The Autism Society Event and Education Recordings Archive

This session will present the outcomes for young children with autism who received either clinic-based or parent-managed eclectic interventions over 2 years. Comparisons were made between the two intervention models and of both child and family progress over time, using growth curve modeling. Factors that predicted outcomes were also examined. Over the past 20 years, there has been considerable interest in the potential impact of early intensive intervention on the development of young children with autism. Much of this interest was initiated by publication of the results of the Young Autism Project, a program based at UCLA in which some children with autism who received 40 hours per week of 1:1 structured behavioral intervention showed evidence of gains that exceeded those previously reported in the research literature (Lovaas, 1987). Over the past few years, several additional reports related to this project have appeared in the literature (e.g., Bibby, Eikeseth, Martin, Mudford, & Reeves, 2001; Eikeseth, Smith, Jahr, & Eldevik, 2002). These and other studies suggest that the impact of intensive intervention can vary considerably, depending on the nature and amount of service provided.

This session will focus on the results of early intensive intervention for young children with autism from British Columbia, Canada, that were gathered over the 3 years from 2001-2004. The study was conducted by independent researchers and utilized a prospective, non-randomized group design with two treatments, no control group, and a total of 70 participants. One group of children (n = 39) received services through clinic-based programs that provided approximately 20 hours per week of home- and/or preschool intervention. Typically, these programs consisted of 1:1 structured teaching delivered in homes by trained behavior interventionists, speech-language pathologists, and occupational therapists. Another group of children (n = 31) received parent-managed programs that were more eclectic in nature, ranging from 1:1 behavioral intervention alone to a combination of other therapies alone (e.g., speech-language, occupational, recreational, etc.). Participants were evaluated at baseline and again after 6, 12, and 24 months of intervention; the clinic-based group was also evaluated at 32 months. Each child is assigned an evaluation team comprised of a psychologist, a speech-language pathologist, and a graduate student trained to conduct family interviews. A standard set of assessment instruments is administered to all children and families. The child instruments included measures of autism severity, cognitive ability, receptive and expressive language, play and social skills, adaptive behaviour, temperament and problem behaviour, and sensory functioning. The family instruments included measures of parenting stress, child and family social networks, home and community activity patterns, parent perceptions of child progress, and parent satisfaction. Traditional statistical procedures (e.g., analysis of variance, paired t-tests) were used to compare outcomes for the clinic-based and parent-managed groups, for children with autism vs, PDD-NOS, and for children who were testable vs. untestable at both baseline and6 months. Growth curve modeling was used to examine both the children's change over time and a number of baseline variables that predicted the outcomes. We also developed a novel way to estimate the proportion of change due to both maturation and treatment. We will present the results data and discuss their implications for decisions regarding general program outcomes and the comparative progress in the two types of treatment programs. The session adds to the growing body of research examining the outcomes of early intervention and extends previous work with analyses that were sensitive to changes across both individual children and time.

References

Bibby, P., Eikeseth, S., Martin, N.T., Mudford, O.C., & Reeves, D. (2001). Progress and outcomes for children with autism receiving parent-managed intensive interventions. Research in Developmental Disabilities, 23, 425-447.

Eikeseth, S., Smith, T., Jahr, E., & Eldevik, S. (2002). Intensive behavioral treatment at school for 4- to 7- year old children with autism. Behavior Modification, 26, 49-68.

Lovaas, O.I. (1987). Behavioral treatment and normal educational and intellectual functioning in young autistic children. Journal of Consulting and Clinical Psychology, 55, 3-9.

Content Area: Early Intervention