'First Stone' ('Prima Pietrà', in Italian) is unique to Italy and among the first in Europe, involving a sample of 30 children aged 18 to 30 months and their parents. It is directed by the Local Health Authority of Potenza (ASP) and the University Hospital G Martino in Messina, Sicily.

The project reinterprets, thanks to the creation of interactive technology and tele-rehabilitation environment, the Denver model for early autism intervention (Early Start Denver Model - ESDM), a treatment for autism spectrum disorders (ASD). This comes as the result of a synergy between clinicians, researchers, psychologists and rehabilitation providers, with the coordination of the CNR (National Research Centre) Clinical Physiology Institute of Pisa.

"The traditional Denver model provides direct intervention with the child and its environment so as to promote and to strengthen social participation and to encourage learning opportunities," explained Giovanni Pioggia of the CNR Clinical Physiology Institute. "All the developmental language, social and cognitive skills of early childhood are activated and evaluated - speech, play, imitation, movement, behaviour and autonomy - through the provision of materials and games which make up daily life, among which the child chooses the learning activity."

At the heart of the 'First Stone' project system is a tablet PC allowing for a continuous link between the parent and the healthcare provider. "Based on the principles of the Denver model, tele-rehabilitation treatment intervention is implemented to promote the relational, sensory, motor and cognitive development of young patients, conducted by their parents with the online supervision of a medical-psychological team connected audiovisually by an on board telecamera," continued Mr Pioggia. He described the system as "a simple graphical interface, adaptable to the user with an intuitive touch screen, that - thanks to voice control and a virtual keyboard - allows multi-modal interaction."

"Parents will be trained and given directions by qualified personnel at their homes, thus helping to reduce the costs of the social health system while improving the quality of life of young ASD patients and their families," concluded Mr Pioggia. "Thanks to these innovative technologies, 'First Stone' will enable the application of the Denver model anywhere [in the country]."

A resident system in the tablet PC will manage the set of applications and therapeutic games, the interactive and tele-rehabilitation platform, as well as clinical data. "The tablet will be connected via a local wireless network to a webcam positioned appropriately in the room, to allow for observation and communication with the operator at the university hospital's medical facility in Messina," Mr Pioggia added. In addition, a system of miniature and non-invasive sensors will enable the control of behavioural and physiological parameters such as a child's posture, movement and heart rate.

The project is the first step in the implementation of a Framework Agreement aimed at creating a scientific research institute in Sicily and a clinical rehabilitative study in the context of prevention, diagnosis and treatment of ASD. It was recently signed by the National Research Centre, the University Hospital G Martino, the Local Health Authority of Potenza, the Stella Maris Institute for Child and Adolescent Neuropsychiatry in Messina and the Interdepartmental Research Centre E. Piaggi of the University of Pisa.

Further information:

• Original news article - National Research Council (in Italian)