Communication-centered Parent-mediated treatment for Autism Spectrum Disorder in South Asia (COMPASS).

Lead Research Organisation: University of Manchester
Department Name: School of Biological Sciences

Abstract

Eighty percent of the world's children with Autism Spectrum Disorders (ASD) live in low resource settings. Recent evidence from high-income countries supports the effectiveness of targeted parent-mediated interventions for the early treatment of children with ASD. Interventions that are delivered through parents have the additional advantages of improving parental knowledge and morale, potentially promoting the social empowerment of mothers, generalising into improvements in the family environment for the child and thus potentially conferring long-term impacts on the social context, the child's environment and functional outcomes. The Pre-school Autism Communication Therapy (PACT) trial conducted in the UK is the largest yet trial of this kind. It is targeted at getting parents to recognize their child's social communication difficulties and create an environment which gives the child a space and time to communicate at their own pace. This intervention uses video feedback techniques to work with parents to enhance their understanding and responsiveness to the atypical communications of young children with autism. The trial showed that children with ASD who received this treatment benefited from the enriched communication environment that their parents were able to create; this in turn had a positive impact on the social interactions the children initiated. More importantly these changes, in the parent child interaction and independent communication from the child, were sustained in a follow up study after six years which demonstrated a decrease in autism symptoms in children who received the intervention. The intervention has now been successfully adapted for use in South Asia, including relevant cultural adaptation to enhance parental acceptability, developing a supervision and training cascade to allow the intervention to be delivered by community based non-specialist workers, and delivery of the intervention at home. The resulting Parent mediated intervention for Autism Spectrum Disorders in South Asia (PASS) was subsequently evaluated in a pilot trial which demonstrated its acceptability, feasibility and efficacy. Subsequently, the team in India have developed and piloted a complementary comorbidity package creating a comprehensive intervention for children with ASD in the 2-9 year age group (PASS Plus). Evaluation methods have also been adapted and tested in both of these pilot studies. Most children with ASD in India and other low resource settings do not receive evidence based care which the proposal investigators have shown can reduce the symptoms of ASD and is feasible and acceptable for delivery in the proposed study setting. The proposed trial will build on this pilot work already carried out in India, and will carry out the largest, definitive, trial of the intervention, involving 240 participants recruited through two tertiary government hospitals in the capital city of New Delhi, which cater to an urban poor population. The intervention will be delivered through existing health system frontline workers. The trial will evaluate the effectiveness and cost effectiveness of the intervention on symptoms of ASD and parent-child interaction as well as more general impacts on child functioning, parental well-being and social empowerment. COMPASS will be the largest trial of its kind for ASD in any low resource setting and the evidence generated will have an impact not only health policy and practice in India, home to over 5 million children with ASD, but also other low resource settings in the region.

Technical Summary

Objectives: Phase 3 trial of the clinical and cost-effectiveness of the 'Parent-mediated intervention for Autism Spectrum Disorders in South Asia-Plus' (PASS+) intervention in addition to treatment as usual (TAU) compared to treatment as usual (TAU) alone in India. The study will take the already successfully piloted PASS+ intervention to scale.

Design: Two centre, two arm single (rater) blinded random allocation parallel group study of experimental treatment plus TAU against TAU alone. Primary endpoint 9 months, follow-up 15 months. Primary outcome: autism symptom severity (blind-rated Brief Observation of Social Communication Change). Secondary outcomes: include parent-child communication, child adaptation and QoL, parental wellbeing. Primary analysis intention to treat; planned secondary analysis of proposed mediators of treatment effect. Health Economic evaluation will estimate the cost-effectiveness of the intervention from a societal perspective using a QoL index valued to allow calculation of QALYs.

Participants: 240 children aged 2 to 9 years with ASD, recruited from Autism clinics in two tertiary government hospitals in New Delhi, India.

Treatments: PASS+ is a manualised and piloted adaptation of the UK Pre-school Autism Communication Therapy (PACT), that uses video-feedback with parents to help them enhance social communication in their autistic child. It will be delivered by existing health system frontline workers, in 12 home-based sessions. TAU in the two recruitment centres is delivered through weekly autism clinics, an eclectic mix of behavioural therapy approaches which are delivered once a month delivered by specialists. The duration of therapy is based on the families' ability to follow up, adherence is under 50%.

Outcome: Generalizability and policy impact will be maximized through embedding the trial in routine facilities with embedded primary health-care workers, and using our policy influence to disseminate the findings.

