Clinical outcomes of children with ASD - Preliminary findings from a 18 month follow up study.

Abstract

Parent-mediated intervention for children with Autism Spectrum Disorder (ASD) is a critical component to deliver evidence-based interventions in resource-limited settings. There is a need for methodologically rigorous longitudinal and follow-up studies of children with ASD to understand clinical outcome and developmental trajectories. We report the clinical outcome at 18-month follow-up of children diagnosed with ASD who received parent-mediated intervention for a 3-month period as part of a feasibility study. The study participants were followed up for 18 months as part of Treatment As Usual (TAU). Symptom severity and adaptive functioning were assessed on Childhood Autism Rating Scale (CARS) and Vineland Social Maturity Scale (VSMS) respectively. All the study participants(n = 42), continued to show improvement between baseline and the two follow-up evaluations at 3 months and 18 months respectively, with reduction in symptom severity, improvement in core features of ASD and adaptive functioning. The maximum gains were attained during the first three months. Three subgroups were identified based on the trajectory of improvement: 1) Children with best possible outcomes, 2) Child with maintenance of gains, and 3) Children with minimal improvement. Seven participants (16.7 %) had the 'best possible' outcome at 18-month follow-up with CARS scores in the non-autistic range and they no longer qualified for a DSM-5 diagnosis of ASD. The intensity of early intervention is pivotal to positively alter the developmental trajectories in children with ASD. Parent-mediated intervention is the best possible mode of intervention delivery to initiate early intervention and address the prevailing challenges in resource-limited settings.