Assesment of change during early interventions in infants with autism by Single Case Experimental Design

Early intervention in young children with Autism Spectrum Disorder have recently changed. We have moved from models of intensive interventions, in ecologically irrelevant situations, centered on childrens’ autistic behaviors, to less intensive interventions, within the dyad, in ecological contexts. They target parent / child interaction, including synchrony, parental sensitivity, language skills and child social communication. Various video feed-back techniques, particularly relevant in autistic children, have been developed: VIPP, PACT and Interactive Guidance Therapy (IGT). The challenge is to develop these techniques in a reproducible and measurable way, while respecting the specificity of each dyad.
Aim of the study
To meet these challenges, we propose to develop the single-case experimental design (SCED) in order to assess the effects of early interventions in children with autism. SCED focus on the process of change, allows descriptive clinical quantitative assessments that reflect the core processes of change. Material and Methods
We will present the design of a SCED research assessing IGT in children with Autism Spectrum Disorder, less than 3 years. The child is its own control. The design will be described (6 groups of 4 patients = 24 patients), and the way to assess the change. The principal criteria is the joint attention during the 10 min infant/parent play. The secondary criteria are the symptomatic changes assessed by ADOS, ADI R, CARS, and the developmental course assessed by VABS, IDE, MSEL.
Conclusions
The SCED method is a new and interesting way which principal advantage is to diminish the number of children necessary to show effects, in replacing the number of inter-assessment by intra-assessments. New ways to organize designs offer a feasability of clinical trials in manageable settings.