title: Randomised controlled trial of improvisational music therapy's effectiveness for children with autism spectrum disorders (TIME-A): study protocol Language outcome in autism: randomized comparison of joint attention and play interventions. Social Skills Training for Young Adults with High-Functioning Autism Spectrum Disorders: A Randomized Controlled Pilot Study Joint attention and symbolic play in young children with autism: a randomized controlled intervention study. Avatar Assistant: Improving Social Skills in Students with an ASD Through a Computer-Based Intervention A multi-component social skills intervention for children with Asperger syndrome: the Junior Detective Training Program. Randomized Controlled Trial for Early Intervention for Autism: A Pilot Study of the Autism 1-2-3 Project Randomized, Controlled Trial of an Intervention for Toddlers With Autism: The Early Start Denver Model Brief Report: Pilot Randomized Controlled Trial of Reciprocal Imitation Training for Teaching Elicited and Spontaneous Imitation to Children with Autism A randomized comparison of the effect of two prelinguistic communication interventions on the acquisition of spoken communication in preschoolers with ASD. Theory of Mind Training in Children with Autism: A Randomized Controlled Trial Promoting Social Skill Development in Children With Pervasive Developmental Disorders: A Feasibility and Efficacy Study Randomized Controlled Caregiver Mediated Joint Engagement Intervention for Toddlers with Autism Joint attention training for children with autism using behavior modification procedures. Brief Report: Effects of Cognitive Behavioral Therapy on Parent-Reported Autism Symptoms in School-Age Children with High-Functioning Autism Use of LEGO© as a Therapeutic Medium for Improving Social Competence Parent-mediated communication-focused treatment in children with autism (PACT): a randomised controlled trial The Efficacy of a Social Skills Group Intervention for Improving Social Behaviors in Children with High Functioning Autism Spectrum Disorders Brief Report: Effect of a Focused Imitation Intervention on Social Functioning in Children with Autism A randomized controlled trial of Hanen's 'More Than Words' in toddlers with early autism symptoms. The Effects of Improvisational Music Therapy on Joint Attention Behaviors in Autistic Children: A Randomized Controlled Study Randomized comparison of two communication interventions for preschoolers with autism spectrum disorders. Systemizing empathy: teaching adults with Asperger syndrome or high-functioning autism to recognize complex emotions using interactive multimedia. Randomized Controlled Trial of the Focus Parent Training for Toddlers with Autism: 1-Year Outcome Teacher-implemented joint attention intervention: pilot randomized controlled study for preschoolers with autism. Cognitive Enhancement Therapy for Adults with Autism Spectrum Disorder: Results of an 18-month Feasibility Study Treatment of Children with Autism: A Randomized Controlled Trial to Evaluate a Caregiver‐Based Intervention Program in Community Day‐Care Centers Randomized trial of intensive early intervention for children with pervasive developmental disorder. Social Stories: Mechanisms of Effectiveness in Increasing Game Play Skills in Children Diagnosed with Autism Spectrum Disorder Using a Pretest Posttest Repeated Measures Randomized Control Group Design Relationship-Focused Early Intervention With Children With Pervasive Developmental Disorders and Other Disabilities: A Comparative Study Prevalence of pervasive developmental disorders in the British nationwide survey of child mental health Using computerized games to teach face recognition skills to children with autism spectrum disorder: the Let's Face It! program. Social skills improvement in children with high-functioning autism: a pilot randomized controlled trial The development and evaluation of a computer-based program to test and to teach the recognition of facial affect Using The Transporters DVD as a Learning Tool for Children with Autism Spectrum Disorders (ASD) Children with autism's response to novel stimuli while participating in interventions targeting joint attention or symbolic play skills Children with Autism Display more Social Behaviors after Repeated Imitation Sessions A new social communication intervention for children with autism: pilot randomised controlled treatment study suggesting effectiveness. Promoting Imitation in Young Children with Autism: A Comparison of Reciprocal Imitation Training and Video Modeling The effectiveness of Picture Exchange Communication System (PECS) training for teachers of children with autism: a pragmatic, group randomised controlled trial. Thought-Bubbles Help Children with Autism Acquire an Alternative to a Theory of Mind Evaluation of a New Computer Intervention to Teach People with Autism or Asperger Syndrome to Recognize and Predict Emotions in Others Intervention targeting development of socially synchronous engagement in toddlers with autism spectrum disorder: a randomized controlled trial. Preschool Based JASPER Intervention in Minimally Verbal Children with Autism: Pilot RCT RCT of a Manualized Social Treatment for High-Functioning Autism Spectrum Disorders Teaching emotion recognition skills to young children with autism: a randomised controlled trial of an emotion training programme. Emotional, motivational and interpersonal responsiveness of children with autism in improvisational music therapy Prospective trial of equine-assisted activities in autism spectrum disorder. Learning through interaction in children with autism: Preliminary data from asocial-communication-based intervention The Social Communication Intervention Project: a randomized controlled trial of the effectiveness of speech and language therapy for school-age children who have pragmatic and social communication problems with or without autism spectrum disorder. A randomized controlled trial of preschool-based joint attention intervention for children with autism. A play and joint attention intervention for teachers of young children with autism: A randomized controlled pilot study A pilot randomised control trial of a parent training intervention for pre-school children with autism
  
abstract: Background Previous research has suggested that music therapy may facilitate skills in areas typically affected by autism spectrum disorders such as social interaction and communication . However , generalisability of previous findings has been restricted , as studies were limited in either method ological accuracy or the clinical relevance of their approach . The aim of this study is to determine effects of improvisational music therapy on social communication skills of children with autism spectrum disorders . An additional aim of the study is to examine if variation in dose of treatment ( i.e. , number of music therapy sessions per week ) affects outcome of therapy , and to determine cost-effectiveness . Methods / Design Children aged between 4;0 and 6;11 years who are diagnosed with autism spectrum disorder will be r and omly assigned to one of three conditions . Parents of all participants will receive three sessions of parent counselling ( at 0 , 2 , and 5 months ) . In addition , children r and omised to the two intervention groups will be offered individual , improvisational music therapy over a period of five months , either one session ( low-intensity ) or three sessions ( high-intensity ) per week . Generalised effects of music therapy will be measured using st and ardised scales completed by blinded assessors ( Autism Diagnostic Observation Schedule , ADOS ) and parents ( Social Responsiveness Scale , SRS ) before and 2 , 5 , and 12 months after r and omisation . Cost effectiveness will be calculated as man years . A group sequential design with first interim look at N = 235 will ensure both power and efficiency . Discussion Responding to the need for more rigorously design ed trials examining the effectiveness of music therapy in autism spectrum disorders , this pragmatic trial sets out to generate findings that will be well generalisable to clinical practice . Addressing the issue of dose variation , this study 's results will also provide information on the relevance of session frequency for therapy outcome .Trial Registration Current Controlled Trials IS RCT N78923965 This study reports results of a r and omized controlled trial aim ed at joint attention ( JA ) and symbolic play ( SP ) in preschool children with autism , with prediction to language outcome 12 months later . Participants were 58 children ( 46 boys ) with autism between 3 and 4 years of age . Children were r and omized to a JA intervention , an SP intervention , or control group . Interventions were conducted 30 min daily for 5 - 6 weeks . Assessment s of JA skills , SP skills , mother-child interactions , and language development were collected at 4 time points : pre- and postintervention and 6 and 12 months postintervention by independent testers . Results indicate that expressive language gains were greater for both treatment groups compared with the control group , and results could not be explained by differences in other interventions in which children participated . For children beginning treatment with the lowest language levels , the JA intervention improved language outcome significantly more than did the SP or control interventions . These findings suggest clinical ly significant benefits