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One-year follow-up of the outcome of a randomized controlled trial of a home-based intervention programme for children with autism and developmental delay and their families
Article first published online: 8 JUN 2009
DOI: 10.1111/j.1365-2214.2009.00953.x
© 2009 The Authors. Journal compilation © 2009 Blackwell Publishing Ltd
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How to Cite
Rickards, A. L., Walstab, J. E., Wright-Rossi, R. A., Simpson, J. and Reddihough, D. S. (2009), One-year follow-up of the outcome of a randomized controlled trial of a home-based intervention programme for children with autism and developmental delay and their families. Child: Care, Health and Development, 35: 593–602. doi: 10.1111/j.1365-2214.2009.00953.x
Publication History
- Issue published online: 5 AUG 2009
- Article first published online: 8 JUN 2009
- Accepted for publication 31 December 2008
- Abstract
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Keywords:
- autism spectrum disorder;
- developmental disorders;
- early intervention;
- home-based;
- randomized controlled trial
Abstract
Introduction There is debate about the type and intensity of early childhood intervention that is most helpful for children with developmental problems. The aim of the study was to determine whether a home-based programme provided over 12 months resulted in sustained improvement in development and behaviour 12 months after the intervention ceased. The characteristics of the children and families who benefited most from the intervention were also studied.
Method Randomized controlled trial.
Participants A total of 59 children, aged 3–5 years, attending two early childhood intervention centres in Melbourne, Australia.
Intervention Half of the subjects received an additional home-based programme consisting of 40 weekly visits.
Main outcome measures Bayley Scales of Infant Development and Wechsler Preschool and Primary Scale of Intelligence Revised, Preschool Behaviour Checklist, Bayley Behaviour Rating Scale and Behaviour Screening Questionnaire. All tests administered pre-intervention, following the intervention and 12 months later.
Secondary outcome measures Family stress, support and empowerment.
Results Fifty-four children completed the assessments 12 months after conclusion of the intervention. Compared with the control group, improvement in aspects of cognitive development in the children who received the extra intervention was sustained 1 year later (P= 0.007) while significant behavioural differences post intervention were not. Analyses of the data by the Reliable Change Index indicated improvement of clinical significance occurred in non-verbal areas. In contrast to the control group who deteriorated, language skills in the intervention group remained stable. Improvements were significantly associated with higher stress in the families.
Conclusion Improvements following the provision of a home-based programme to preschool children with developmental disabilities were sustained 1 year later. Children from highly stressed families appeared to benefit most, reinforcing the importance of involving families in early childhood intervention programmes.