Using the Clinical Global Impression scale to assess social communication change in minimally verbal children with autism spectrum disorder.
Christina Toolan, Alison Holbrook, Andrew Schlink and 3 others
PMID 34800004WHAT IT FOUND
In minimally verbal children with autism, one-question clinician ratings after six weeks matched independent communication coding: children rated much improved showed more joint-attention gains, while request and total gains did not differ.
Key findings
01In 54 minimally verbal school-aged children with ASD, Week 6 CGI-I ratings classified 20 as fast responders and 34 as slow responders, with no child rated unchanged or worse.
02CGI-I fast/slow responder status was significantly associated with whether CGI-S ratings improved (p<0.001).
03Fast responders showed greater improvement in CCS Optimal joint attention scores than slow responders (median change 1 vs 0, p=.04), while change in Overall Optimal and Optimal BR scores did not differ.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The analysis used 54 children from one site, so it may not apply broadly. CGI-S and CGI-I scores had a narrow range: almost all children entered at severity 5 or 6, and all Week 6 CGI-I ratings were 2 or 3. CGI ratings were made by people involved in the intervention, not independent blinded clinicians, so treatment context and rater familiarity may have influenced ratings. The study did not compare the interventions with no treatment, usual care, or a control condition. The analysis only covered the first six weeks and did not examine later adaptive treatment decisions. Optimal joint attention scores were unavailable for 11 children. The change finding therefore applies only to children with enough joint attention to be scored.
Declared interests
No conflicts of interest are stated in the supplied text. The article is tagged as supported by NIH extramural and non-U.S. government research support.
The easy way to misread this
Do not read the CGI-I improvement as proof that DTT or JASPER-EMT caused change. All children received active intervention, ratings came from people involved in treatment, and the study did not compare treatment with no treatment or usual care.