of actively treating JA and SP skills in young children with autism Despite the psychosocial difficulties common among young adults with autism spectrum disorders ( ASD ) , little to no evidence -based social skills interventions exist for this population . Using a r and omized controlled trial ( RCT ) design , the current study tested the effectiveness of an evidence -based , caregiver-assisted social skills intervention known as PEERS for Young Adults  with high-functioning young adults with ASD ( ages 18–23 ) using self- and caregiver-report measures . Results revealed that treated young adults reported significantly less loneliness and improved social skills knowledge , while caregivers reported significant improvements in young adults ’ overall social skills , social responsiveness , empathy , and frequency of get-togethers . Results support the effectiveness of using this caregiver-assisted , manualized intervention for young adults with ASD BACKGROUND Delays and deficits in joint attention and symbolic play constitute two important developmental problems in young children with autism . These areas of deficit have been well studied in autism but have rarely been the focus of treatment efforts ( see Kasari , Freeman , & Paparella , 2001 ) . In this study , we examine the efficacy of targeted interventions of joint attention and symbolic play . METHODS Participants were 58 children with autism aged 3 and 4 years ( 46 boys ) . Children were r and omized to a joint attention intervention , a symbolic play intervention , or control group . Interventions were conducted 30 minutes daily for 5 - 6 weeks . Both structured assessment s of joint attention and play skills and mother-child interactions were collected pre and post intervention by independent assessors . RESULTS Results indicate that both intervention groups improved significantly over the control group on certain behaviors . Children in the joint attention intervention initiated significantly more showing and responsiveness to joint attention on the structured joint attention assessment and more child-initiated joint attention in the mother-child interaction . The children in the play group showed more diverse types of symbolic play in interaction with their mothers and higher play levels on both the play assessment and in interaction with their mothers . CONCLUSIONS This r and omized controlled trial provides promising data on the specificity and generalizability of joint attention and play interventions for young children with autism . Future studies need to examine the long-term effects of these early interventions on children 's development This study assessed the efficacy of FaceSay , a computer-based social skills training program for children with Autism Spectrum Disorders ( ASD ) . This r and omized controlled study ( N = 49 ) indicates that providing children with low-functioning autism ( LFA ) and high functioning autism ( HFA ) opportunities to practice attending to eye gaze , discriminating facial expressions and recognizing faces and emotions in FaceSay ’s structured environment with interactive , realistic avatar assistants improved their social skills abilities . The children with LFA demonstrated improvements in two areas of the intervention : emotion recognition and social interactions . The children with HFA demonstrated improvements in all three areas : facial recognition , emotion recognition , and social interactions . These findings , particularly the measured improvements to social interactions in a natural environment , are encouraging BACKGROUND The study aim ed to investigate the effectiveness of a new multi-component social skills intervention for children with Asperger syndrome ( AS ) : The Junior Detective Training Program . This 7-week program included a computer game , small group sessions , parent training sessions and teacher h and outs . METHOD Forty-nine children with AS were recruited to participate and r and omly assigned to intervention ( n = 26 ) or wait-list control ( n = 23 ) conditions . RESULTS Relative to children in the wait-list group , program participants showed greater improvements in social skills over the course of the intervention , as indicated by parent-report measures . Teacher-report data also confirmed that children receiving the intervention made significant improvements in social functioning from pre- to post-treatment . Treatment group participants were better able to suggest appropriate emotion-management strategies for story characters at post-intervention than at pre-intervention , whereas control participants were not . However , there was no difference in the improvements made by children in the intervention and control conditions on facial expression and body-posture recognition measures . Follow-up data suggested that treatment gains were maintained by children at 5-months post-intervention . CONCLUSIONS The Junior Detective Training Program appeared to be effective in enhancing the social skills and emotional underst and ing of children with AS . Limitations and suggestions for future research are discussed We piloted a 2-week “ Autism-1 - 2 - 3 ” early intervention for children with autism and their parents immediately after diagnosis that targeted at ( 1 ) eye contact , ( 2 ) gesture and ( 3 ) vocalization/words .  Seventeen children were r and omized into the Intervention ( n = 9 ) and Control ( n = 8) groups . Outcome measures included the Autism Diagnostic Observation Schedule , Ritvo-Freeman Real Life Rating Scale , Symbolic Play Test , and Parenting Stress Index .  Children with autism improved in language /communication , reciprocal social interaction , and symbolic play . Parents perceived significant improvement in their children ’s language , social interaction , and their own stress level . This intervention can serve as short-term training on communication and social interaction for children with autism , and reduce the stress of their parents during the long waiting time for public health services OBJECTIVE : To conduct a r and omized , controlled trial to evaluate the efficacy of the Early Start Denver Model ( ESDM ) , a comprehensive developmental behavioral intervention , for improving outcomes of toddlers diagnosed with autism spectrum disorder ( ASD ) . METHODS : Forty-eight children diagnosed with ASD between 18 and 30 months of age were r and omly assigned to 1 of 2 groups : ( 1 ) ESDM intervention , which is based on developmental and applied behavioral analytic principles and delivered by trained therapists and parents for 2 years ; or ( 2 ) referral to community providers for intervention commonly available in the community . RESULTS : Compared with children who received community-intervention , children who received ESDM showed significant improvements in IQ , adaptive behavior , and autism diagnosis . Two years after entering intervention , the ESDM group on average improved 17.6 st and ard score points ( 1 SD : 15 points ) compared with 7.0 points in the comparison group relative to baseline scores . The ESDM group maintained its rate of growth in adaptive behavior compared with a normative sample of typically developing children . In contrast , over the 2-year span , the comparison group showed greater delays in adaptive behavior . Children who received ESDM also were more likely to experience a change in diagnosis from autism to pervasive developmental disorder , not otherwise specified , than the comparison group . CONCLUSIONS : This is the first r and omized , controlled trial to demonstrate the efficacy of a comprehensive developmental behavioral intervention for toddlers with ASD for improving cognitive and adaptive behavior and reducing severity of ASD diagnosis . Results of this study underscore the importance of early detection of and intervention in autism Children with autism exhibit significant deficits in imitation skills .  Reciprocal Imitation Training ( RIT ) , a naturalistic imitation intervention , was developed to teach young children with autism to imitate during play . This study used a r and omized controlled trial to evaluate the efficacy of RIT on elicited and spontaneous imitation skills in 21 young children with autism . Results found that children in the treatment group made significantly more gains in elicited and spontaneous imitation , replicating previous single-subject design studies . Number of spontaneous play acts at pre-treatment was related to improvements in imitation during the intervention , suggesting that children with a greater play repertoire make greater gains during RIT PURPOSE This r and omized group experiment compared the efficacy of 2 communication interventions ( Responsive Education and Prelinguistic Milieu Teaching [ RPMT ] and the Picture Exchange Communication System [ PECS ] ) on spoken communication in 36 preschoolers with autism spectrum disorders ( ASD ) . METHOD Each treatment was delivered to children for a maximum total of 24 hr over a 6-month period . Spoken communication was assessed in a rigorous test of generalization at pretreatment , posttreatment , and 6-month follow-up periods . RESULTS PECS was more successful than RPMT in increasing the number of nonimitative spoken communication acts and the number of different nonimitative words used at the posttreatment period . Considering growth over all 3 measurement periods , an exploratory analysis showed that growth rate of the number of different nonimitative words was faster in the PECS