Parent-mediated intervention in infants with an elevated likelihood for autism reduces dwell time during a gaze-following task.

Rachael Bedford, Jonathan Green, Teodora Gliga, Emily H Jones, Mayada Elsabbagh, Greg Pasco, Ming Wai Wan, Vicky Slonims, Tony Charman, Andrew Pickles, Mark H Johnson
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Abstract

Cognitive markers may in theory be more sensitive to the effects of intervention than overt behavioral measures. The current study tests the impact of the Intervention with the British Autism Study of Infant Siblings-Video Interaction for Promoting Positive Parenting (iBASIS-VIPP) on an eye-tracking measure of social attention: dwell time to the referred object in a gaze following task. The original two-site, two-arm, assessor-blinded randomized controlled trial (RCT) of this intervention to increase parental awareness, and responsiveness to their infant, was run with infants who have an elevated familial likelihood for autism (EL). Fifty-four EL infants (28 iBASIS-VIPP intervention, 26 no intervention) were enrolled, and the intervention took place between 9 months (baseline) and 15 months (endpoint), with gaze following behavior measured at 15 months. Secondary intention to treat (ITT) analysis showed that the intervention was associated with significantly reduced dwell time to the referent of another person's gaze (β = -0.32, SE = 0.14, p = 0.03) at 15-month treatment endpoint. Given the established link between gaze following and language, the results are considered in the context of a previously reported, non-significant and transient trend toward lower language scores at the treatment endpoint (Green et al. (2015) The Lancet Psychiatry, 2(2), 133-140). Future intervention trials should aim to include experimental cognitive measures, alongside behavioral measures, to investigate mechanisms associated with intervention effects.

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对自闭症可能性较高的婴儿进行家长干预,可减少其在目光追随任务中的停留时间。
理论上,认知标记可能比明显的行为测量对干预效果更敏感。本研究测试了英国婴儿兄弟姐妹自闭症研究--促进积极养育的视频互动干预(iBASIS-VIPP)对社会注意力眼动跟踪测量的影响:在注视跟踪任务中对所指对象的停留时间。这项干预措施旨在提高父母对婴儿的关注度和响应度,最初的两地、双臂、评估者盲法随机对照试验(RCT)针对的是自闭症(EL)家族可能性较高的婴儿。54名自闭症婴儿(28名接受iBASIS-VIPP干预,26名未接受干预)接受了干预,干预时间为9个月(基线)至15个月(终点),15个月时对婴儿的凝视行为进行测量。次要意向治疗(ITT)分析表明,在 15 个月的治疗终点,干预与显著减少对他人注视参照物的停留时间有关(β = -0.32,SE = 0.14,p = 0.03)。考虑到目光追随与语言之间的既定联系,这一结果应与之前报道的治疗终点时语言得分降低的非显著性和短暂性趋势结合起来考虑(Green 等人(2015)The Lancet Psychiatry,2(2), 133-140)。未来的干预试验应将实验性认知测量与行为测量结合起来,以研究与干预效果相关的机制。
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