COMPASS: Communication centered Parent mediated intervention for Autism Spectrum disorder in South Asia

PROJECT OVERVIEW

COMPASS is the result of research work done by Sangath in the field of autism since 2009. After exploratory qualitative work in Autism Research Training Initiative (ARTI; 2009-2012), and two pilot trials (PASS; 2012-14 and PASS Plus; 2016-18), this phase 3 trial of the effectiveness of the Parent-mediated Autism Social communication intervention for non-Specialists Plus (PASS Plus) commenced in 2019. COMPASS aims to assess whether non-specialist government frontline workers, the Accredited Social Health Activists (ASHAs) when trained and supervised, can deliver a quality home-based intervention to caregivers to support their young children’s social communication difficulties. It is the largest randomized control trial for autism in a low- and middle-income country, involving a sample size of 261 participants in 11 districts of Delhi, India.

 

In the words of COMPASS Evaluation team “COMPASS is a painting, where each child becomes a unique stroke, enhancing its beauty. Beyond trials, it transforms into an empathetic journey, unveiling autism’s intricate layers within the community, one family at a time” and Intervention team “COMPASS is an expedition, to ensure caregivers are bestowed with adequate guidance and a treasure of resources through an accessible support system to learn the art of navigating communication in autism with ease.”

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LOCATION

National Capital Territory of Delhi

PROJECT DURATION

April 2018 – June 2024

PROJECT GOAL

  • To determine whether the Parent-mediated Autism Social Communication intervention for Non-Specialists Plus (PASS Plus), is effective when delivered by non-specialists in community settings.
  • To assess and understand feasibility and cost effectiveness for the PASS Plus against the usual treatments received by the children.
  • To generate resources for policymakers to support and guide the scale-up of a universal intervention for young children with autism in low resource settings.

KEY COMPONENTS

Intervention Arm

 

 

  • A team of Intervention Coordinators was trained in PASS Plus intervention to facilitate the training and supervision of non-specialists.
  • Recruitment of non-specialist was done through a systematic process of identification, training, practice session delivery and competency. Seven ASHA workers and 10 COMPASS counsellors achieved competency through this process.
  • 17 non-specialists have delivered the intervention to 130 families of children with autism in Delhi. The sessions were adapted to be delivered virtually and in hybrid mode to ensure the continuity of session delivery during the lockdowns associated with the COVID-19 pandemic.
  • Monthly refresher trainings and weekly supervisions have been conducted to ensure quality session delivery.
  • Intervention arm activities were completed in Sept 2023.

 

Evaluation Arm

 

 

    • Referrals for the trial, encompassing a total of 261 participants, were obtained from two tertiary care hospitals viz., All India Institute of Medical Sciences and Maulana Azad Medical College-Lok Nayak Hospital.
    • A team of psychologists were trained on conducting assessments with children with autism and their caregivers in order to understand the development of children across three time points, strategically spread over a period of 15 months.
    • Some of the assessment measures were culturally adapted to align within the context of the participants.
    • Data collection has been done using both using traditional paper-based measures and a secure online database known as REDCap.
    • All data is being collected as per predefined standard operating procedures, ensuring accuracy and consistency.
    • The team has achieved significant milestones by successfully completing assessments for two time-points in the trial viz., baseline and endline (at 9 months) while follow-up (at 15 months) is still in progress. The trial activities are projected to be complete in April 2024.

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batches of participants

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participants oriented

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participants completed the course

TEAM

Prof Jonathan Green
Chief Investigator
University of Manchester

Prof Vikram Patel
Principle Investigator Harvard University

Dr. Gauri Divan
Co-Investigator
Sangath

Vivek Vajaratkar
Co-Investigator
Goa Medical College

Dr. Sheffali Gulati
Site Investigator
All India Institute of Medical Sciences

 

Dr. Monica Juneja
Site Investigator
MAMC and Lok Nayak Hospital

R.Roy
Trial Director
Sangath

Dr. Kathy Leadbitter
Trial Coordinator
University of Manchester

For further details, please contact Dr. Gauri Divan at gauri.divan@sangath.in

FUNDERS

PARTNERS

RELEVANT LINKS

RESOURCES

Reetabrata Roy et al

Neurodevelopmental disabilities,

2023

Indu Dubey, Rahul Bishain, Gauri Divan, Bhismadev Chakrabarti, Jayashree Dasgupta, Supriya Bhavnani, Vikram Patel, et al

Sage Journals,

2023

Lavangi Naithani, Priya Sangwan, Sanjana Guha Roy, Sreepriya Menon, Zakiya Azar, Shweta Lakhera, Divya Kumar, Minal Kakra Abhilashi, Reetabrata Roy, Vivek Vajaratkar, Carol Taylor, Vikram Patel, Jonathan Green, Gauri Divan

Frontiers, Frontiers in Psychiatry,

2022

Lavangi Naithani, Caitlin Goldie, Abhipreet Kaur, Charlotte Butter, Shweta Lakhera, Kathy Leadbitter, Gauri Divan

Frontiers, Frontiers in Psychiatry,

2022

D Mukherjee, S Bhopal, S Bhavnani, K Kant Sharma, R Roy, G Divan, S Mandal, S Soremekun, B Kirkwood, V Patel

Wellcome Open Research,

2022

Indu Dubey, Simon Brett, Liliana Ruta, Rahul Bishain, Sharat Chandran, Supriya Bhavnani, Matthew K. Belmonte, Georgia Lockwood Estrin, Mark Johnson, Teodora Gliga, Bhismadev Chakrabarti

Plos One,

2022

PRESS MENTIONS

Ritu Shrivastava, Lochan Sharma, Mehak Jolly, Romi Ahuja, Radhika Sharma, John A Naslund, Jyotsna Agrawal, Rahul Shidhaye, Seema Mehrotra, Steve D Hollon, Vikram Patel, Deepak Tugnawat, Ananth Kumar, Anant Bhan, Ameya P Bondre

Soc Sci Med,

2023

Jan M. Heijdra Suasnabar, Abhijit Nadkarni, Benjamin Palafox

Wiley Online Library,

2023

Ritu Shrivastava, Abhishek Singh, Azaz Khan, Shivangi Choubey, Juliana Restivo Haney, Eirini Karyotaki, Deepak Tugnawat, Anant Bhan, John A. Naslund

SSM-Mental Health,

2023

Abhijit Nadkarni, Yashi Gandhi, Urvita Bhatia and Richard Velleman

Cambridge University Press, Global Mental Health,

2022

Ameya P. Bondre, Ritu Shrivastava, Harikeerthan Raghuram, Deepak Tugnawat, Azaz Khan, Snehil Gupta, Mohit Kumar, Urvakhsh Meherwan Mehta, Matcheri Keshavan, Tanvi Lakhtakia, Prabhat Kumar Chand, Jagadisha Thirthalli, Vikram Patel, John Torous, Abhijit R. Rozatkar, John A. Naslund, Anant Bhan

SSM - Mental Health,

2022

Kendra S. Knudsen MA, Kimberly D. Becker PhD, Karen Guan PhD, Resham Gellatly PhD, Vikram H. Patel MD, Kanika Malik PhD, Maya M. Boustani PhD, Sonal Mathur PhD, Bruce F. Chorpita PhD

Journal of Evaluation in Clinical Practice,

2022

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