Parent Training and Therapy in Children with Autism

Area of Science:

• Neurodevelopmental Disorders
• Child Psychology
• Developmental Pediatrics

Background:

• Autism spectrum disorder (ASD), classified under neurodevelopmental disorders in DSM-5, involves impaired social adaptation and emotional recognition due to underdeveloped inhibitory mechanisms.
• Early detection and intervention are crucial for children diagnosed with a risk of ASD, particularly those aged 20-30 months.

Purpose of the Study:

• To investigate the efficacy of two distinct parental training (PT) programs in enhancing joint attention (JA) in infants at risk for ASD.
• To assess the impact of Applied Behavior Analysis (ABA) and reflective functioning (RF) training on JA, a precursor to theory of mind (ToM) and mentalization.

Main Methods:

• A sample of 84 children (20-30 months) diagnosed with a risk of ASD (Level 1) were divided into two groups.
• Group 1 received weekly PT based on ABA principles.
• Group 2 received weekly PT focused on enhancing reflective functions and parental awareness, inspired by Fonagy's mentalization model.

Main Results:

• Both ABA-based and RF-focused PT interventions showed potential in improving JA.
• Parents' ability to understand their own and their child's mental states was identified as a significant protective factor for development.
• The RF-focused training highlighted the importance of parental mentalization in supporting children with atypical development.

Conclusions:

• Parental training programs, particularly those enhancing reflective functions and mentalization, can positively impact the development of joint attention in infants at risk for ASD.
• The capacity of parents to mentalize their child's experiences is a crucial element in fostering healthy development, even in the context of neurodevelopmental differences.
• Early, targeted parental interventions are vital for supporting social-cognitive development in young children identified with a risk of autism spectrum disorder.