Thailand Overview 2/8/2012. Thailand and Canada Both Published in 2011

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1 Thailand and Canada Both Published in 2011 Thailand Overview Thirty two participants were enrolled in the study. Children were assigned to either the typical treatment or DIRFloortime supplemented treatment groups Intervention based on the DIRFloortime intervention Parents added home based DIRFloortime intervention at an average of 15.2 hours/week for three months. Parent Training The study treatment involved intervention entirely by the parents of children with ASD, rather than a therapist with a child Parents in the intervention group attended a one day training i workshop kh to learn about the DIRFloortime model. Parents received a 3 hour DVD lecture taken from a workshop recorded by Dr. Stanley Greenspan. Parents were trained for 1.5 hours in a one on one session where they observed the investigator modeling the DIRFloortime techniques and were asked to independently demonstrate the same techniques. 1

2 Outcome Tools FEAS = Functional Emotional Assessment Scale (Greenspan et al., 2000) CARS = Childhood d Autism Scale (Schopler et al., 1986) FEDQ = Functional Emotional Development Questionnaires (Greenspan and Greenspan, 2002). Mean (SD) changes in standard scores Control Intervention (n=16) (n=15) FEAS 1.9 (6.1) 7.0 (6.3) CARS 0.8 (1.2) 2.9 (2.0) FEDQ 0.8 (1.4) 7.7 (8.1) On the FEAS the intervention group showed a gain of 7.0 points during the 3 month period, which was statistically significant compared to the gain of 1.9 points in the comparison group. Home based DIRFloortime helped the children with autism to better engage, relate and communicate with their caregivers when compared to those who received the routine behavioral interventions. It was found that the 9 parents who added home based DIRFloortime intervention 10 hours per week or more made greater gains in the FEAS than the 6 parents who added the intervention less than 10 hours per week. *Compared to the results of Solomon s study, in which the FEAS increased from 38.1 to 44.6 within a 1 year period of DIRFloortimebased intervention, the children in the intervention group showed similar results within a shorter duration 2

3 Canada Overview Randomized controlled trial of 51 children aged 2 years to 4 years 11 months. All children were previously diagnosed with ASD Families in the target treatment group were given 2 hours of therapy and coaching each week, and expected to spend 3 hours per day interacting with their child. Community Treatment (CT)group received a variety of services averaging 3.9 hours per week. After 1 year, outcomes were measured to determine changes in the groups in social interaction and communication. Measurements A modified version of the Child Behavior Rating Scale (Kim and Mahoney, 2004; Mahoney and Perales, 2003) (henceforth mcbrs) was used to rate children s interactions with their parents at the beginning and 12 months into treatment. The 5 point Likert type scale is designed to track what Mahoney and colleagues call pivotal behaviors, (Core learning processes that mediate between parental responsiveness and developmental cognitive, linguistic and socio emotional functioning). Capacity Group Pre Treatment Scores(means) Attention to Activity Treatment Standard Involvement Treatment Standard Compliance Treatment Standard Initiation of Joint Treatment Attention Standard Enjoyment in Treatment Interaction Standard Post Treatment Scores(means) 3

4 The treatment group showed statistically significant results on the following capacities: Showed significantly greater enjoyment in interactions with their parents Were both significantly more attentive and more involved in interactions with their parents Initiated more joint attentional frames. That is, all but compliance. Most children in the CT group received traditional behavioral interventions for autism. Behavioral interventions tend to emphasize teaching children to be compliant. Therefore, it would be expected that these children improve on Compliance. It is equally important to note that children in the treatment group, which did not specifically target this behavior, seemed to have made greater improvements in Compliance than the CT group, although it was not statistically significant at the.05 level. Small positive changes made by the treatment group caregivers made a statistically significant difference in children s development. There is an association between improvements in caregiver behaviors and improvements in children s social communicative functioning. The direction of the causality is not clear. 4

5 Reference Thailand Study A pilot randomized controlled trial of DIR/Floortime parent training intervention for pre school children with autistic spectrum disorders Kingkaew Pajareya and Kaewta Nopmaneejumruslers Autism published online 13 June 2011 The online version of this article can be found at: DOI: / Autism Reference Canada Study Learning Through Interaction in Children With Autism: Preliminary Data From a Social Communication Based Intervention Devin M. Casenhiser, Stuart G. Shanker and Jim Stieben Autism published online 26 September 2011 The online version of this article can be found at: