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FC14-05 - Parent-mediated communication-focused treatment for preschool children with autism (MRC PACT); a randomised controlled trial

Published online by Cambridge University Press:  16 April 2020

J. Green ,
T. Charman ,
H. Mc Conachie ,
C. Aldred ,
V. Slonims ,
P. Howlin ,
A. Le Couteur ,
K. Leadbitter ,
K. Hudry  and
S. Byford
...Show all authors
J. Green
Affiliation:
University of Manchester, Manchester, UK
T. Charman
Affiliation:
Institute of Education, London, UK
H. Mc Conachie
Affiliation:
Newcastle University, Newcastle Upon Tyne, Manchester, UK
C. Aldred
Affiliation:
Stockport PCT, Stockport, Manchester, UK
V. Slonims
Affiliation:
Guys Hospital, Manchester, UK
P. Howlin
Affiliation:
King's College London (Institute of Psychiatry), London, UK
A. Le Couteur
Affiliation:
Newcastle University, Newcastle Upon Tyne, Manchester, UK
K. Leadbitter
Affiliation:
Education Authority, Manchester, UK
K. Hudry
Affiliation:
Institute of Education, London, UK
S. Byford
Affiliation:
King's College London (Institute of Psychiatry), London, UK
B. Barrett
Affiliation:
King's College London (Institute of Psychiatry), London, UK
K. Temple
Affiliation:
Newcastle University, Newcastle Upon Tyne, Manchester, UK
W. Macdonald
Affiliation:
University of Manchester, Manchester, UK
A. Pickles
Affiliation:
University of Manchester, Manchester, UK

Abstract

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Introduction

Evidence from previous small trials has suggested the effectiveness of early social communication interventions for autism.

Objectives

The Preschool Autism Communication Trial (PACT) investigated the efficacy of such an intervention in the largest psychosocial autism trial to date.

Aims

To provide a stringent test of a pre-school communication intervention for autism.

Methods

152 children with core autism aged 2 years - 4 years 11 months in a 3 site 2 arm single (assessor) blinded randomised controlled trial of the parent-mediated communication-focused intervention added to treatment as usual (TAU) against TAU alone. Primary outcome; severity of autism symptoms (modified social communication algorithm from Autism Diagnostic Observation Schedule-Generic, ADOS-G). Secondary outcomes; blinded measures of parent-child interaction, child language, and adaptation in school.

Results

At 13 month endpoint the treatment resulted in strong improvement in parental synchronous response to child (adjusted between-group effect size 1.22 (95% CI 0.85, 1.59) and child initiations with parent (ES 0.41 (0.08, 0.74) but small effect on autism symptomatology (ADOS-G, ES -0.24 (95% CI -0.59, 0.11) ns). Parents (not blind to allocation) reported strong treatment effects on child language and social adaptation but effects on blinded research assessed language and school adaptation were small.

Conclusions

Addition of the PACT intervention showed clear benefit in improving parent-child dyadic social communication but no substantive benefit over TAU in modifying objectively rated autism symptoms. This attenuation on generalisation from ‘proximal’ intervention effects to wider symptom change in other contexts remains a significant challenge for autism treatment and measurement methodology.

Type
Research Article
Information
European Psychiatry , Volume 26 , Issue S2: Abstracts of the 19th European Congress of Psychiatry , March 2011 , pp. 1897
Copyright
Copyright © European Psychiatric Association 2011
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