For infants who are at-risk of developing autism spectrum disorder, video-based therapy can improve engagement, attention, and social behavior, according to a new study published in The Lancet Psychiatry.
The therapy may also reduce the likelihood that these children will later develop autism. The video-feedback therapy allows parents to understand and respond to their at-risk infants in ways that can curb the emergence of autism symptoms.
Although autism isn’t typically diagnosed until a child is aged 3 to 4 years, they can start exhibiting symptoms as early as 8 months. These early symptoms include reduced behavioral attention to social scenes, declining attention to eyes, and attenuated neural response to eye gaze. At 14 months, they can show symptoms such as altered attention disengagement and atypical infant temperament.
Since parents often struggle to interpret atypical infant behavior, their interactions with the child may maintain or even increase their likelihood of developing autism. Intervention can improve parent-child social interaction, and such interventions have already been successful in children aged 2 to 5 years with autism spectrum disorder. In this study, the researchers wanted to see if the effects of intervention could extend to even younger children, potentially optimizing the effects.
The study included 54 families with infants aged 7 to 10 months who had a high risk of autism: 28 were randomly assigned to intervention and 26 to no intervention. The intervention was a modification of the Video Interaction for Promoting Positive Parenting (VIPP), which the researchers called iBASIS-VIPP.
In the intervention, a therapist videotapes parent-infant interactions in the home. Based on these videos, the therapist works with the parents in 6 to 12 sessions that focus on improving the parents’ understanding of how their infant communicates.
After 5 months, the infants who received intervention showed improved engagement, attention, and social behavior compared with the control group.
The intervention group showed an average reduction of 2.51 points on the Autism Observation Scale for Infants compared with controls, suggesting that iBASIS-VIPP may curb the emergence of autism symptoms. Despite the mostly positive outcomes, the infants in the intervention group did exhibit a reduction in responsiveness to language sounds.
“Previous research has shown that parent-based interventions — similar to the one we tested here, but delivered later in the pre-school years and to children already diagnosed with autism — tend to have the greatest effects on parent-child interaction, whilst having little impact on actual autism symptoms,” said Jonathan Green, MD, researcher and Professor of Child and Adolescent Psychiatry at the University of Manchester in the United Kingdom. “In contrast, the video-based intervention we tested in this study in early infancy seems to have wider impact on a number of behavioral effects and risk markers for later autism.”
Despite the intervention’s early success, the researchers note that larger studies are needed before they can definitively assess the effectiveness of iBASIS-VIPP.