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Children with ASD benefited more from individual vs. social interaction
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Individualized parent coaching in natural environments positively affects children with autism spectrum disorders, according to recent data published in Pediatrics, which suggest individual social interaction has greater effects than group interaction.
Amy M. Wetherby, PhD, of Weill Cornell Medical College in New York, and colleagues randomly assigned 82 children diagnosed with ASD at age 16 to 20 months to an individual or group parent-implemented Early Social Interaction (ESI) intervention for 9 months. Outcomes were assessed at baseline and at the end of the 9-month intervention.
Both interventions used the Social Communication, Emotional Regulation and Transactional Supports curriculum and focused on teaching parents the importance of intensive intervention and how to support active engagement in natural environments. Researchers encouraged parents to employ evidence-based strategies in everyday activities for at least 25 hours per week.
Parents in the individual ESI intervention met with interventionists three times a week for 6 months (twice at home, once in clinic) and two times a week for 3 months (once at home, once in community setting) to review, update and practice supports and strategies in three to five activities, problem solving and planning.
For the group ESI intervention, interventionists met with four or five families of children with ASD, communication delays or typical development in a clinic once a week. Once a month there was an educational meeting that discussed content without children present. Playgroups constituted the remaining sessions.
Children in both interventions improved on the social composite, but children who received individual ESI had significantly greater improvement than children who received group ESI.
Children in both interventions had similar rates of improvement regarding speech and symbolic composites.
All children improved on social affect and worsened on restricted, repetitive behavior.
Regarding communication, children in individual ESI significantly improved, and children in group ESI had no change. Similarly, children in individual ESI showed significant improvement on daily living, while children in group ESI exhibited no change.
Socialization remained constant among children in individual ESI and decreased among children in group ESI.
Both groups exhibited decreases in standard scores for motor skills.
Regarding visual reception, neither group gained T scores but maintained their baseline scores and kept up with normative progress compared with Mullen Scales of Early Learning norms.
Fine motor skill T scores declined among both groups of children. However, this decline was caused by failure to make normative progress rather than a loss of skills during intervention, according to researchers.
Children in individual ESI significantly improved their receptive language skills and children in group ESI showed no change. Both groups of children improved their expressive language skills.
“The efficacy of individual-ESI compared with group-ESI on many child outcomes is particularly important in light of lack of main effects on child outcomes of most other parent-implemented interventions with toddlers with ASD,” the researchers wrote. “Although there may be a narrow window of time for effectiveness of this approach, the potential to identify children with ASD by 18 to 24 months is within our reach.”
Disclosure: See the full study for a complete list of relevant financial disclosures.
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