Video-feedback Intervention to promote Positive Parenting for Autism

Children with autism have a higher risk to develop insecure-disorganized
attachment relationships, and disorganized attachments lead to less optimal
developmental outcomes (Naber et al, 2007). The attachment security of children
with autism is about one-half of a standard deviation lower than comparisons
without autism (Rutgers et al., 2004). One of the most frequently documented
determinants of attachment is parental sensitivity. Parental sensitivity may,
however, be affected by the impaired communicative abilities of the child with
autism.
Video feedback intervention to promote positive parenting (VIPP) has been
proven to be effective in families with typically developing children as well
as in clinical groups (Juffer, Bakermans-Kranenburg, & Van IJzendoorn, 2007).
However, this low cost, short term, attachment-based intervention has not yet
been evaluated in families with preschoolers with autism. The VIPP-AUTI is
developed to improve parental sensitivity in case of autism, by decreasing the
risk for disorganized attachments. In addition better social skills of the
child, and less burden for the family is expected.

The effectiveness of Video feedback Intervention to promote Positive Parenting
for Autism (VIPP-AUTI) will be investigated on the sensitivity for autism
spectrum disorders (ASD) in parents of a child recently diagnosed with ASD,
based on the the attachment relationship of the child and the parent-child
interaction.
Additionally the effectiveness of the VIPP-AUTI will be studied on
developmental skills of the child with ASD and parental efficacy, burden and
stress.

In a non-invasive, therapeutic intervention study the effectiveness of the
VIPP-AUTI will be assessed, in parents - and their child with ASD - versus care
as usual.

Beside the usual psychiatric care the experimental group will receive
structured nursing care, according to the VIPP-AUTI, at five home visits during
three months.
The control group will receive also the psychiatric care, as usual combined
with unstructured nursing care. The usual nursing care comprises an average of
five home visits (at least three and at most seven home visits), over a period
of maximally six months, depending of the preference of the parents.

The study is non-invasive, without any risks for the participants. The burden
comprises two visits to the hospital to test the child psychiatric and
psychological and to interview the primary caregiver(s). In addition the
primary caregiver(s) will be asked to filling in questionnaires at home (about
four hours totally). Three home visits by the investigator will take place to
videotape assessments (1.5 hour a visit). The therapy (parental guidance by a
nurse) is provided in an average of five home visits of two hours each.