Planned Impact

The primary stakeholders impacted by this work will be young people affected by ASD and their families and the wider communities where these individuals live.
Recent epidemiological evidence has shown that about 1% of children are affected by Autism Spectrum Disorders (ASD), translating to at least five million affected families in India alone. The vast majority, approaching nearly 100% of these children, do not receive community based interventions. COMPASS will represent the first definitive trial of the effectiveness and cost-effectiveness of such an intervention, which has been piloted to ensure contextual acceptability to parents and feasibility for delivery by low-cost frontline workers, in the region. The intervention has been carefully adapted to address social and cultural barriers through four years of systematic formative and piloting research.

Young people and their families will therefore benefit from improved social communication skills and thus improved social integration both with their families and within their communities, enhancing their wellbeing for all of these groups. Young people, families and communities will benefit from better understanding of ASD and the increased social acceptance of neurodevelopmental disability. A successful outcome from the trial will bring economic benefits to families (reducing costs associated with loss of wages for parents, changing residences to seek care, changing schools) and national healthcare systems (direct medical expenses born by the health system for autism care).

Healthcare workers and national health systems will benefit from the outcomes of this study along with the scientific community. Health workers will benefit from a defined programme of training and supervision, upskilling them and providing a resource which will be able to perpetuate these skills into the future. The team in India has developed and evaluated an enhancement of the core communication component with modules to address comorbidities to increase acceptability of the intervention by parents and the potential effectiveness of the intervention. We will also use a digital platform to embed self-learning and supervision needs of the health worker, preparing a way to take this intervention to scale. We are including a systematic tracking method for children and families with a view to assessing the long term impact of an early comprehensive intervention package on symptom severity and functioning.

Government and international policy bodies will benefit from the development of an evidenced protocol for a community based ASD intervention, applicable in India and other LMICs, which will have an impact on health and wealth of individuals and communities and therefore ultimately the country as a whole. We are generating key economic data on the cost-effectiveness of the interventions, based upon which we will be able to estimate the additional cost of scaling up this intervention across the country. The scientific community will benefit from the new knowledge generated by this trial which will inform the design and delivery of future interventions in LMICs. The model for management of a developmental disability through trained community based workers and parents working in partnership with specialists could be replicated for other neurodevelopmental disabilities in LMIC.

We will build on our policy influence and engagement to disseminate the findings; for instance Divan serves on WHO consultative groups for developing interventions for child mental disorders and on national committees for autism and developmental disabilities in India; Patel serves on the WHO expert advisory group for mental health; and this project has the backing of the two leading national institutions concerned with front-line workers (the National Health Systems Resource Centre) and child development (the Rashtriya Bal Swasthya Karykram) - see Letters of Support.

Publications

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Description 'Pint of Science', Didsbury Manchester, 'Improving the outcome for Autism', 20th May 2019. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact lecture in a debate series with general public on mental health
Year(s) Of Engagement Activity 2019
 
Description All India Institute of Medical Sciences, Lecture, 'The ASD phenotype in Neurofibromatosis and its intervention', 23rd Jan 2019. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact invited lecture in India
Year(s) Of Engagement Activity 2019
 
Description Asturias Special Education Services for Autism 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Key note lecture
Year(s) Of Engagement Activity 2016
 
Description Autistic identities, participatory research & gender, National Conference, University of Kent, Keynote and Panel, 4th July 2019. 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Patients, carers and/or patient groups
Results and Impact keynote lecture and debate on autistic identiy
Year(s) Of Engagement Activity 2019
 
Description BBC 2 - interview on Victoria Derbyshire TV show (26-10-16) 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact To discuss the PACT 7-11 results.
Year(s) Of Engagement Activity 2016
 
Description BBC News TV (26-10-16) 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact To discuss the PACT 7-11 results.
Year(s) Of Engagement Activity 2016
 
Description BBC Radio 4 - 'Today' programme (26-10-16) 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact To discuss the PACT 7-11 results.
Year(s) Of Engagement Activity 2016
 
Description BBC Radio 5 - 'Breakfast' programme (26-10-16) 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact To discuss the PACT 7-11 results.
Year(s) Of Engagement Activity 2016
 
Description BBC World Service Radio (26-10-16) 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact To discuss the PACT 7-11 results.
Year(s) Of Engagement Activity 2016
 
