Skip to main content

Spectrum: Autism Research News

For behavioral therapy, location is key

by  /  28 November 2014
THIS ARTICLE IS MORE THAN FIVE YEARS OLD

This article is more than five years old. Autism research — and science in general — is constantly evolving, so older articles may contain information or theories that have been reevaluated since their original publication date.

Ionut Radulescu

There’s little question that behavioral interventions delivered by doctors can improve language and social skills in children with autism. And access to these therapies is expanding, with clinicians coaching parents on how to deliver the treatments themselves.

But proof that parent-led interventions can ease autism symptoms is hard to muster. Part of the problem is a dearth of well-designed clinical trials.

A new study of 82 toddlers with autism aims to fill this gap.

In the study, published 3 November in Pediatrics, researchers taught parents how to help their child learn new skills during everyday activities such as dressing, playing and eating. The parents also learned new ways to respond to their child’s sounds, eye gaze, gestures and other body movements.

Roughly half the parents were trained in small groups during weekly hour-long clinic visits. The rest were coached privately in their homes and in neighborhood venues, such as grocery stores and playgrounds, up to three times a week. The researchers encouraged both groups of parents to apply their newly learned skills in activities with their children at least 25 hours per week.

At the end of the nine-month training program, children in both groups showed similar improvements in communication and social interaction on the Autism Diagnostic Observation Schedule, which measures autism symptoms. This is notable, given that few randomized controlled trials of behavioral interventions have demonstrated such improvements.

Both groups also improved on tests of language comprehension and communication skills, but children whose parents were trained at home showed the greatest gains. Their scores on measures of social and daily living skills also improved slightly on average, whereas the scores of the other group tended to worsen over time.

The study did not include a control group of children who received no treatment at all. Because of this, it’s impossible to know whether the interventions are directly responsible for the improvements. However, other studies have shown that autism symptoms tend to remain stable or worsen without treatment. That supports the argument for parent-mediated therapies — especially those learned at home.

This in-home training may take more time and resources than group training at a clinic. But it’s still more efficient than conventional therapies, which can require up to 30 hours a week of one-on-one time with a therapist.

When you look at it that way, training parents at home is a time- and cost-effective way to expand access to behavioral interventions for autism. And anything that brings therapies to more children is surely worth the effort.