group than in the RPMT group for children who began treatment with relatively high object exploration . In contrast , analogous slopes were steeper in the RPMT group than in the PECS group for children who began treatment with relatively low object exploration Many children with Autism Spectrum Disorders ( ASD ) participate in social skills or Theory of Mind ( ToM ) treatments . However , few studies have shown evidence for their effectiveness . The current study used a r and omized controlled design to test the effectiveness of a 16-week ToM treatment in 8–13 year old children with ASD and normal IQs ( n = 40 ) . The results showed that , compared to controls , the treated children with ASD improved in their conceptual ToM skills , but their elementary underst and ing , self reported empathic skills or parent reported social behaviour did not improve . Despite the effects on conceptual underst and ing , the current study does not indicate strong evidence for the effectiveness of a ToM treatment on the daily life mindreading skills A r and omized controlled design was employed to evaluate a social skills intervention for children with pervasive developmental disorders . Aims included evaluating the acceptability of the program and gathering preliminary evidence on efficacy . Forty-four children , ages 8–11 years , were r and omly assigned to  treatment or wait list . Treatment consisted of a 16-week group intervention design ed to teach appropriate social behavior . Between group comparisons showed that children in treatment were rated as improved on the primary outcome measure , ( unblinded parent report ) , but not on the secondary outcome measure , a parent question naire . Parents reported a high level of satisfaction with the intervention . The study supports the feasibility of this intervention to families and highlights challenges for future research in social skills intervention This study aim ed to determine if a joint attention intervention would result in greater joint engagement between caregivers and toddlers with autism . The intervention consisted of  24 caregiver-mediated sessions  with follow-up 1 year later . Compared to caregivers and toddlers r and omized to the waitlist control group the immediate treatment ( IT ) group made significant improvements in targeted areas of joint engagement . The IT group demonstrated significant improvements with medium to large effect sizes in their responsiveness to joint attention and their diversity of functional play acts after the intervention with maintenance of these skills 1 year post-intervention . These are among the first r and omized controlled data to suggest that short-term parent-mediated  interventions can have important effects on core impairments in toddlers with autism . Clinical Trials # : NCT00065910 BACKGROUND Deficits in joint attention are considered by many research ers to be an early predictor of childhood autism ( e.g. , Osterling & Dawson , 1994 ) and are considered to be pivotal to deficits in language , play , and social development in this population ( Mundy , 1995 ) . Although many research ers have noted the importance of joint attention deficits in the development of children with autism ( e.g. , Mundy , Sigman , & Kasari , 1994 ) and have called for intervention strategies ( e.g. , Mundy & Crowson , 1997 ) , few studies have attempted to target joint attention . In this study , joint attention behaviors were taught to children with autism using a behavior modification procedure . METHODS A multiple-baseline design was implemented to evaluate intervention effects . The following target behaviors were included in the intervention : 1 )  Responding to showing , pointing , and gaze shifting of adult ;  2 ) Coordinated gaze shifting  ( i.e. , coordinated joint attention ) ; and 3 )  Pointing ( with the purpose of  sharing  , not requesting ) . Generalization to setting and parent , follow-up sessions , and social validation measures were also analyzed . RESULTS Joint attention behaviors were effectively trained and targeted behaviors generalized to other setting s. In addition , positive changes were noted by naive observers using social validation measures . CONCLUSIONS Integrating joint attention training into existing interventions may be important for children with autism . In addition , training parents in these techniques may help to maintain joint attention skills outside of the treatment setting This pilot study tested the effect of cognitive behavioral therapy ( CBT ) on  parent-reported autism symptoms . Nineteen children with autism spectrum disorders and an anxiety disorder ( 7–11 years old ) were r and omly assigned to 16 sessions of CBT or a waitlist condition . The CBT program emphasized in vivo exposure supported by parent training and school consultation to promote social communication and emotion regulation skills . Parents completed a st and ardized autism symptom checklist at baseline and posttreatment/postwaitlist and 3-month follow-up assessment s. CBT outperformed the waitlist condition at posttreatment/postwaitlist on total parent-reported autism symptoms ( Cohen ’s d effect size = .77 ) . Treatment gains were maintained at 3-month follow-up . Further investigation of this intervention modality with larger sample s and broader outcome measures appears to be indicated A repeated- measures , waiting list control design was used to assess efficacy of a  social skills intervention for autistic spectrum children focused on individual and group LEGO © play . The intervention combined aspects of behavior therapy , peer modeling and naturalistic communication strategies . Close interaction and joint attention to task play an important role in both group and individual therapy activities . The goal of treatment was to improve social competence ( SC ) which was construed as reflecting three components : ( 1 ) motivation to initiate social contact with peers ; ( 2 ) ability to sustain interaction with peers for a period of time ; and ( 3 ) overcoming autistic symptoms of aloofness and rigidity . Measures for the first two variables were based on observation of subjects in unstructured situations with peers ; and the third variable was assessed using a structured rating scale , the SI subscale of the GARS . Results revealed significant improvement on all three measures at both 12 and 24 weeks with no evidence of gains during the waiting list period . No gender differences were found on outcome , and age of clients was not correlated with outcome . LEGO © play appears to be a particularly effective medium for social skills intervention , and other research ers and clinicians are encouraged to attempt replication of this work , as well as to explore use of LEGO © in other method ologies , or with different clinical population Summary Background Results of small trials suggest that early interventions for social communication are effective for the treatment of autism in children . We therefore investigated the efficacy of such an intervention in a larger trial . Methods Children with core autism ( aged 2 years to 4 years and 11 months ) were r and omly assigned in a one-to-one ratio to a parent-mediated communication-focused ( Preschool Autism Communication Trial [ PACT ] ) intervention or treatment as usual at three specialist centres in the UK . Those assigned to PACT were also given treatment as usual . R and omisation was by use of minimisation of probability in the marginal distribution of treatment centre , age ( ≤42 months or > 42 months ) , and autism severity ( Autism Diagnostic Observation Schedule-Generic [ ADOS-G ] algorithm score 12–17 or 18–24 ) . Primary outcome was severity of autism symptoms ( a total score of social communication algorithm items from ADOS-G , higher score indicating greater severity ) at 13 months . Complementary secondary outcomes were measures of parent-child interaction , child language , and adaptive functioning in school . Analysis was by intention to treat . This study is registered as an International St and ard R and omised Controlled Trial , number IS RCT N58133827 . Results 152 children were recruited . 