Authors: Aldred C, Green J, Emsley R, McConachie H
Title: Brief report: Mediation of treatment effect in a communication intervention for pre-school children with autism
Source: Journal of Autism and Developmental Disorders 2012 42(3): 447-454
Year: 2012
Research Design: Randomised Controlled Trial
Rating Score: 06/10
This rating is confirmed
Eligibility specified - N
Random allocation - Y
Concealed allocation - N
Baseline comparability - N
Blind subjects - N
Blind therapists - N
Blind assessors - Y
Adequate follow-up - Y
Intention-to-treat analysis - Y
Between-group comparisons - Y
Point estimates and variability - Y
Abstract:

Tests of mediation in treatment trials can illuminate processes of change and suggest causal influences in development. We conducted a mediation analysis of a previously published randomised controlled trial of parent-mediated communication-focused treatment for autism against ordinary care, with 28 children aged 2-5 years (Aldred et al. in J Child Psychol Psychiatr 45:1-11, 2004). The hypothesised mediating process, targeted by the intervention, was an increase in parental synchronous response within parent-child interaction. The results showed partial mediation, with change in synchrony accounting for 34% of the positive intervention effect on autism symptomatology (Autism Diagnostic Observation Schedule communication and social domain algorithm); the result was confirmed by bootstrap estimation. Improved parental synchronous response to child communication can alter short-term autism symptom outcome with targeted therapy.

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