Ranjan Rajeev, Jain Meha, Sinha Muskan, Kumar Pankaj, Ahmad Shamshad, Maharshi Vikas
Department of Psychiatry, All India Institute of Medical Sciences, Patna 801507, India.
Department of Psychiatry, All India Institute of Medical Sciences, Patna 801507, India; Amity Institute of Clinical Psychology, Amity University, Jaipur-303002 India.
Asian J Psychiatr. 2024 Jun;96:104052. doi: 10.1016/j.ajp.2024.104052. Epub 2024 Apr 16.
Family Mediated Intervention (FMI) and Early Intensive Behavioural Intervention (EIBI) are found to be standard of care for children with Autism Spectrum Disorder (ASD). Comparison of their efficacy were assessed using ISAA as primary outcome measure.
This study was a parallel arm, open label, randomized active- controlled non-inferiority clinical trial. 50 Children diagnosed with ASD were randomized into FMI and EIBI groups. Clinical status was checked by using Indian scale for assessment of autism (ISAA), Oro- motor and sensory profile at baseline, after three and six months.
Difference between change in mean ISAA score between FMI and EIBI group at the end of 6 months as per protocol (PP) analysis was -7.23 (CI=-18.41, 3.94), which was within pre-defined clinically relevant non-inferiority (NI) margin of - 24. FMI was found to be non-inferior to EIBI at the end of 6 months as the lower bound of 95% CI (-18.41) for ISAA score was higher than NI margin. ISAA scores were found to be statistically lower in both FMI and EIBI groups at the end point compared to baseline which indicated improvement in symptom severity.
FMI was non-inferior to EIBI as therapy for children with ASD at the end of six months. Finding also indicated longer duration of treatment is required for FMI to be superior. FMI can be recommended for children with ASD in view of improved ISAA scores reported in our study.
CTRI/2020/08/027099 (Registered with Clinical Trials Registry- India).
家庭介导干预(FMI)和早期强化行为干预(EIBI)被认为是自闭症谱系障碍(ASD)儿童的标准治疗方法。使用印度自闭症评估量表(ISAA)作为主要结局指标评估了它们的疗效。
本研究是一项平行组、开放标签、随机活性对照非劣效性临床试验。50名被诊断为ASD的儿童被随机分为FMI组和EIBI组。在基线、3个月和6个月后,使用印度自闭症评估量表(ISAA)、口面部和感觉概况检查临床状态。
根据方案(PP)分析,6个月结束时FMI组和EIBI组平均ISAA评分变化之间的差异为-7.23(CI=-18.41,3.94),这在预先定义的临床相关非劣效性(NI)界限-24之内。由于ISAA评分95%CI的下限(-18.41)高于NI界限,发现6个月结束时FMI不劣于EIBI。与基线相比发现,终点时FMI组和EIBI组的ISAA评分在统计学上均较低,这表明症状严重程度有所改善。
6个月结束时,FMI作为ASD儿童的治疗方法不劣于EIBI。研究结果还表明,FMI要想更具优势需要更长的治疗时间。鉴于我们的研究报告了ISAA评分有所改善,FMI可推荐用于ASD儿童。
CTRI/2020/08/027099(在印度临床试验注册中心注册)。