77 were assigned to PACT ( London [ n=26 ] , Manchester [ n=26 ] , and Newcastle [ n=25 ] ) ; and 75 to treatment as usual ( London [ n=26 ] , Manchester [ n=26 ] , and Newcastle [ n=23 ] ) . At the 13-month endpoint , the severity of symptoms was reduced by 3·9 points ( SD 4·7 ) on the ADOS-G algorithm in the group assigned to PACT , and 2·9 ( 3·9 ) in the group assigned to treatment as usual , representing a between-group effect size of −0·24 ( 95 % CI −0·59 to 0·11 ) , after adjustment for centre , sex , socioeconomic status , age , and verbal and non-verbal abilities . Treatment effect was positive for parental synchronous response to child ( 1·22 , 0·85 to 1·59 ) , child initiations with parent ( 0·41 , 0·08 to 0·74 ) , and for parent-child shared attention ( 0·33 , −0·02 to 0·68 ) . Effects on directly assessed language and adaptive functioning in school were small . Interpretation On the basis of our findings , we can not recommend the addition of the PACT intervention to treatment as usual for the reduction of autism symptoms ; however , a clear benefit was noted for parent-child dyadic social communication . Funding UK Medical Research Council , and UK Department for Children , Schools and Families This study tested the efficacy of a new social skills intervention , SocialSkillsGRoupINtervention-High Functioning Autism ( S.S.GRIN-HFA ) , design ed to improve social behaviors in children with high functioning autism spectrum disorders . Fifty-five children were r and omly assigned to S.S.GRIN-HFA treatment ( n = 27 ) or control ( i.e. , traditional S.S.GRIN intervention ; n = 28 ) . Examination of the direction and magnitude of change in functioning revealed that children who participated in S.S.GRIN-HFA exhibited significantly greater mastery of social skill concepts compared to children in the control group . Parents of S.S.GRIN-HFA group participants reported an improved sense of social self-efficacy , whereas parents of control participants reported a decline . The advantages of a specialized intervention such as S.S.GRIN-HFA , design ed specifically for children with high functioning autism spectrum disorders , are discussed Imitation is an early skill thought to play a role in social development , leading some to suggest that teaching imitation to children with autism should lead to improvements in social functioning . This study used a r and omized controlled trial to evaluate the effect of a focused imitation intervention on initiation of joint attention and social-emotional functioning in 27 young children with autism . Results indicated the treatment group made significantly more gains in joint attention initiations at post-treatment and follow-up and social-emotional functioning at follow-up than the control group . Although gains in social functioning were associated with treatment , a mediation analysis did not support imitation as the mechanism of action . These findings suggest the intervention improves social functioning in children with ASD BACKGROUND This r and omized controlled trial compared Hanen 's ' More than Words ' ( HMTW ) , a parent-implemented intervention , to a ' business as usual ' control group . METHODS Sixty-two children ( 51 boys and 11 girls ; M age = 20 months ; SD = 2.6 ) who met criteria for autism spectrum disorders ( ASD ) and their parents participated in the study . The HMTW intervention was provided over 3.5 months . There were three measurement periods : prior to r and omization ( Time 1 ) and at 5 and 9 months post enrollment ( Times 2 and 3 ) . Children 's communication and parental responsivity were measured at each time point . Children 's object interest , a putative moderator , was measured at Time 1 . RESULTS There were no main effects of the HMTW intervention on either parental responsivity or children 's communication . However , the effects on residualized gains in parental responsivity from Time 1 to both Times 2 and 3 yielded noteworthy effect sizes ( Glass 's Δ = .71 , .50 respectively ) . In contrast , there were treatment effects on child communication gains to Time 3 that were moderated by children 's Time 1 object interest . Children with lower levels of Time 1 object interest exhibited facilitated growth in communication ; children with higher levels of object interest exhibited growth attenuation . CONCLUSIONS The HMTW intervention showed differential effects on child communication depending on a baseline child factor . HMTW facilitated communication in children with lower levels of Time 1 object interest . Parents of children who evidence higher object interest  may require greater support to implement the HMTW strategies , or may require different strategies than those provided by the HMTW curriculum The purpose of this study was to investigate the effects of improvisational music therapy on joint attention behaviors in pre-school children with autism . It was a r and omized controlled study employing a single subject comparison design in two different conditions , improvisational music therapy and play sessions with toys , and using st and ardized tools and DVD analysis of sessions to evaluate behavioral changes in children with autism . The overall results indicated that improvisational music therapy was more effective at facilitating joint attention behaviors and non-verbal social communication skills in children than play . Session analysis showed significantly more and lengthier events of eye contact and turn-taking in improvisational music therapy than play sessions . The implication s of these findings are discussed further This r and omized group experiment compared the efficacy of 2 communication interventions ( Responsive Education and Prelinguistic Milieu Teaching [ RPMT ] and the Picture Exchange Communication System [ PECS ] ) in 36 preschoolers with autism spectrum disorders . Each treatment was delivered 3 times per week , in 20-min sessions , for 6 months . The results revealed that the RPMT facilitated the frequency of generalized turn taking and generalized initiating joint attention more than did the PECS . The latter effect occurred only for children who began treatment with at least some initiating joint attention . In contrast , the PECS facilitated generalized requests more than the RPMT in children with very little initiating joint attention prior to treatment . These effect sizes were large This study evaluated Mind Reading , an interactive systematic guide to emotions , for its effectiveness in teaching adults with Asperger syndrome ( AS ) and high-functioning autism ( HFA ) to recognize complex emotions in faces and voices . Experiment 1 tested a group of adults diagnosed with AS/HFA ( n = 19 ) who used the software at home for 10 - 15 weeks . Participants were tested on recognition of faces and voices at three different levels of generalization . A matched control group of adults with AS/HFA ( n = 22 ) were assessed without any intervention . In addition , a third group of general population controls ( n = 24 ) was tested . Experiment 2 repeated the design of Experiment 1 with a group of adults with AS/HFA who used the software at home and met in a group with a tutor on a weekly basis . They were matched to a control group of adults with AS/HFA attending social skills training and to a general population control group ( n = 13 for all three groups ) . In both experiments the intervention group improved significantly more than the control group on close , but not distant , generalization tasks . Verbal IQ had significant effects in Experiment 2 . Using Mind Reading for a relatively short period of time allows users to learn to recognize a variety of complex emotions and mental states . However , additional methods are required to enhance generalization This r and omized controlled trial compared results obtained after 12 months of nonintensive parent training plus care-as-usual and care-as-usual alone . The training focused on stimulating joint attention and language skills and was based on the intervention described by Drew et al. ( Eur Child Adolesc Psychiatr 11:266–272 , 2002 ) . Seventy-five toddlers with autism spectrum disorder ( 65 autism , 10 PDD-NOS , mean age = 34.4 months , SD = 6.2 ) were enrolled . Analyses were conducted on a final sample of 67 children ( lost to follow-up = 8) . No significant intervention effects were found for any of the primary ( language ) , secondary ( global clinical improvement ) , or mediating ( child engagement , early precursors of social communication , or parental skills ) outcome variables , suggesting that the ‘ Focus parent training ’ was not of additional value to the more general care-as-usual OBJECTIVE The vast majority of children with an autism spectrum disorder ( ASD ) attend public preschools at some point in their childhood . Community preschool practice s often are not evidence based , and almost none target the prelinguistic core deficits of ASD . This study investigated the effectiveness of public preschool teachers implementing a vali date d intervention ( the Joint Attention and Symbolic Play/Engagement and Regulation intervention ; JASP/ER ) on a core deficit of autism , initiating joint attention . METHOD Sixteen dyads ( preschoolers with ASD and the public school teachers who worked in the child 's classroom ) were r and omly assigned to the 6-week JASP/ER intervention or a control group . RESULTS At the end of the intervention , JASP/ER teachers used more  JASP/ER strategies than the control teachers , and JASP/ER preschoolers used more joint attention in their classroom than control children . Additionally , JASP/ER children spent more time in supported engagement and less time in object engagement than control preschoolers on a taped play interaction . CONCLUSIONS Findings suggest that teachers were able to improve a core deficit of children with ASD in a public preschool context Adults with autism experience significant impairments in social and non-social information processing for which few treatments have been developed . This study conducted an 18-month uncontrolled trial of Cognitive Enhancement Therapy ( CET ) , a comprehensive cognitive rehabilitation intervention , in 14 verbal adults with autism spectrum disorder to investigate its feasibility , acceptability , and initial efficacy in treating these impairments . Results indicated that CET was satisfying to participants , with high treatment attendance and retention . Effects on cognitive deficits and social behavior were also large ( d = 1.40–2.29 ) and statistically significant ( all p < .001 ) . These findings suggest that CET is a feasible , acceptable , and potentially effective intervention for remediating the social and non-social cognitive impairments in verbal adults with autism & NA ; This study reports on the results of a r and omized controlled