Randomized Clinical Trial Comparing Dialogical Family Guidance with Ordinary Clinical Treatment for Families with a Child with Neurodevelopmental Disorders

Abstract

Objectives Previous studies have highlighted the need to offer targeted interventions to strengthen the wellbeing of family members in families with children with neurodevelopmental disorders (NDD). Interventions for this target group require research and development. The purpose of this study was to test a new family intervention: Dialogical Family Guidance (DFG). Methods Families of children with NDD were randomized into an intervention group that was delivered DFG and a comparison group provided with ordinary clinical treatment. The Family Functioning, Family Health and Social Support (FAFHES) and the DFG instrument were used to collect data at baseline and after 3 months. Repeated measure analysis of variance (ANOVA) was used as an analytical strategy. Results There was a significant within-subjects effect of time on family health and social support, indicating that family health and social support increased in both groups over time. There was also a significant between-subjects effect of group and interaction between time and group on social support, indicating that social support increased more in the intervention group than in the control group. Managing in daily life and the relationship between parents were associated with family functioning and family health. Conclusion DFG can strengthen parental experiences of social support. Managing in daily life, relationship between parents, practical guidance, psychoeducation, dialogue, and receiving positive feedback on parenting were strengthening factors during DFG. However, the results of this study must be considered as only preliminary, as they relate only to parental perceptions of the intervention effects. Trial registration ClinicalTrials.gov NCT04892992 (retrospectively registered).

Implications of Early Diagnosis and Intervention in the Management of Neurodevelopmental Delay (NDD) in Children: A Systematic Review and Meta-Analysis

“…The forest plot as shown in Figure 2 below provides a clear interpretation of the findings of this study [14][15][16][17][18][19][20][21][22][23][24][25][26]. The columns indicate the included studies, the intervention group, the control group, the weight, and the outcome effect in the numerical and graphical format [27].…”

“…This study aimed to investigate the implications of early diagnosis and treatment on managing NDD in children. A study was conducted to compare standard clinical treatment with dialogical family guidance in diagnosing and managing NDD [ 14 ]. The effectiveness of dialogical family guidance was observed since it strengthened social support and opened a dialogue for practical guidance and managing children with NDD.…”

“…Also, a similar study incorporated the LEaP model for learning, engaging, and playing to improve NDD outcomes [ 21 ]. It was observed that strengthening family relationships and encouraging communication promoted functional outcomes in NDD management [ 14 , 21 ]. In 2013, a similar model applied a routine-based approach whose intervention significantly promoted family-selected goals and functional outcomes in NDD children [ 22 ].…”

“…In 2013, a similar model applied a routine-based approach whose intervention significantly promoted family-selected goals and functional outcomes in NDD children [ 22 ]. As a result, it was proposed to use a family-related dialogical model that strengthens social relationships and communication within the family in establishing functional outcomes for NDD [ 14 , 21 , 22 ].…”

“…Figure 3 provides a negative risk difference, meaning that early intervention and diagnosis reduced the risk of severe NDDs in children [14][15][16][17][18][19][20][21][22][23][24][25][26]. In other words, a negative risk difference means that it was easy to manage NDD children following early intervention and diagnosis.…”