PLAY Project Home Consultation Intervention Program for Young Children With Autism Spectrum Disorders

Abstract

Objective To evaluate the effectiveness of the PLAY Project Home Consultation (PLAY) model, in combination with usual community services (CS), to improve parent-child interaction, child development, and autism symptomatology in young children with autism spectrum disorders (ASD) compared to CS only. Methods Children (N=128) with autism or PDD-NOS (DSM IV criteria), 2 years-8 months to 5 years-11 months, recruited from five disability agencies in four U.S. states, were randomized in two one-year cohorts. Using videotape and written feedback within a developmental framework, PLAY consultants coached caregivers monthly for 12 months to improve caregiver-child interaction. CS included speech/language and occupational therapy and public education services. Primary outcomes included change in: parent and child interactions; language and development; and autism-related diagnostic category/symptoms. Secondary outcomes included parent stress and depression; and home consultant fidelity. Data were collected pre and post intervention. Results Using intent-to-treat analysis (ITT), large treatment effects were evident for parent and child interactional behaviors on the Maternal and Child Behavior Rating Scales. Child language and developmental quotient did not differ over time by group though functional development improved significantly. PLAY children improved in diagnostic categories on the Autism Diagnostic Observation Schedule (ADOS). PLAY caregivers’ stress did not increase; depressive symptomatology decreased. Home Consultants administered the intervention with fidelity. Conclusions PLAY intervention demonstrated substantial changes in parent-child interaction without increasing parent stress/depression. ADOS findings must be interpreted cautiously as results do not align with clinical experience. PLAY offers communities a relatively inexpensive, effective intervention for children with ASD and their parents.

The Effect of Music Therapy Along With Play Therapy on Social Behaviors and Stereotyped Behaviors of Children With Autism

“…They showed that activities related to MT facilitate social communication and dynamic, common, and active interaction in children with autism. Our results with training using PT was found to be consistent with the research conducted by Solomon et al (2014); Gutman et al (2012);and Rodrigues, Sei, and Arruda (2013). They showed that playing intervention programs increases interaction and language development in children with autism.…”

Efficacy of early interventions for infants and young children with, and at risk for, autism spectrum disorders

“…Two RCTs identified effects on parent responsivity in a parent coaching condition, compared to a treatment-as-usual group (Solomon, Van Egeren, Mahoney, Quon Huber, & Zimmerman, 2014) or parent advocacy control group (Siller, Hutman, & Sigman, 2013), even when coaching occurred only once monthly for 12 months (similar to Drew et al, 2002) (Solomon et al, 2014) or once weekly for 12 weeks (Siller et al, 2013). In a 1-year follow-up of participants in Solomon et al’s (2014) sample, the lack of child treatment effects persisted (Oosterling et al, 2010). In Siller et al’s (2013) study, children in the parent coaching group having baseline expressive language skills below the 12-month level showed greater expressive language gains compared to controls 1 year later, at follow-up.…”

Evidence Base Update for Autism Spectrum Disorder

“…Further, responsive caregiver behavior correlated with positive child outcomes (Casenhiser et al, 2013). In another RCT of an intervention based on Floortime, Solomon et al (2014) evaluated the Play and Language for Autistic Youngsters (PLAY) program, which included monthly home consultation with parents. Children in the PLAY group showed significant improvements in ASD classification, social-emotional skills, and quality of parent-child interactions but not ASD symptoms, communication skills, or development level.…”