Parent-mediated intervention in infants with an elevated likelihood for autism reduces dwell time during a gaze-following task.

Researchers tested a video-based parent training program with 54 babies who had higher chances of developing autism due to family history. Parents learned to be more aware and responsive to their babies between 9-15 months old. At 15 months, babies in the program looked less at objects that adults pointed to with their eyes. This might seem concerning since following others' gaze usually helps with language development, but more research is needed to understand what this means.

This randomized controlled trial examined the effects of iBASIS-VIPP, a parent-mediated intervention, on social attention in 54 infants with elevated familial likelihood for autism. The intervention, delivered between 9-15 months of age, aimed to increase parental awareness and responsiveness. Eye-tracking measures assessed gaze-following behavior at 15 months. Results showed the intervention group had significantly reduced dwell time to objects referenced by another person's gaze compared to controls.

The authors note this finding should be interpreted alongside previously reported trends toward lower language scores at treatment endpoint, suggesting complex intervention effects that warrant further investigation using both cognitive and behavioral measures.

Results suggest parent-mediated interventions may have complex effects on early social attention mechanisms. The finding of reduced gaze-following, combined with previous trends toward lower language scores, indicates careful monitoring is needed when implementing early interventions to ensure positive developmental outcomes.

Small sample size of 54 infants limits generalizability. The clinical significance of reduced gaze-following is unclear, particularly given potential negative implications for language development. Study focused on single cognitive measure rather than comprehensive assessment of intervention effects.

Cognitive markers may in theory be more sensitive to the effects of intervention than overt behavioral measures. The current study tests the impact of the Intervention with the British Autism Study of Infant Siblings-Video Interaction for Promoting Positive Parenting (iBASIS-VIPP) on an eye-tracking measure of social attention: dwell time to the referred object in a gaze following task. The original two-site, two-arm, assessor-blinded randomized controlled trial (RCT) of this intervention to increase parental awareness, and responsiveness to their infant, was run with infants who have an elevated familial likelihood for autism (EL). Fifty-four EL infants (28 iBASIS-VIPP intervention, 26 no intervention) were enrolled, and the intervention took place between 9 months (baseline) and 15 months (endpoint), with gaze following behavior measured at 15 months.

Secondary intention to treat (ITT) analysis showed that the intervention was associated with significantly reduced dwell time to the referent of another person's gaze (β = -0.32, SE = 0.14, p = 0.03) at 15-month treatment endpoint. Given the established link between gaze following and language, the results are considered in the context of a previously reported, non-significant and transient trend toward lower language scores at the treatment endpoint (Green et al. (2015) The Lancet Psychiatry, 2(2), 133-140). Future intervention trials should aim to include experimental cognitive measures, alongside behavioral measures, to investigate mechanisms associated with intervention effects.