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Early social intervention offers hope for autism patients

March 10, 2017

This is the Medscape Psychiatry Minute. I’m Dr Peter Yellowlees. It is not known whether early intervention can improve long-term autism symptom outcomes. Now a team of investigators[1] from Kings College, London, has followed up on the Preschool Autism Communication Trial (PACT) to investigate whether the PACT intervention had a long-term effect on autism symptoms and continued effects on parent and child social interaction. Of the 152 trial participants, 121 (80%) were traced and assessed for, on average, 82 months after the study. [Editor’s note: The author originally misstated that follow-up was 10.5 years.] Effect sizes in group difference in favor of the PACT intervention, based on the Autism Diagnostic Observation Schedule, was 0.64 at treatment endpoint and 0.70 at follow-up, demonstrating an overall reduction in symptom severity over the course of the whole trial and follow-up period. There were also group differences in measures of child initiations when interacting with their parents, but there were no group differences in the language composite at follow-up. The researchers concluded that the results are the first to show long-term symptom reduction after a randomized controlled trial of early intervention in autism spectrum disorder.

These are fascinating, important, and encouraging results that will give hope to many families affected by autism in a child, as well as to many clinicians and researchers. The consistency of positive effects of the PACT intervention should strongly encourage this approach to treatment and other long-term follow-up studies, and it also has significant implications for our understanding of the etiology of developmental disorders and the plasticity of the brain, and how strong the effect of early social interventions can be.


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