Autism identification and moving towards treatments (Swamagnata Aakalan and Upacharachi Disha [SAAD])

INTERVENTION: A single‐site, two‐parallel group, single (assessor) blinded randomized controlled trial of the PASS+ intervention compared to routine care for children with Autism Spectrum Disorders (ASD). Treatment arm The PASS+ intervention will be delivered to the participants of the intervention arm which at its core targets the social communication impairments in autism. The aim of the core intervention is to increase parental sensitivity and responsiveness to their child’s communication and reduce over‐directive parental responses which are delivered through video‐feedback by addressing the parent‐child interaction during a play session. The incremental development of the child’s communication is helped by the promotion of a range of strategies such as action routines, familiar repetitive language, and pauses within a culturally adapted, manualised and staged intervention which represents the developmental progression of early language skills (see web appendix: http://sangath.com/images/file/PASS_Manual_web‐2015.pdf). The pace of work is individualised to the parent and child’s specific needs and progress and interim goals are reached before moving to the next stage. The PASS intervention has been evaluated through a two‐arm pilot randomised control trial (ISRCTN79675498) and the publication is in press. The Plus component is an additional manualised intervention to address the common comorbidities found in children and families of children with autism. This includes a general psychoeducation package, and modules to address sensory integration, feeding, toileting, sleeping and behavioural problems along with a module for supporting maternal mental health. Each module comprises of a treatment decision algorithm to help identify a specific problem which then leads to stepwise advice for the care‐giver. This Plus component will be introduced in the second month of the intervention period and the facilitator will be guided to the appropriate module based on the needs of the i CONDITION: Autism Spectrum Disorder (ASD) ; Mental and Behavioural Disorders ; Childhood autism PRIMARY OUTCOME: 1. ASD symptoms: Brief Observation of Social Communication Change (BOSCC), Janina, K., et al (2014); 2. Synchronous parent acts: Dyadic Communication Measure for Autism (DCMA), Green. J., et al (2010); ; At baseline ‐ from January 2016 to March 2016; At endpoint ‐ from July 2016 to November 2016 INCLUSION CRITERIA: 1. Children aged 2‐9 years 2. Developmental age of > 1 year 3. Fulfilling the criterion of Autism Spectrum Disorder as defined in INCLEN Diagnostic Tool for ASD (INDT‐ASD) 4. Developmental age 1 year or above 5. Residence within study area of the trial SECONDARY OUTCOME: 1. Adaptive scores : Vineland Adaptive Behaviour Scale, Sparrow, S. S., et. al. (2006).; 2. Maternal mental health: Patient Health Questionnaire – 9, Patel, V., et al. (2008).; 3. Impact of comorbid problems: Developmental Behaviour Checklist (DBC), Witwer. A N. and Lecavalier. L. (2007); 4. Parental acceptance of the condition in their child: Research in Autism for Families in India (RAFIN), Rachel, B., et al (2013); 5. Parent competence in managing difficulties experienced by their child as a result of ASD: Research in Autism for Families in India (RAFIN), Rachel, B., et al (2013); 6. Empowerment experienced by the family: Research in Autism for Families in India (RAFIN), Rachel, B., et al (2013); ; At baseline ‐ from January 2016 to March 2016; At endpoint ‐ from July 2016 to November 2016