trial that evaluated a caregiverbased intervention program for children with autism in community day‐care centers . Thirty‐five preschool children with a DSM III‐R diagnosis of autism or pervasive developmental disorder were r and omized to an experimental or control group . Children in the experimental group were enrolled in day care and their parents and child care workers received a 12‐week intervention consisting of lectures and on‐site consultations to day‐care centers . In addition , supportive work was undertaken with families . Control subjects received day care alone . In the experimental group , there were greater gains in language abilities , significant increases in caregivers ' knowledge about autism , greater perception of control on the part of mothers , and greater parent satisfaction . We conclude that this research design demonstrated that the intervention was significantly superior to day care alone Young children with pervasive developmental disorder were r and omly assigned to intensive treatment or parent training . The  intensive treatment group ( 7 with autism , 8 with pervasive developmental disorder not otherwise specified -- NOS ) averaged 24.52 hours per week of individual treatment for one year , gradually reducing hours over the next 1 to 2 years . The  parent training group ( 7 with autism , 6 with pervasive developmental disorder NOS ) received 3 to 9 months of parent training . The groups appeared similar at intake on all measures ; however , at follow-up the intensive treatment group outperformed the parent training group on measures of intelligence , visual-spatial skills , language , and academics , though not adaptive functioning or behavior problems .  Children with pervasive developmental disorder NOS may have gained more than those with autism An increasing body of literature has indicated that social stories are an effective way to teach individuals diagnosed with autism appropriate social behavior . This study compared two formats of a social story targeting the improvement of social skills during game play using a pretest posttest repeated measures r and omized control group design . A total of 45 children diagnosed with Autism Spectrum Disorder ( ASD ) ages 7–14 were r and omly assigned to st and ard , directive , or control story conditions . Results demonstrated that the st and ard and directive story formats were equally as effective in eliciting , generalizing and maintaining the targeted social skills in participants who had prior game play experience and Verbal Comprehension Index ( VCI ) scores from the WISC-IV intelligence test in the borderline range or above ABSTRACT . This study compares the effects of relationship-focused early intervention on toddlers and preschool-age children who were classified as having either pervasive developmental disorders ( PDDs ) ( N = 20 ) or developmental disabilities ( DDs ) ( N = 30 ) . The intervention was conducted over a 1-year period through weekly individual parent-child sessions . It focused on helping parents use responsive teaching strategies to encourage their children to acquire and use pivotal developmental behaviors that addressed their individualized developmental needs . Before and after comparisons indicated significant increases in parents ' responsiveness and children 's pivotal behavior . Both groups of children made significant improvements in their cognitive , communication , and socioemotional functioning . However , children with PDDs made statistically greater improvements on the developmental measures than children with DDs . On several developmental measures , children 's improvements were related to increases in both their parents ' responsiveness and their own pivotal behavior The prevalence of pervasive developmental disorders ( PDD ) is not well established and needs monitoring . We investigated the prevalence of PDDs in the 1999 nationwide British survey of child and adolescent mental health . A r and omized stratified sample of children ( n = 12,529 ) aged 5 - 15 was generated from Child Benefit Records . Trained interviewers interviewed parents and youths aged 11 or older with a st and ardized diagnostic interview ( Development and Well-Being Assessment ) and question naire data ( Strengths and Difficulties Question naire ) were obtained from teachers and parents who also completed self-report measures of psychological distress . A team of experienced clinicians using all data sources achieved final diagnostic determination . A total of 10,438 ( 83 % ) interviews were conducted . There were two girls with Rett syndrome ( weighted prevalence : 3.8/10,000 girls ) and 27 children with other PDDs ( weighted prevalence : 26.1/10,000 ) . Compared to children with a psychiatric disorder other than PDD , social but not behavioural problems were more frequent in the PDD group . Parents of children with PDDs had higher rates of psychological distress than those from the two comparison groups . Consistent with other recent surveys , PDD rates are higher than those reported 30 years ago . The burden associated with PDDs is very high BACKGROUND An emerging body of evidence indicates that relative to typically developing children , children with autism are selectively impaired in their ability to recognize facial identity . A critical question is whether face recognition skills can be enhanced through a direct training intervention . METHODS In a r and omized clinical trial , children diagnosed with autism spectrum disorder were pre-screened with a battery of subtests ( the Let 's Face It ! Skills battery ) examining face and object processing abilities . Participants who were significantly impaired in their face processing abilities were assigned to either a treatment or a waitlist group . Children in the treatment group ( N = 42 ) received 20 hours of face training with the Let 's Face It ! ( LFI ! ) computer-based intervention . The LFI ! program is comprised of seven interactive computer games that target the specific face impairments associated with autism , including the recognition of identity across image changes in expression , viewpoint and features , analytic and holistic face processing strategies and attention to information in the eye region . Time 1 and Time 2 performance for the treatment and waitlist groups was assessed with the Let 's Face It ! Skills battery . RESULTS The main finding was that relative to the control group ( N = 37 ) , children in the face training group demonstrated reliable improvements in their analytic recognition of mouth features and holistic recognition of a face based on its eyes features . CONCLUSION These results indicate that a relatively short-term intervention program can produce measurable improvements in the face recognition skills of children with autism . As a treatment for face processing deficits , the Let 's Face It ! program has advantages of being cost-free , adaptable to the specific learning needs of the individual child and suitable for home and school applications High-functioning autism ( HFA ) is characterized by persistent impairment in social interaction despite the absence of mental retardation . Although an increasing number of group-based programs for the improvement of social skills have been described , r and omized controlled trials are needed to evaluate their efficacy . To compare the effect of a Social Skills Training Group-based Program ( SST-GP ) and a Leisure Activities Group-based Program ( LA-GP ) on the perception of facial emotions and quality of life ( QoL ) in young people with HFA . Eligible patients were children and adolescents with HFA . Participants were r and omized to the SST or LA group . The primary outcome was defined as an improvement of 2 points in error rates for facial emotion labeling ( DANVA2 ) from baseline . After the 6-month training period , the SST Group made fewer errors in labeling anger on adult faces , whereas error rates in the LA Group remained stable . Progress in the ability to recognize anger in the SST Group was due to better recognition of low intensity stimuli on adult faces . QoL increased in the SST Group in the dimension of school environment , as a marker of the transfer of skills acquired in the treatment setting to their use in the community . The SST-GP had higher efficacy than the LA-GP . Data justify replication using larger sample Autism is a chronic pervasive neurodevelopmental disorder characterized by the early onset of social and communicative impairments as well as restricted , ritualized , stereotypic behavior . The endophenotype of autism includes neuropsychological deficits , for instance a lack of “ Theory of Mind ” and problems recognizing facial affect . In this study , we report the development and evaluation of a computer-based program to teach and test the ability to identify basic facially expressed emotions .  