Effect of Multidisciplinary Intervention on Clinical Outcomes of Children with Autism Spectrum Disorder in Mumbai, India

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Purpose: To analyse clinical outcomes in terms of functional changes in children with Autism Spectrum Disorder (ASD), before and after receiving a multidisciplinary developmental intervention programme.

Methods: Structured goal-oriented multidisciplinary intervention, individualised to each child, was implemented through 5 child development centres in Mumbai, India, in 2014-2015. Secondary data analysis of 38 children diagnosed with ASD, in the age group of 2.1 - 6.1 years, was conducted.  All children received occupational therapy and speech therapy, and parental counselling was also done. The average number of intervention sessions were 48-72 for occupational therapy (twice or thrice a week), 24-48 for speech therapy (once or twice a week) and 5-6 for parental counselling (once a month). Childhood Autism Rating Scale (CARS) and Vineland Social Maturity Scale (VSMS) were used for assessment, before and after intervention.

Results: Mean positive difference in CARS total scores through paired t-test was 4.18 (p < 0.0001). Significant positive changes in functional ability were observed in most of the sub-scales (relating to people; object use; visual response; verbal and non-verbal communication; taste, smell and touch response and use; level and consistency of intellectual response and general impression). Paired t-test also showed significant positive changes on all VSMS sub-scales, except Socialisation.

Conclusions: The model used in this multidisciplinary intervention, and adherence to its protocols, has the potential to improve functional ability (or the child’s adaptation to his/her condition) in children with ASD, in a region with limited awareness of developmental disabilities.

Limitations: Separate effects of factors outside the intervention could not be tested due to inadequate sample sizes for sub-analyses. Results also need to be validated by tests that do not depend on parental reporting (e.g., CARS and VSMS) but assess the performance of the child instead.

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Authors

Samir H Dalwai

Dr. Samir Dalwai (MD, DNB, DCH, FCPS, DNB and LLB) is a Developmental Paediatrician and Director of New Horizons Child Development Centre (NHCDC), Mumbai, India.  In the last 14 years, NHCDC has developed five centres and currently houses a team of 60+ paramedical professionals. Dr. Dalwai and the NHCDC team has evaluated over 10,000 children and provided comprehensive inter-disciplinary intervention programs. Dr. Dalwai has contributed in the field of child welfare through national level eradication of child malnutrition with the Young Parliamentarians’ Citizens Alliance against Malnutrition. In the field of child rights, Dr. Dalwai has convened India’s first University level Program, Post Graduate Diploma in Juvenile Jurisprudence and Juvenile Justice Systems. In the capacity of Chairperson of The National Commission for the Protection of Child Rights, Dr. Dalwai has developed a report for reinstating children with special needs who are expelled from mainstream schools. Dr. Dalwai is the chairperson of the Mumbai branch of the Indian Academy of Paediatrics (IAP) and has recently co-authored National Consensus Guidelines approved by the IAP on management of Autism Spectrum Disorder, Attention Deficit Hyperactivity Disorder, Learning Disability, as well as guidelines on Newborn Hearing Screening.

Deepti Kanade Modak

Mrs. Deepti Kanade Modak has completed Masters in Clinical Psychology and has worked for over 14 years with children and adolescents having developmental and behavioural-emotional concerns. She has worked in the capacity of the Clinical Director of New Horizons Child Development Centre for five years and she is currently in-charge of New Horizons Health and Research Foundation.

Ameya P Bondre

Dr. Ameya Bondre has received training as a physician (MBBS) and has completed Masters of Science in Public Health. Dr. Bondre has worked for over seven years with public health research projects focused on child health, nutrition and development and is currently the Project Coordinator of New Horizons Health and Research Foundation.

Sajeda Ansari

Mrs. Sajeda Ansari has completed Masters in Clinical Psychology and Post-Graduate Diploma in Advanced Counselling. Mrs. Ansari has worked as a Research Associate at New Horizons Health and Research Foundation. Mrs. Ansari has over five years of experience working as a Clinical Psychologist at New Horizons Child Development Centre, with children and adolescents having developmental and behavioural-emotional concerns.

Dania Siddiqui

Ms.Dania Siddiqui has completed Masters in Clinical Psychology and a course in Critical Clinical Training in Counseling and Psychotherapy. Ms. Siddiqui has worked as a Clinical Associate and a Clinical Psychologist at New Horizons Child Development Centre, for over five years with children and adolescents having developmental and behavioural-emotional concerns.

Diksha Gajria

Ms. Diksha Gajria has completed Masters in Clinical Psychology. Ms. Diksha has worked as a Research Associate at New Horizons Health and Research Foundation and a Clinical Psychologist at New Horizons Child Development Centre, for over three years with children and adolescents having developmental and behavioural-emotional concerns.

Research Associate, New Horizons Health and Research Foundation

MA Clinical Psychology

How to Cite

Samir H Dalwai, Deepti Kanade Modak, Ameya P Bondre, Sajeda Ansari, Dania Siddiqui, Diksha Gajria (2017-08-22). Effect of Multidisciplinary Intervention on Clinical Outcomes of Children with Autism Spectrum Disorder in Mumbai, India. Disability, CBR & Inclusive Development, Vol. 28 No. 2 (2017): Summer 2017, 95-116. https://doi.org/10.5463/dcid.v28i2.508

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