Description British Association of Clinical Psychology, National Conference; Bath UK, , Keynote, Early development intervention for Autism Spectum Disorder', 5th Sept 2019 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact keynote lecture
Year(s) Of Engagement Activity 2019
 
Description Channel Five News TV (26-10-16) 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact To discuss the PACT 7-11 results.
Year(s) Of Engagement Activity 2016
 
Description Coram BAAF, lecture on first evidence for autism treatment success 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Presentation of research findings.
Year(s) Of Engagement Activity 2016
 
Description Danish National conference on autism 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Keynote - Intervention for Autism'
Year(s) Of Engagement Activity 2017
 
Description Deutsche Bank, Birmingham - new treatments for autism; major donor for national group Autistica 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Presentation of research findings.
Year(s) Of Engagement Activity 2017
 
Description European Conference on Autism - ethics aspects of early intervention in autism. Agenda setting for field. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Audience reported changes in views, opinions or behaviours.
Year(s) Of Engagement Activity 2016
 
Description How can we help Autism 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Public/other audiences
Results and Impact invited participation in Manchester's Pint of Science event 2019
Year(s) Of Engagement Activity 2019
 
Description IMFAR, International meeting for autism research, lecture on outputs from trial. First evidence for autism treatment success. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Presentation of research findings.
Year(s) Of Engagement Activity 2016
 
Description Institute of Neurology, London, Karl Friston Research Seminar, 'Autistic experience and cognitive neuroscience', 12th March 2019. 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact a neuroscience presentation with autism advocates
Year(s) Of Engagement Activity 2019
 
Description Journal - 'Nature' - 'Autism study finds early intervention has lasting effects' 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact PACT 7-11 results.
Year(s) Of Engagement Activity 2016
 
Description Lecture " Making a difference- how has autism research improved the daily lives of individuals with autism?" University of Newcastle, Neurodevelopment and Disability Research Day - 15th June 2017. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Lecture " Making a difference- how has autism research improved the daily lives of individuals with autism?" University of Newcastle, Neurodevelopment and Disability Research Day - 15th June 2017.
Year(s) Of Engagement Activity 2010
 
Description Lecture Malta 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact lecture keynote: Diagnosis & early intervention in young children with ASD
Year(s) Of Engagement Activity 2017
 
Description Lecture New York 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Keynote.'Parent-mediated intervention for autism and its long term effects on reducing autism severity'. Oct 2017.
Year(s) Of Engagement Activity 2017
 
Description Magazine - 'New Scientist' - 'Autism intervention is first to show benefits over the long term' 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact PACT 7-11 results.
Year(s) Of Engagement Activity 2016
 
Description Montreal - evidence for autism treatment. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Audience reported change in views, opinions or behaviours.
Year(s) Of Engagement Activity 2016
 
Description NW Deanery, Manchester lecture on outputs from trial. First evidence for autism treatment success. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Presentation of research findings.
Year(s) Of Engagement Activity 2016
 
Description National Autism Conference. Tonsberg Norway 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Keynote. 'Early Social Communication Intervention for Autism'. June 2016
Year(s) Of Engagement Activity 2016
 
Description National Autistic Society early intervention for autism - evidence and practice in early intervention for autism. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Presentation of research findings.
Year(s) Of Engagement Activity 2016
 
Description National Conference, Autistica, University of Reading, , 'Global Evidence to local action; evidence based intervention for autism', 23rd May 2019 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Third sector organisations
Results and Impact keynote lecture and debate
Year(s) Of Engagement Activity 2019
 
Description Newcastle University Child Health Academic Programme: Early intervention in ASD (Ann Le Couteur) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Findings from the PACT 7-11 follow up study.
Year(s) Of Engagement Activity 2016
 
Description Newcastle University, Institute of Health and Society presentation: Neurodisability across the lifespan including presentation of early intervention in ASD (Ann Le Couteur) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact To inform.
Year(s) Of Engagement Activity 2016
 
Description Newspaper - 'Independent' - 'Parent-led therapy in autistic children can help reduce core symptoms long-terms, study shows' 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact PACT 7-11 results.
Year(s) Of Engagement Activity 2016
 
Description Newspaper - 'The Guardian' - 'Study offers potential breakthrough in care of children with autism' 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact PACT 7-11 results.
Year(s) Of Engagement Activity 2016
 