10 adolescent or adult subjects with high-functioning autism or Asperger-syndrome were included in the investigation . A priori the facial affect recognition test had shown good psychometric properties in a normative sample ( internal consistency : rtt=.91-.95 ; retest reliability : rtt=.89-.92 ) . In a prepost design , one half of the sample was r and omly assigned to receive computer treatment while the other half of the sample served as control group . The training was conducted for five weeks , consisting of two hours training a week . The trained individuals improved significantly on the affect recognition task , but not on any other measure . Results support the usefulness of the program to teach the detection of facial affect . However , the improvement found is limited to a circumscribed area of social-communicative function and generalization is not ensured Data from two groups of children who were r and omly allocated to those groups showed that the ability of children with ASD to identify and label basic and complex facial expressions following a 3-week home based DVD intervention significantly improved when viewing The Transporters DVD . Improvements in emotion recognition appear related to the content of the DVD as participants in a control group who observed an alternate DVD showed no such improvement . Although social behaviour improved significantly as a result of watching The Transporters , a significant improvement in social behaviour was however , also observed in the Thomas the Tank Engine condition suggesting the unique content of The Transporters DVD was not pivotal to the improvement of social behaviour in general Thirty-five children diagnosed with autism were r and omly assigned to either a joint attention or a symbolic play intervention . During the 5—8 week treatment , three novel probes were administered to determine mastery of joint attention skills . The probes consisted of auditory and visual stimuli , such as a loud spider crawling or a musical ball bouncing . The current study examined affect , gaze , joint attention behaviors , and verbalizations at three different time points of intervention . Results revealed that children r and omized to the joint attention group were more likely to acknowledge the probe and engage in shared interactions between intervener and probe upon termination of intervention . Additionally , the joint attention group improved in the proportion of time spent sharing coordinated joint looks between intervener and probe . These results suggest that generalization of joint attention skills to a novel probe did occur for the group targeting joint attention and provides further evidence of the effectiveness of the joint attention intervention Based on earlier studies , an adult ’s imitations of the behaviors of children with autism lead to increased social behavior in the children . The present study explored the effects of repeated sessions of imitation .  Twenty children were recruited from a school for children with autism to attend three sessions during which an adult either imitated all of the children ’s behaviors or simply played with the child . During the second session the children in the imitation group spent a greater proportion of time showing distal social behaviors toward the adult including : ( 1 ) looking ; ( 2 ) vocalizing ; ( 3 ) smiling ; and ( 4 ) engaging in reciprocal play . During the third session , the children in the imitation group spent a greater proportion of time showing proximal social behaviors toward the adult including : ( 1 ) being close to the adult ; ( 2 ) sitting next to the adult ; and ( 3 ) touching the adult . These data suggest the potential usefulness of adult imitative behavior as an early intervention BACKGROUND Psychosocial treatments are the mainstay of management of autism in the UK but there is a notable lack of a systematic evidence base for their effectiveness . R and omised controlled trial ( RCT ) studies in this area have been rare but are essential because of the developmental heterogeneity of the disorder . We aim ed to test a new theoretically based social communication intervention targeting parental communication in a r and omised design against routine care alone . METHODS The intervention was given in addition to existing care and involved regular monthly therapist contact for 6 months with a further 6 months of 2-monthly consolidation sessions . It aim ed to educate parents and train them in adapted communication tailored to their child 's individual competencies . Twenty-eight children with autism were r and omised between this treatment and routine care alone , stratified for age and baseline severity . Outcome was measured at 12 months from commencement of intervention , using st and ardised instruments . RESULTS All cases studied met full Autism Diagnostic Interview ( ADI ) criteria for classical autism . Treatment and controls had similar routine care during the study period and there were no study dropouts after treatment had started . The active treatment group showed significant improvement compared with controls on the primary outcome measure -- Autism Diagnostic Observation Schedule ( ADOS ) total score , particularly in reciprocal social interaction-- and on secondary measures of expressive language , communicative initiation and parent-child interaction . Suggestive but non-significant results were found in Vinel and Adaptive Behaviour Scales ( Communication Sub-domain ) and ADOS stereotyped and restricted behaviour domain . CONCLUSIONS A R and omised Treatment Trial design of this kind in classical autism is feasible and acceptable to patients . This pilot study suggests significant additional treatment benefits following a targeted ( but relatively non-intensive ) dyadic social communication treatment , when compared with routine care . The study needs replication on larger and independent sample s. It should encourage further RCT design s in this area The inability to imitate is a salient diagnostic marker for autism . It has been suggested that for children with autism , imitation may be a prerequisite skill that can assist in the development of various skills . Using a multiple baseline design across subjects , the purpose of this research was to determine if two interventions , reciprocal imitation training and video modeling were effective in promoting imitation acquisition in young children with autism . Six boys were matched across various features ( i.e. , age , language , autism severity ) and r and omly placed in a treatment condition . Results indicated that all six participants increased their imitation skills to varying degrees in both conditions , and imitation maintained and generalized at higher than baseline levels post treatment OBJECTIVE To assess the effectiveness of expert training and consultancy for teachers of children with autism spectrum disorder in the use of the Picture Exchange Communication System ( PECS ) . METHOD DESIGN Group r and omised , controlled trial ( 3 groups : immediate treatment , delayed treatment , no treatment ) . PARTICIPANTS 84 elementary school children , mean age 6.8 years . TREATMENT A 2-day PECS workshop for teachers plus 6 half-day , school-based training sessions with expert consultants over 5 months . OUTCOME MEASURES Rates of : communicative initiations , use of PECS , and speech in the classroom ; Autism Diagnostic Observation Schedule-Generic ( ADOS-G ) domain scores for Communication and Reciprocal Social Interaction ; scores on formal language tests . RESULTS Controlling for baseline age , developmental quotient ( DQ ) and language ; rates of initiations and PECS usage increased significantly immediately post-treatment ( Odds Ratio ( OR ) of being in a higher ordinal rate category 2.72 , 95 % confidence interval 1.22 - 6.09 , p < .05 and OR 3.90 ( 95%CI 1.75 - 8.68 ) , p < .001 , respectively ) . There were no increases in frequency of speech , or improvements in ADOS-G ratings or language test scores . CONCLUSIONS The results indicate modest effectiveness of PECS teacher training/consultancy . Rates of pupils ' initiations and use of symbols in the classroom increased , although there was no evidence of improvement in other areas of communication . TREATMENT effects were not maintained once active intervention ceased Children with autism have specific difficulties underst and ing complex mental states like thought , belief , and false belief and their effects on behaviour . Such children benefit from focused teaching , where beliefs are likened to photographs-in-the-head . Here two studies , one with seven participants and one with 10 , tested a picture- in-the-head strategy for dealing with thoughts and behaviour by teaching children with autism  about cartoon thought-bubbles as a device for representing such mental states . This prosthetic device led children with autism to pass not only false belief tests , but also related theory of mind tests . These results confirm earlier findings of the efficacy of picture-in-the-head teaching about mental states , but go further in showing that thought-bubble training more easily extends to children ’s underst and ing of thoughts ( not just behaviour ) and to enhanced performance on several transfer tasks . Thought-bubbles provide a theoretically interesting as well as an especially easy and effective teaching technique This r and omized controlled trial looked at the effect of a new computer program design ed to teach people with autistic spectrum disorders to better recognize and predict emotional responses in others . Two groups of 11 children ( age 12 - 18 ) with autism or Asperger syndrome at two special schools participated :  one group used the computer program for 10 half-hour sessions over 2 weeks . Within-program data showed a significant reduction in errors made from first to last use . Students were assessed pre- and post-intervention using facial expression photographs , cartoons depicting emotion-laden situations , and non-literal stories . Scores were not related to age or verbal ability . The experimental group