Video feedback may help babies 'at risk of autism'
Researchers have been keen to establish whether you can reduce the effects of autism on a child's development if you intervene early enough. A new study with autistic babies claims that you can.
Autism affects about one in every 100 children. It can affect every aspect of their experience and make the world a scary and confusing place. This causes children to behave in ways that can bewilder their parents, who then lose confidence in their ability to parent. So it is critical to discover what works best to restore parents' confidence and reduce some of the negative effects of autism on their relationship with their child.
The new study, led by Jonathan Green of the University of Manchester, is the first to focus on babies "at risk of autism" and their parents. It is the earliest age at which such work has been carried out.
Each of the 54 babies enrolled in the study had an older sibling with autism, which makes it more likely that they would have autism themselves, as it often runs in families. About half the families were randomly assigned to receive the intervention; the other half were assigned to the control group (no intervention).
The intervention took place for five months in participants' homes, starting when the babies were nine months old. It involved therapists giving parents feedback, via video, on their interactions with their children. This was designed to support parents with understanding and adapting to their child's modes of communication and engagement.
At three years old, the children who received the intervention showed greater improvement in behaviour associated with autism than those who were part of the control group. Most importantly, these improvements continued after the intervention ended.
It is not possible to say how many of these at-risk-of-autism children would have gone on to receive the diagnosis without the intervention, but, at age three, two-thirds of the overall cohort were described as "typically developing". There is no claim made here, however, that the intervention prevents autism. It just helps to reduce some of the behaviour that might inhibit an autistic child's development and well-being.
Other approaches, such as Early Bird and Hanen, have made use of video in this way and reported benefits on parent-child engagement. But no research has been done before with children so young, and with such encouraging results.
The results suggest that support for parents in a child's early years can have lasting positive effects as children become older. So supporting parents of autistic infants could improve the lives of children and their parents for the long term and reduce the demand on services.
Studies into approaches to support autistic children are notoriously difficult to defend. All children are unique and develop differently, so it is difficult to claim a true comparison group.
Children usually experience other interventions – such as speech and language therapy, picture exchange system or intensive interaction – at the same time as these trials, so working out which is making the difference is often impossible.
The researchers in this latest study made every effort to control these sorts of variables by, for example, using two researchers to independently analyse the data, delivering the research across two sites and using known and validated assessment tools.
In doing so, they have produced high quality research, but some questions remain unanswered. For example, the study involved parents who already had an older autistic child so we would expect them to have developed some skills in adjusting their communication and relationship styles. It means that we can't be sure that this approach would work as well with parents with no experience of communicating and relating to a child with autism. We also don't know how families of infant autistic children without an older autistic sibling would be identified so they could benefit from this approach.
Despite the inevitable challenges to autism research this study makes a very positive contribution. When children are first trying to make sense of the world and parents are first trying to make sense of their children, it is critical that parents are supported. And if the results of this study are replicated, it may be just the kind of support they need.