In 2010, an RCT (also known as PACT, the Pre-school Autism Communication Trial) reported that children whose parents received the training were using words and gestures more often than those in the control group. In 2017, a ‘follow-up’ study showed that these benefits had persisted. Children also showed enhanced social skills and fewer repetitive behaviours.
The approach is attracting considerable interest because of the substantial number of children involved in the RCT, and the retention of positive outcomes over the longer term. The successful use of parents as therapists also has the benefit of being naturalistic and cost-effective, making the intervention a good choice for low and middle income countries. A culturally appropriate version of PACT is being trialled in India (Divan, 2017). Given the dearth of available specialists in India, the approach was adapted to enable lay people to train parents. Though viewing videos of themselves was challenging for some parents, they came to value the guidance. One mother commented that the approach was ‘making a change in my child, but also making a change in me’ (Divan, 2017). RCTs of the Indian initiative are underway.