COMPASS
Communication-centred Parent-mediated treatment for Autism Spectrum disorder in South Asia
Completed project (2018-2024).
The Aim of the Study:
Led by Dr. Jonathan Green (Chief Investigator, University of Manchester), Dr. Vikram Patel (Co-PI, Harvard Medical School), Gauri Divan (Co-I, Sangath) and Richard Emsley (King’s College London), COMPASS was a project focused on generating evidence for care for Autism in India, with the goal of evaluating the effectiveness of a parent-mediated intervention for Autism Spectrum Disorders in South Asia, delivered by lay health workers in community settings.
In addition to the evaluation, COMPASS also investigated the cost-effectiveness of the intervention, and generated tools and evidence for policymakers to guide the scale-up of the intervention.
The Background:
Autism is a neurodevelopmental disability that is present from birth and has a lifelong impact on the development of a child’s social communication and social interactions with others. Core impairments also include restricted interests and repetitive behaviors, and individuals with autism have difficulties in processing the information from the world around them. A recent study from India indicated that there are over two million families in India with a child (2-9 years) with autism.
Most treatments that are being offered to families of children with autism tend to be ‘imported’ and ‘eclectic’ – this means that they haven’t been evaluated properly in Indian settings. To meet this challenge, the team in Sangath, along with collaborators, adapted and expanded an evidence-based intervention from the UK called Preschool Autism Communication Therapy (PACT), and named it the Parent-mediated Autism Social Communication intervention for non-Specialist Plus (PASS Plus). PASS Plus has two parts:
The novel elements of this intervention is that it has a training and competency curriculum which has been designed to skill up lay health workers to deliver this intervention at homes of families. The PASS and the expanded PASS Plus interventions were evaluated with families having a child with Autism in Goa (2012-2014) and Kolhapur (2014-16) respectively, through pilot randomized controlled trials. Both interventions have shown a high level of acceptability and feasibility along with indications of effectiveness.
The Project Plan:
COMPASS conducted a definitive trial of PASS Plus by recruiting 261 families with a child with autism aged 2 to 9 years through two tertiary care hospitals in New Delhi: Maulana Azad Medical College and Lok Nayak Hospital, and the All India Institute of Medical Sciences. ASHA workers delivered 12 sessions over 6 to 8 months to caregivers, integrating additional support for autism-related challenges, including anxiety and sensory-seeking behaviors.
Assessment Sessions
Counselor Session Delivery
Supporters and Project Duration:
COMPASS was funded by the Medical Research Council (MRC) in the UK and ran from 2018 to 2024.
For more information, visit: COMPASS | Sangath
Publications:
Investigators and Team Members:
Prof Jonathan Green
Chief Investigator, University of Manchester
Prof Vikram Patel
Principle Investigator, Harvard Medical School
Dr. Gauri Divan
Co-Investigator, Sangath
Prof Richard Emsley
Kings College London
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