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Jonathan Green
Professor
Professor of Child Psychiatry at University of Manchester and Royal Manchester Children’s Hospital
Jonathan Green is Professor of Child and Adolescent Psychiatry at University of Manchester and Hon Consultant Child and Adolescent Psychiatrist at the Royal Manchester Children’s Hospital. He studied medicine at Cambridge, Paediatrics in London and Psychiatry in Oxford before establishing clinical and research groups in Manchester, UK. He has developed and tested early parent-mediated interventions for autistic development for both pre-school diagnosed children (PACT) and in the pre-diagnostic stage (iBASIS). These are now disseminated and tested internationally and form the basis of his proposal for a new evidenced early care pathway in the condition. He has collaborated in adapting this method for non-specialist delivery in India and Pakistan, and now co-leads a large-scale implementation of the pathway across South Asia. Recently, he has undertaken increasing participatory work with the autistic community, including a novel phenomenology project.
Jonathan sat on the most recent UK NICE development group for autism. He is a Senior Investigator in NIHR, Fellow of the UK Academy of Medical Sciences, and UK Global Senior Leader for autism for the International Society of Autism Research (INSAR).
Parent-mediated early intervention in autism; theory, evidence and practice in UK and South Asia
In recent years there has been a shift of emphasis in autism intervention towards the involvement of parents. From intervention being seen as something that could only be undertaken by expert therapists directly with the child, it is now the case that “parent mediated therapy” (that is intervention with and through the parent of an autistic child) seems to have some of the best evidence for longer term developmental outcomes. Why should this be? I will outline the theoretical rationale for parent mediated intervention and illustrate some of the scientific evidence supporting it; from basic science developmental studies, to randomised controlled trials of such interventions in the context of: i) babies with high likelihood of autistic development, ii) babies with early identified community concerns for later autism, iii) children with a diagnosis of autism, both in high income and low and medium income countries.
I will also present mechanistic studies which investigate the logic model of this form of intervention and what can be learnt from them in turn about autistic development – and this informed the adaptation of the PACT model for non-specialist delivery in South Asia.
Are there particular indications or contra indications for this form of intervention and are there any potential adverse effects? How does this work feed into potentially integrated and developmentally focused autism care pathways in different health systems? I will include a discussion of the neurodiversity movement and ethics of healthcare and finish with the theory, ethics and practice of an integrated early intervention pathway for autism and neurodiversity.