SCOPE

Autism Spectrum Disorders (ASD) are recognized rather late in the Netherlands, as elsewhere, which delays adequate early intervention. Growing scientific evidence indicates that early intervention improves long-term outcomes and reduces negative consequences such as comorbid problems, negative impact on families and high societal costs. The Social COmmunication Programme supported by E-health (SCOPE) aims to improve quality and efficiency of care, to accelerate procedures and to optimize collaboration between the youth-healthcare (JGZ) and the specialized mental healthcare (S-GGZ), so that timely detection of ASD followed by an early start of adequate intervention will be made possible.

SCOPE includes (1) raising awareness via an online platform for parents and professionals, (2) training and consultation for primary care providers, and (3) a short home-based early intervention named BEAR (Blended E-health for children at eArly Risk). BEAR is a parent training will be offered to parents of children (12-30 months) who are screened positive (and are therefore at risk for ASD) in regular well-baby clinic visits. The training will be offered before a full diagnostic assessment program has been performed.

The main objective of this study is to investigate the effectiveness of BEAR (a parent training combining e-learning and home visits) compared to care-as-usual (CAU) in young children (12-30 months) who are at risk of developing ASD, in a cluster randomized controlled trial.



The primary research question is:

1) What is the effectiveness of BEAR compared to CAU in terms of change in joint engagement in the parent child interaction, directly after the treatment at 8 weeks, and at follow-up at 24 weeks?

Secondary research questions are:

2) What is the effectiveness of BEAR, compared to CAU, in terms of social-communicative development and adaptive functioning of the child?

3) What is the effectiveness of BEAR, compared to CAU, in parental intervention skills and parental well-being?

4) What is the effectiveness of BEAR, compared to CAU, in terms of parental satisfaction about care?

5) What is the effectiveness of BEAR, compared to CAU, in time between first concerns of ASD and start of intervention?

6) What is the effectiveness of BEAR, compared to CAU, in cost efficiency?

Baseline measure, two weeks before the start of treatment.

End of treatment measure, eight weeks after the start of treatment.

Follow-up, 6 months after the start of treatment.

The BEAR (Blended E-health for children at eArly Risk) parent training. is a blended e-health intervention offered to children (12-30 months) who are considered to be at risk for ASD based on screen positive results of a screening list (the CoSoS, ¡Ý3) or based on clinical judgement, and their parents. The intervention consists of 7 home visits and 5 e-learning sessions and will be delivered by a professional working in the youth health care (JGZ), under supervision of professional working in the specialized mental Healthcare (S-GGZ). During the first and the last visit, the (S)GGZ-professional will accompany the JGZ-professional.

The BEAR parent training consists of several possible treatment modules, covering domains such as communication, social interaction and flexible behaviour. Three out of five treatment modules will be chosen based on personalized treatment goals.