Description Newspaper - 'The Telegraph' - 'Scientists hail first successful treatment for children with autism' 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact PACT 7-11 results.
Year(s) Of Engagement Activity 2016
 
Description Newspaper - 'The Times' - 'Autistic children can be helped by video training for parents' 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact PACT 7-11 results.
Year(s) Of Engagement Activity 2016
 
Description North East Regional Paediatric Neurodisability Conference (Jeremy Parr) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact To inform.
Year(s) Of Engagement Activity 2016
 
Description Norwegian Association for Autism - first evidence for autism treatment. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Presentation of research findings.
Year(s) Of Engagement Activity 2016
 
Description PACT 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact presentation about PACT to London Special Interest Group for Autism (speech and language therapists). Dissemination meeting. 


positive interest in intervention training
Year(s) Of Engagement Activity 2010
 
Description Perth Children's Hospital Telethon Institute. Keynote: 'Parent-mediated Developmental Interventions for Autism', June 2018. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact Compaiired looks for sericulse be cose it absence of h
Year(s) Of Engagement Activity 2018
 
Description Presentation at the ACAMH annual meeting in June 2018 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Presentation ACAMH annual meeting June 2018
Year(s) Of Engagement Activity 2018
 
Description Royal College of Psychiatrists, CPD update on ASD 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Presentation of research findings.
Year(s) Of Engagement Activity 2016
 
Description Salford Autism Group, lecture on evidence base for autism treatment and new findings. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Presentation of clinical activity and choices.
Year(s) Of Engagement Activity 2017
 
Description The Danish Mental Health Foundation; Keynote, 11th workshop on applied research for mental health in children and adolescents. Dec, 2018 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact keynote lecture led to research collaboration
Year(s) Of Engagement Activity 2018
 
Description The Danish Mental Health Foundation; Keynote, 11th workshop on applied research for mental health in children and adolescents. Dec, 2018 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact keynote in US charity
Year(s) Of Engagement Activity 2018
 
Description The Great North Children's research Community conference, Newcastle - PACT 7-11: improving outcomes for children with autism (Ann Le Couteur) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact To inform re PACT 7-11 results.
Year(s) Of Engagement Activity 2016
 
Description The PDA Society, Research Meeting, Kings College, London, 'PDA, a sceptical viewpoint', 8th January 2019. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Patients, carers and/or patient groups
Results and Impact talk at seminar
Year(s) Of Engagement Activity 2019
 
Description The emergence and development of pre-school autism" 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? Yes
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact DISSEMINATION MEETING


positive interest in intervention training
Year(s) Of Engagement Activity 2010
 
Description UK Association of Child Psychology and Psychiatry National Conference, London, Keynote, 'Early dyadic intervention in Autism Spectrum Disorder', 8th March 2019 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact keynote lecture at annual meeting of main professional association in child mental health in UK
Year(s) Of Engagement Activity 2019
 
Description Update: Early intervention in autism. Invited Polani 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Other audiences
Results and Impact McConachie, H Update: Early intervention in autism. Invited Polani
lecture, British Academy of Childhood Disability, Manchester,
Year(s) Of Engagement Activity 2007
 
Description Welsh Neurodevelopmental Service Improvement Programme in September 2018 Regards 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Welsh Neurodevelopmental Service Improvement Programme in September 2018
Year(s) Of Engagement Activity 2018
 
Description Workshop : Intervención en niños con autismo.Teachers Education and Resource Centre, Oviedo, Asturias. Jan 19 2018 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Workshop : Intervención en niños con autismo.Teachers Education and Resource Centre, Oviedo, Asturias. Jan 19 2018
Year(s) Of Engagement Activity 2018
 
Description World Association of Infant Mental Health 17th World Congress, Brisbane Australia, Keynote, 'Developmentally-focused early intervention for Autism', 7th June 2020. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact key note lecture
Year(s) Of Engagement Activity 2020
 
Description World Health Organisation, Experts Conference on Childhood Disability, Rome, Italy, 6th December 2018. 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact WHO expert meeting Milano
Year(s) Of Engagement Activity 2018
 
Description Zero to Three Annual Conference, Ft Lauderdale Florida, USA, Keynote, 'Delivering Autism Intervention in Development', 4th October 2019. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact keynote lecture
Year(s) Of Engagement Activity 2019
 
Description lecture Isreal 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Keynote.'Parent-mediated Developmental Interventions for Autism' Oct 2017.
Year(s) Of Engagement Activity 2017