made gains relative to the control group on all three measures . Gains correlated significantly with the number of times the computer program was used and results suggest positive effects . Further research could assess whether these gains generalized into real life or improved performance on theory of mind measures BACKGROUND Social and communication impairments are core deficits and prognostic indicators of autism . We evaluated the impact of supplementing a comprehensive intervention with a curriculum targeting socially synchronous behavior on social outcomes of toddlers with autism spectrum disorders ( ASD ) . METHODS Fifty toddlers with ASD , ages 21 to 33 months , were r and omized to one of two six-month interventions : Interpersonal Synchrony or Non-Interpersonal Synchrony . The interventions provided identical intensity ( 10 hours per week in classroom ) , student-to-teacher ratio , schedule , home-based parent training ( 1.5 hours per month ) , parent education ( 38 hours ) , and instructional strategies , except the Interpersonal Synchrony condition provided a supplementary curriculum targeting socially engaged imitation , joint attention , and affect sharing ; measures of these were primary outcomes . Assessment s were conducted pre-intervention , immediately post-intervention , and , to assess maintenance , at six-month follow-up . R and om effects models were used to examine differences between groups over time . Secondary analyses examined gains in expressive language and nonverbal cognition , and time effects during the intervention and follow-up periods . RESULTS A significant treatment effect was found for socially engaged imitation ( p = .02 ) , with more than doubling ( 17 % to 42 % ) of imitated acts paired with eye contact in the Interpersonal Synchrony group after the intervention . This skill was generalized to unfamiliar context s and maintained through follow-up . Similar gains were observed for initiation of joint attention and shared positive affect , but between-group differences did not reach statistical significance . A significant time effect was found for all outcomes ( p < .001 ) ; greatest change occurred during the intervention period , particularly in the Interpersonal Synchrony group . CONCLUSIONS This is the first ASD r and omized trial involving toddlers to identify an active ingredient for enhancing socially engaged imitation . Adding social engagement targets to intervention improves short-term outcome at no additional cost to the intervention . The social , language , and cognitive gains in our participants provide evidence for plasticity of these developmental systems in toddlers with ASD . http://www . clinical trials.gov/ct2/show/NCT00106210?term = l and a&rank = 3 In this pilot study , we tested the effects of a novel intervention ( JASPER , Joint Attention Symbolic Play Engagement and Regulation ) on 3 to 5 year old , minimally verbal children with autism who were attending a non-public preschool . Participants were r and omized to a control group ( treatment as usual , 30 h of ABA-based therapy per week ) or a treatment group ( substitution of 30 min of JASPER treatment , twice weekly during their regular program ) . A baseline of 12 weeks in which no changes were noted in core deficits was followed by 12 weeks of intervention for children r and omized to the JASPER treatment . Participants in the treatment group demonstrated greater play diversity on a st and ardized assessment . Effects also generalized to the classroom , where participants in the treatment group initiated more gestures and spent less time unengaged . These results provide further support that even brief , targeted interventions on joint attention and play can improve core deficits in minimally verbal children with ASD This RCT examined the efficacy of a manualized social intervention for children with HFASDs . Participants were r and omly assigned to treatment or wait-list conditions .  Treatment included instruction and therapeutic activities targeting social skills , face-emotion recognition , interest expansion , and interpretation of non-literal language . A response-cost program was applied to reduce problem behaviors and foster skills acquisition . Significant treatment effects were found for five of seven primary outcome measures ( parent ratings and direct child measures ) . Secondary measures based on staff ratings ( treatment group only ) corroborated gains reported by parents . High levels of parent , child and staff satisfaction were reported , along with high levels of treatment fidelity . St and ardized effect size estimates were primarily in the medium and large ranges and favored the treatment group BACKGROUND Children with autism have difficulties in emotion recognition and a number of interventions have been design ed to target these problems . However , few emotion training interventions have been trialled with young children with autism and co-morbid ID . This study aim ed to evaluate the efficacy of an emotion training programme for a group of young children with autism with a range of intellectual ability . METHODS Participants were 55 children with autistic disorder , aged 4 - 7 years ( FSIQ 42 - 107 ) . Children were r and omly assigned to an intervention ( n = 28 ) or control group ( n = 27 ) . Participants in the intervention group watched a DVD design ed to teach emotion recognition skills to children with autism  ( the Transporters ) , whereas the control group watched a DVD of Thomas the Tank Engine . Participants were assessed on their ability to complete basic emotion recognition tasks , mindreading and theory of mind ( TOM ) tasks before and after the 4-week intervention period , and at 3-month follow-up . RESULTS Analyses controlled for the effect of chronological age , verbal intelligence , gender and DVD viewing time on outcomes . Children in the intervention group showed improved performance in the recognition of anger compared with the control group , with few improvements maintained at 3-month follow-up . There was no generalisation of skills to TOM or social skills . CONCLUSIONS The Transporters programme showed limited efficacy in teaching basic emotion recognition skills to young children with autism with a lower range of cognitive ability . Improvements were limited to the recognition of expressions of anger , with poor maintenance of these skills at follow-up . These findings provide limited support for the efficacy of the Transporters programme for young children with autism of a lower cognitive range Through behavioural analysis , this study investigated the social-motivational aspects of musical interaction between the child and the therapist in improvisational music therapy by measuring emotional , motivational and interpersonal responsiveness in children with autism during joint engagement episodes . The r and omized controlled study ( n = 10 ) employed a single subject comparison design in two different conditions , improvisational music therapy and toy play sessions , and DVD analysis of sessions . Improvisational music therapy produced markedly more and longer events of ` joy ' , ` emotional synchronicity ' and ` initiation of engagement ' behaviours in the children than toy play sessions . In response to the therapist 's interpersonal dem and s , ` compliant ( positive ) responses ' were observed more in music therapy than in toy play sessions , and ` no responses ' were twice as frequent in toy play sessions as in music therapy . The results of this exploratory study found significant evidence supporting the value of music therapy in promoting social , emotional and motivational development in children with autism BACKGROUND Anecdotal reports and some studies suggest that equine-assisted activities may be beneficial in autism spectrum disorders ( ASD ) . OBJECTIVE To examine the effects ofequine-assisted activities on overall severity of autism symptoms using the Childhood Autism Rating Scale ( CARS ) and the quality ofparent-child interactions using the Timberlawn Parent-Child Interaction Scale . In addition , this study examined changes in sensory processing , quality of life , and parental treatment satisfaction . DESIGN AND PARTICIPANTS Children with ASD were evaluated at four time points : ( 1 ) before beginning a 3-to-6 month waiting period , ( 2 ) before starting the riding treatment , and ( 3 ) after 3 months and ( 4 ) 6 months of riding .  