T., Green, J., McConachie, H., Aldred, C. R., & the PACT Consortium. (2011). Identifying therapeutic mechanisms with intervention studies. International Meeting for Autism Research, May 12th 2011. San Diego (USA).Google Scholar
- Rozga, A., Hutman, T., Young, G. S., Rogers, S. J., Ozonoff, S., Dapretto, M., et al. (2011). Behavioral profiles of affected and unaffected siblings of children with ASD: Contribution of measures of mother-infant interaction and nonverbal communication. Journal of Autism and Developmental Disorders, 41, 287–301.PubMedCrossRefGoogle Scholar
- Rutter, M., Bailey, A., & Lord, C. (2003). Social Communication Questionnaire (SCQ). Los Angeles, LA: Western Psychological Services.Google Scholar
- Wan, M. W., Green, J., Elsabbagh, M., Johnson, M., Charman, T., Plummer, F., et al. (2012b). Quality of interaction between at-risk infants and caregiver at 12–15 months is associated with 3-year autism outcome. Journal of Child Psychology and Psychiatry. doi: 10.1111/jcpp.12032.PubMedGoogle Scholar
- Zwaigenbaum, L., Bryson, S. E., Smith, I. M., Szatmari, P., Brian, J., Roberts, W., et al. (2011). A comparison of behavioral markers of ASD in a high-risk infant cohort based on cognitive level at 3 years. International Meeting for Autism Research, May 14th 2011. San Diego, USA.Google Scholar