|Early Intensive Behavioral Intervention for Children With Autism: Predictors of Outcome|
|Monday, May 28, 2012|
|2:00 PM–3:20 PM |
|Area: AUT/PRA; Domain: Applied Research|
|Chair: Daniel W. Mruzek (University of Rochester Medical Center)|
|Discussant: Tristram Smith (University of Rochester Medical Center)|
|CE Instructor: Daniel W. Mruzek, Ph.D.|
Outcomes vary widely across children with autism who receive early intensive behavioral intervention (EIBI), yet reliable predictors of differential response are unavailable. This study reports new findings on predictors from three independent research projects. The first presentation examines intake chronological age (CA), IQ, motor stereotypy, and social communication as predictors for children with autism who entered EIBI in publicly funded community agencies in New York at age 2-4 years. Children were assessed at pretreatment (N = 71) and followed up after one year (N = 67) and two years (N = 64). The second presentation compares children receiving one year of EIBI (N = 35) to children receiving treatment as usual (N = 24) in Norway. For a subset of the EIBI group (n = 17), the investigators tested whether treatment gains were associated with the number and type of stimuli that function as reinforcers. The third presentation focuses on skill acquisition in the first 6 months of intervention as a predictor of outcome for children with autism (N = 40, age 2-4 years at treatment onset) who participated in EIBI for >2 years from university-run and publicly funded programs in the United Kingdom and Norway between 2007 and 2011.
|Keyword(s): autism, early intensive, outcome, predictor|
Prediction of Outcome After One Year and Two Years of Early Intensive Behavioral Intervention
|DANIEL W. MRUZEK (University of Rochester Medical Center), Rafael Klorman (University of Rochester), Tristram Smith (University of Rochester Medical Center)|
Outcomes vary widely across children with autism who receive early intensive behavioral intervention (EIBI), yet reliable predictors of differential response are unavailable. We examined predictors in children with autism who entered EIBI in publicly funded community agencies at age 2-4 years. Children were evaluated at pretreatment (N = 71) and followed up after one year (N = 67) and two years (N = 64). Predictor variables included intake chronological age (CA), IQ, motor stereotypy, social approach, preverbal communication (joint attention and social orienting), and imitation. Outcome variables were IQ (Mullen Scales of Early Learning), adaptive behavior (Vineland Adaptive Behavior Scales), and autistic behavior (Autism Diagnostic Observation Schedule). A multiple regression was performed for each outcome measure, entering intake CA and IQ first. In preliminary analyses, pretreatment CA predicted Year 1 IQ ( = 0.35, p = 0.02) but not other outcome variables. Pretreatment IQ and motor stereotypy did not predict any outcome variable. Social approach, preverbal communication, and imitation formed one factor and predicted Year 1 IQ ( = 0.40, p = 0.005) and adaptive behavior ( = 0.51, p = 0.002), though not autism symptoms. Year 2 data have all been collected and will be presented.
Children With Autism Receiving Early Intensive Behavioral Intervention in Mainstream Preschool and Kindergarten Settings
|SVEIN EIKESETH (Oslo and Akershus University College of Applied Sciences), Lars Klintwall (Oslo and Akershus University College of Applied Sciences), Erik Jahr (Akershus University Hospital), Peter Karlsson (Psykologpartners)|
Although Early Intensive Behavioral Intervention (EIBI) for children with autism is well established in university-based studies, its effectiveness of EIBI in community settings remains under-researched. This study compared children receiving one year of EIBI (N = 35) to children receiving treatment as usual (TAU; N = 24). At intake, the groups did not differ significantly in chronological age or adaptive behavior. After one year of treatment, the EIBI group scored significantly higher on all scales of adaptive behavior than the TAU group. Moreover, the EIBI group showed significant improvements in adaptive behaviors, maladaptive behaviors, and autism symptoms, and this change continued into the second year of treatment, albeit to a lesser degree. For a subgroup of 17 children, we investigated whether treatment gains were associated with the number and type of stimuli that function as reinforcers. Results showed that treatment gains positively correlated with the number of socially mediated reinforcers and negatively correlated with automatic reinforcers. These two dimensions taken together explained 61 % of the variation in treatment gains for children after one year of EIBI. Limitations of the study include lack of independent assessments of children receiving EIBI, and lack of random assignment of participants to treatment groups.
Early Detection of Differential Responsiveness to Intensive and Long-term Behavior Treatment
|ERIK JAHR (Akershus University Hospital), Sigmund Eldevik (Oslo and Akershus University College of Applied Sciences)|
The study involves children with autism (age 2-4 years at treatment onset) receiving intensive (20- 40 hours/week) and long-term (>2 years) behavior intervention from university-run and publicly funded programs between 2007 and 2011: Southampton Childhood Autism Programme; SCAmP) in the United Kingdom (N = 14) or Akershus University Hospital in Norway (N=26). At intake, Year 1, and Year 2, all children underwent comprehensive, multidisciplinary assessments of both medical and developmental functioning including cognitive, communicative and adaptive functioning, using standardized and norm-referenced assessment tools. In addition, all children were measured on a uniform assessment of skills (ASK) covering basic, intermediate and advanced areas at intake, and after 6, 12, 18 and 24 months. Preliminary data analysis of the UK sample indicates possible division into three groups in terms of progression emerging at 6 months and remaining on all subsequent assessments. Furthermore change on the skill assessment after 6 months was strongly associated with changes in IQ and adaptive (Vineland) skills after 12 and 24 months. Improvement on certain skill areas of the ask were significantly related to later improvement on both the assessment and the standardized measures. Analysis on the Norwegian sample remains.