The effectiveness of an intensive, parent mediated, multi-component, early intervention for children with autism
Aim: Most children with autism do not receive early intervention, unless parents are trained, in countries with low child mental health resources. To maximize the existing resource, we evaluated the feasibility and effectiveness of an intensive, parent mediated, multi-component, early intervention for autism in India.
Methods: Data of 77 children with an ICD-10 diagnosis of autism who completed a 12-week, five days a week, intervention program and regular practice at home was collected from the database of a teaching hospital. Intervention components included the standard intervention protocol, the Psycho-Educational Profile intervention (PEP-R) and the Carolina Curriculum for Infants and Toddlers with Special Needs.Pre and post-intervention PEP-R rating of parents were used to evaluate the intervention outcome. Appropriate bivariate, multivariate and resampling techniques were used to evaluate the intervention effectiveness.
Results: The effect size (ES) for the intervention was moderate to large for the PEP-R developmental age as well as perception, fine motor, gross motor, eye-hand coordination, cognitive performance and cognitive verbal domain among children with mild to moderate (ES ranged from 0.70 to 0.88) and severe autism (ES ranged from 0.73 to 0.87). There was no difference in the intervention effect between the groups (ES ranged from 0.004 to 0.30). The effectiveness of the intervention continued after controlling the confounding effect of baseline developmental quotient, developmental age and adaptive skills.
Conclusion: It is feasible to provide an effective parent mediated early intervention for mild to severe autism in countries where parents are the cornerstone in childhood disability care.