Twenty-four participants completed the waiting list period and began the riding program  , and 20 participants completed the entire 6 months of riding . Pretreatment was compared to posttreatment with each child acting as his or her own control . RESULTS A reduction in the severity of autism symptoms occurred with the therapeutic riding treatment . There was no change in CARS scores during the pretreatment baseline period ; however , there was a significant decrease after treatment at 3 months and 6 months of riding . The Timberlawn Parent-Child Interaction Scale showed a significant improvement in Mood and Tone at 3 months and 6 months of riding and a marginal improvement in the reduction of Negative Regard at 6 months of riding . The parent-rated quality of life measure showed improvement , including the pretreatment waiting period . All of the ratings in the Treatment Satisfaction Survey were between good and very good . CONCLUSION These results suggest that children with ASD benefit from equine-assisted activities The study evaluates a social-communication-based approach to autism intervention aim ed at improving the social interaction skills of children with autism spectrum disorder . We report preliminary results from an ongoing r and omized controlled trial of 51 children aged 2 years 0 months to 4 years 11 months . Participants were assigned to either a target treatment or community treatment group . Families in the target treatment group were given 2 hours of therapy and coaching each week in an intervention emphasizing social-interaction and the parent-child relationship . Children in the community treatment group received a variety of services averaging 3.9 hours per week . After 12 months , outcomes were measured to determine changes in the groups in social interaction and communication . In addition , a regression analysis was conducted to determine whether changes in social interaction skills were associated with language development . Results suggest that children in the treatment group made significantly greater gains in social interaction skills in comparison to the community treatment group , but no between-group differences were found for st and ard language assessment s. Initiation of joint attention , involvement , and severity of language delay were found to be significantly associated with improvement of language skills in children with autism . Finally caregiver skills targeted by the intervention were found to be significantly associated with changes in children ’s interaction skills BACKGROUND Children who show disproportionate difficulty with the pragmatic as compared with the structural aspects of language are described as having pragmatic language impairment ( PLI ) or social communication disorder ( SCD ) . Some children who have PLI also show mild social impairments associated with high-functioning autism or autism spectrum disorder ( ASD ) . There is little robust evidence of effectiveness of speech- language interventions which target the language , pragmatic or social communication needs of these children . AIMS To evaluate the effectiveness of an intensive manualized social communication intervention ( SCIP ) for children who have PLI with or without features of ASD . METHODS & PROCEDURES In a single-blind RCT design , 88 children with pragmatic and social communication needs aged 5;11 - 10;8 , recruited from UK speech and language therapy services , were r and omly assigned in a 2:1 ratio to SCIP or to treatment-as-usual . Children in the  SCIP  condition received up to 20 sessions of direct intervention from a specialist research speech and language therapist working with supervised assistants . All therapy content and methodology was derived from an intervention manual . A primary outcome measure of structural language and secondary outcome measures of narrative , parent-reported pragmatic functioning and social communication , blind-rated perceptions of conversational competence and teacher-reported ratings of classroom learning skills were taken pre-intervention , immediately post-intervention and at 6-month follow-up . Analysis was by intention to treat . OUTCOMES & RESULTS No significant treatment effect was found for the primary outcome measure of structural language ability or for a measure of narrative ability . Significant treatment effects were found for blind-rated perceptions of conversational competence , for parent-reported measures of pragmatic functioning and social communication , and for teacher-reported ratings of classroom learning skills . CONCLUSIONS & IMPLICATION S There is some evidence of an intervention effect on blind and parent/teacher-reported communication outcomes , but not st and ardized language assessment outcomes , for 6 - 11-year-old children who have pragmatic and social communication needs . These findings are discussed in the context of the increasingly central role of service user outcomes in providing evidence for an intervention . The substantial overlap between the presence of PLI and ASD ( 75 % ) across the whole cohort suggests that the intervention may also be applicable to some verbally able children with ASD who have pragmatic communication needs BACKGROUND Deficits in joint attention ( JA ) and joint engagement ( JE ) represent a core problem in young children with autism as these affect language and social development . Studies of parent-mediated and specialist-mediated JA-intervention suggest that such intervention may be effective . However , there is little knowledge about the success of the intervention when done in preschools . AIM Assess the effects of a preschool-based JA-intervention . METHODS 61 children ( 48 males ) with autistic disorder ( 29 - 60 months ) were r and omized to either 8 weeks of JA-intervention  , in addition to their preschool programs  ( n = 34 ) , or to preschool programs only  ( n = 27 ) . The intervention was done by preschool teachers with weekly supervision by trained counselors from Child and Adolescent Mental Health Clinics ( CAMHC ) . Changes in JA and JE were measured by blinded independent testers using Early Social Communication Scale ( ESCS ) and video taped preschool teacher-child and mother-child play at baseline and post-intervention . CLINICAL TRIALS REGISTRATION Clinical trials.gov : NCT00378157 . RESULTS Intention-to-treat analysis showed significant difference between the intervention and the control group , with the intervention group yielding more JA initiation during interaction with the preschool teachers . The effect generalized to significantly longer duration of JE with the mothers . CONCLUSIONS This is the first r and omized study to show positive and generalized effects of preschool-based JA-intervention The aim of this study was to pilot test a classroom-based intervention focused on facilitating play and joint attention for young children with autism in self-contained special education classrooms . Thirty-three children with autism between the ages of 3 and 6 years participated in the study with their classroom teachers ( n = 14 ) . The 14 preschool special education teachers were r and omly assigned to one of three groups : ( 1 ) symbolic play then joint attention intervention , ( 2 ) joint attention then symbolic intervention , and ( 3 ) wait-list control period then further r and omized to either group 1 or group 2 . In the intervention , teachers participated in eight weekly individualized 1-h sessions with a research er that emphasized embedding strategies targeting symbolic play and joint attention into their everyday classroom routines and activities . The main child outcome variables of interest were collected through direct classroom observations . Findings indicate that teachers can implement an intervention to significantly improve joint engagement of young children with autism in their classrooms . Furthermore , multilevel analyses showed significant increases in joint attention and symbolic play skills . Thus , these pilot data emphasize the need for further research and implementation of classroom-based interventions targeting play and joint attention skills for young children with autism Abstract . Few attempts have been made to conduct r and omised control trials ( RCTs ) of interventions for pre-school children with autism . We report findings of a pilot RCT for a parent training intervention with a focus on the development of joint attention skills and joint action routines . Twenty-four children meeting ICD-10 criteria for childhood autism ( mean age = 23 months ) were identified using the CHAT screen and r and omised to the parent training group or to local services only . A follow-up was conducted 12 months later ( mean age = 35 months ) . There was some evidence that the parent training group made more progress in language development than the local services group . However , the present pilot study was compromised by several factors : a reliance on parental report to measure language , non-matching of the groups on initial IQ , and a lack of systematic checking regarding the implementation of the parent training intervention . Furthermore , three parents in the local services group commenced intensive , home-based behavioural intervention during the course of the study . The difficulties encountered in the conduct of RCTs for pre-school children with autism are discussed . Method ological challenges and strategies for future well- design ed RCTs for autism interventions are highlighted
target: While there is some evidence that ToM , or a precursor skill , can be taught to people with ASD , there is little evidence of maintenance of that skill , generalisation to other setting s , or developmental effects on related skills .
  It is possible that the continuing refinement of the ToM model will lead to better interventions which have a greater impact on development than those investigated to date
background: BACKGROUND The ' Theory of Mind ' ( ToM ) model suggests that people with autism spectrum disorder ( ASD ) have a profound difficulty underst and ing the minds of other people - their emotions , feelings , beliefs , and thoughts .
  As an explanation for some of the characteristic social and communication behaviours of people with ASD , this model has had a significant influence on research and practice .
  It implies that successful interventions to teach ToM could , in turn , have far-reaching effects on behaviours and outcome .
  OBJECTIVES To review the efficacy of interventions based on the ToM model for individuals with ASD .