The International Meeting for Autism Research (IMFAR) was recently held in San Diego from May 12-14 by the International Society for Autism Research (INSAR). In one of many research symposiums, recent findings from multiple randomized controlled trials of autism treatments were presented. The methodology used in randomized controlled trials requires substantial resources to develop strong study designs that have often not been used in autism research. Therefore, the research presented in this symposium was quite exciting, as it begins to address many of the current gaps in knowledge that have occurred due to the previous use of study designs that are not well controlled.
Two of the studies that were presented examined the efficacy of parent mediated interventions. One study, conducted in collaboration with our own Seattle Children’s Autism Center, examined whether parents could learn Pivotal Response Training (PRT), a naturalistic behavioral intervention, in a group therapy format and whether their children showed correlated gains in language (Gengoux et al.). Preliminary findings support significantly greater increases in language skills in children receiving PRT than in the control group. A similar study examined the Joint Attention Mediated Learning (JAML) intervention and found that JAML was effective in promoting precursors that promote engagement in joint attention including focusing on faces and turn taking (Schertz et al.).
Several of the studies that were presented discussed findings from social skills intervention programs. While programs of this nature are very common in autism, the research supporting them has been very inconsistent to date. Of the four studies that were presented, two had strong findings, which represents a significant piece of progress in the area of social skills research.
In the following two studies, both demonstrated significant outcomes for their treatment groups, one as compared to a control group and one as compared to a different social skills program. Koning and colleagues demonstrated that children who participated in a 15-week cognitive behavioral therapy (CBT)-based social skills group showed significantly greater improvements in social perception, peer interaction and social knowledge than those in the control group. Similarly, Laugeson and colleagues, examined the PEERS model, which was implemented on a daily basis in classrooms for 14 weeks. Compared to social skills treatment as usual, students receiving the PEERS model showed significant decreases in problem behaviors and autistic mannerisms, and improvements in social responsiveness, awareness, cognition, communication and motivation. Improvements in friendship quality and frequency of hosted social gatherings were reported as well. This latter finding is particularly significant, as studies have rarely demonstrated that social skills programs actually impact friendships and frequency of getting together with peers!
Finally, one study, which received attention from the media, examined the use of N-Acetylcysteine, an antioxidant, in the treatment of behavioral deficits associated with autism (Hardan et al.). Significant reductions in irritability and overall behavioral concerns were found compared to the control group. Although these findings were encouraging, the author was careful to highlight that the findings are still preliminary.
Overall, this symposium highlighted the many exciting directions that autism treatment research is currently taking and the improvements in scientific methodology that many researchers are now prioritizing. While many of the findings were preliminary, the focus on randomized controlled trials represents an important step forward in the quality of research being conducted to better understand the efficacy of various types of autism interventions.
See what Antonio Hardan, MD, professor of child psychiatry at Stanford University School of Medicine and chair of this symposium, had to say about this research.
Link to program book, abstracts and press releases about highlighted studies.
References (from the IMFAR program book):
Social Cognition and Interaction Training In Autism (SCIT-A): Development, Feasibility and Preliminary Findings with Adolescents. L. Turner-Brown*, A. B. Ratto, B. M. Rupp and D. L. Penn, Universityof NorthCarolina
Efficacy of CBT-BASED SOCIAL SKILLS INTERVENTION. C. Koning*1, J. Magill-Evans2 and J. Volden2, (1)Glenrose Rehabiliation Hospital, (2)Universityof Alberta
The ABC’s of Meeting PEERS and Making Friends: Teaching Social Skills to Adolescents with ASD In the Classroom. E. A. Laugeson*1, R. Ellingsen2, S. Bates3, A. Baron4, C. Koeffler3 and J. S. Sanderson1, (1)UCLA Semel Institute for Neuroscience & Human Behavior, (2)UCLA PEERS Program, (3)UCLA Semel Institute, (4)UCLA Semel Institute
Results of a Group Comparison Study of the Joint Attention Mediated Learning Early Intervention for Toddlers with Autism Spectrum Disorders. H. Schertz*1, S. Odom2 and K. Baggett3, (1)Indiana University, (2)University of North Carolina, (3)Universityof Kansas
Group Parent Education In Pivotal Response Treatment (PRT): Preliminary Outcomes of a Randomized Controlled Trial. G. W. Gengoux*1, M. B. Minjarez2, K. L. Berquist1, J. M. Phillips1, T. W. Frazier3 and A. Y. Hardan1, (1)Stanford University School of Medicine/Lucile Packard Children’s Hospital, (2)Seattle Children’s Hospital, (3)Cleveland Clinic
A Randomized Controlled Double-Blind Trial of NAcetylcysteine In Children with Autism. A. Y. Hardan*1, L. K. Fung2, R. A. Libove1, T. V. Obukhanych1, S. Nair2, T. W. Frazier3, L. Herzenberg1 and R. Tirouvanziam1, (1)Stanford University School of Medicine, (2)Stanford University, (3)Cleveland Clinic