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dc.contributor.authorWhitehouse, Andrew JO
dc.contributor.authorVarcin, Kandice J
dc.contributor.authorPillar, Sarah
dc.contributor.authorBillingham, Wesley
dc.contributor.authorAlvares, Gail A
dc.contributor.authorBarbaro, Josephine
dc.contributor.authorBent, Catherine A
dc.contributor.authorBlenkley, Daniel
dc.contributor.authorBoutrus, Maryam
dc.contributor.authorChee, Abby
dc.contributor.authorChetcuti, Lacey
dc.contributor.authorClark, Alena
dc.contributor.authorDavidson, Emma
dc.contributor.authorDimov, Stefanie
dc.contributor.authoret al.
dc.date.accessioned2021-10-12T00:56:32Z
dc.date.available2021-10-12T00:56:32Z
dc.date.issued2021
dc.identifier.issn2168-6203
dc.identifier.doi10.1001/jamapediatrics.2021.3298
dc.identifier.urihttp://hdl.handle.net/10072/408849
dc.description.abstractImportance: Intervention for individuals with autism spectrum disorder (ASD) typically commences after diagnosis. No trial of an intervention administered to infants before diagnosis has shown an effect on diagnostic outcomes to date. Objective: To determine the efficacy of a preemptive intervention for ASD beginning during the prodromal period. Design, Setting, and Participants: This 2-site, single rater-blinded randomized clinical trial of a preemptive intervention vs usual care was conducted at 2 Australian research centers (Perth, Melbourne). Community sampling was used to recruit 104 infants aged 9 to 14 months showing early behaviors associated with later ASD, as measured by the Social Attention and Communication Surveillance-Revised. Recruitment occurred from June 9, 2016, to March 30, 2018. Final follow-up data were collected on April 15, 2020. Interventions: Infants were randomized on a 1:1 ratio to receive either a preemptive intervention plus usual care or usual care only over a 5-month period. The preemptive intervention group received a 10-session social communication intervention, iBASIS-Video Interaction to Promote Positive Parenting (iBASIS-VIPP). Usual care comprised services delivered by community clinicians. Main Outcomes and Measures: Infants were assessed at baseline (approximate age, 12 months), treatment end point (approximate age, 18 months), age 2 years, and age 3 years. Primary outcome was the combined blinded measure of ASD behavior severity (the Autism Observation Scale for Infants and the Autism Diagnostic Observation Schedule, second edition) across the 4 assessment points. Secondary outcomes were an independent blinded clinical ASD diagnosis at age 3 years and measures of child development. Analyses were preregistered and comprised 1-tailed tests with an α level of .05. Results: Of 171 infants assessed for eligibility, 104 were randomized; 50 infants (mean [SD] chronological age, 12.40 [1.93] months; 38 boys [76.0%]) received the iBASIS-VIPP preemptive intervention plus usual care (1 infant was excluded after randomization), and 53 infants (mean [SD] age, 12.38 [2.02] months; 32 boys [60.4%]) received usual care only. A total of 89 participants (45 in the iBASIS-VIPP group and 44 in the usual care group) were reassessed at age 3 years. The iBASIS-VIPP intervention led to a reduction in ASD symptom severity (area between curves, -5.53; 95% CI, -∞ to -0.28; P = .04). Reduced odds of ASD classification at age 3 years was found in the iBASIS-VIPP group (3 of 45 participants [6.7%]) vs the usual care group (9 of 44 participants [20.5%]; odds ratio, 0.18; 95% CI, 0-0.68; P = .02). Number needed to treat to reduce ASD classification was 7.2 participants. Improvements in caregiver responsiveness and language outcomes were also observed in the iBASIS-VIPP group. Conclusions and Relevance: Receipt of a preemptive intervention for ASD from age 9 months among a sample of infants showing early signs of ASD led to reduced ASD symptom severity across early childhood and reduced the odds of an ASD diagnosis at age 3 years. Trial Registration: http://anzctr.org.au identifier: ACTRN12616000819426.
dc.description.peerreviewedYes
dc.languageeng
dc.publisherAmerican Medical Association (AMA)
dc.relation.ispartofpagefrome213298
dc.relation.ispartofjournalJAMA Pediatrics
dc.subject.fieldofresearchPaediatrics
dc.subject.fieldofresearchPsychology
dc.subject.fieldofresearchcode3213
dc.subject.fieldofresearchcode52
dc.titleEffect of Preemptive Intervention on Developmental Outcomes Among Infants Showing Early Signs of Autism: A Randomized Clinical Trial of Outcomes to Diagnosis
dc.typeJournal article
dc.type.descriptionC1 - Articles
dcterms.bibliographicCitationWhitehouse, AJO; Varcin, KJ; Pillar, S; Billingham, W; Alvares, GA; Barbaro, J; Bent, CA; Blenkley, D; Boutrus, M; Chee, A; Chetcuti, L; Clark, A; Davidson, E; Dimov, S; et al., Effect of Preemptive Intervention on Developmental Outcomes Among Infants Showing Early Signs of Autism: A Randomized Clinical Trial of Outcomes to Diagnosis, JAMA Pediatrics, 2021, pp. e213298
dc.date.updated2021-10-01T04:21:31Z
gro.description.notepublicThis publication has been entered in Griffith Research Online as an advanced online version.
gro.hasfulltextNo Full Text
gro.griffith.authorVarcin, Kandice J.


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