Search

This review is aimed at identifying assessment instruments used to measure treatment outcomes in children with autism spectrum disorder who received early and intensive behavioral interventions. Forty three articles were included and appraised using the Council for Exceptional Children’s Standards for Evidence Based Practice quality index rater. Ninety-two outcome measures were discovered. Measures of adaptive functioning (91%), intellectual functioning (86%), and core symptoms (67%) of autism were represented with the highest frequencies. Measures of challenging behavior and parent or caregiver wellbeing were reported at 30% and 14% respectively. Reliability and validity of each measure were determined by recently published psychometric data. The utility of outcome measures in clinical practice is discussed.

Deficits in social referencing have been associated with autism spectrum disorder. It may lead to deficits in language, symbolic abilities, and other social-cognitive behaviors. When deficits in social referencing are detected, teaching such behaviors should be a priority, but effective teaching procedures are lacking. We consider social referencing as a behavior chain and suggest teaching each component in the chain in sequence. We introduce a program to teach the initial component of social referencing, reacting to new and missing objects in the environment through initiating interaction with another present person. Six children with autism spectrum disorder participated. All children acquired the skill within six months and generalized it to new people and materials. Future research could aim to replicate these findings and to develop effective procedures to teach other component skills of social referencing.

This individual participant data meta-analysis is the most intensive possible evaluation of the effectiveness of early intensive applied behaviour analysis–based interventions for pre-school autistic children compared with treatment as usual/eclectic interventions. Data from 491 participants (originally collected in 10 studies) were included. Children receiving early intensive applied behaviour analysis–based interventions improved more on the Vineland adaptive behaviour scale (MD = 7.00; 95% confidence interval = 1.95–12.06) and cognitive ability (intelligence quotient) (MD = 14.13; 95% confidence interval = 9.16–19.10) relative to comparators at 2 years; though effects varied considerably across studies. Evidence for other outcomes was inconclusive due to insufficient evidence and there were few data on longer-term effects. All studies were at risk of bias across several domains, often due to the lack of randomisation or blinding of outcome assessors. Given the emerging evidence of modest, albeit short term, effects of a range of pre-school autism interventions and the limitations of the quality of evaluation studies to date, future research should investigate which supports and interventions are most effective for children and families prioritising outcomes measures that are meaningful for the autism community and longer-term follow-up. Further systematic reviews of the existing evidence are unlikely to add to the findings presented here. Lay abstract Early intensive applied behaviour analysis–based interventions are designed to support young autistic children’s learning and development. Unfortunately, the available evidence about the effectiveness of these interventions remains unclear. Several reviews have focused on the published findings rather than contacting the authors to collect and analyse data about the individual participants in the original studies. Also, most of the studies were carried out by groups involved in delivering the interventions leading to the potential bias in interpreting the results. Our research team (supported by an international advisory group) carried out an independent individual patient data review by collecting the original participant data from the authors of the studies, to examine the effectiveness of these interventions. The results suggested that early intensive applied behaviour analysis–based interventions might lead to some changes in children’s cognitive ability (intelligence quotient) and everyday life skills after 2 years, compared with standard treatments. However, all the studies had problems with the way they were designed. Also, few of the studies looked at outcomes that have been described as most important to autistic people or followed children beyond 2 years. We think that further systematic reviews of the existing evidence are unlikely to add to the findings of our review. Furthermore, we recommend that future research should investigate which types of supports and interventions are most effective for children and families, prioritising outcomes measures that are meaningful for the autism community and include, wherever possible, longer-term follow-up.

Individuals with a diagnosis of Autism Spectrum Disorder (ASD) and individuals with Intellectual Disabilities (ID) are at a higher risk of developing challenging behavior as compared to other populations. In this chapter, we discuss the nature, prevalence, and characteristics of challenging behaviors in individuals with ASD and ID. Aggressive behavior, self-injurious behavior, and stereotypic behavior are addressed separately. Each of these behaviors is discussed in terms of nature and characteristics, definition, topography, prevalence, and risk factors. Clearly, addressing these behaviors is pivotal to improving outcomes for affected individuals, and interventions informed by functional analysis provide an effective technology for achieving this.

Training of behaviour analysts for autism services, in general, has improved notably within a European higher education context. However, the discrepancies associated with regional economic, health care, social services, and institutional policies are problematic and magnify the importance of creating appropriate unified training and consumer protection. Although the European Association for Behaviour Analysis (EABA) has endorsed the Behavior Analyst Certification Board’s (BACB) designations, the absence of European and national regulations, recognition, and accreditation remain significant barriers to quality training and implementation. This problem is particularly pertinent in light of the decision by BACB to limit certification to residents in the USA and Canada after 2022. Advances, challenges, and future directions are discussed within the context of higher education in (1) the United Kingdom, (2) the Czech Republic, (3) Greece, (4) Iceland, (5) Italy, (6) Norway, and (7) Sweden. The post-Bologna European agenda for higher education and globalisation is discussed and opportunities for the training of behaviour analysts within European higher education are outlined.

Although a foundation in the basic science of behavior represents a common goal of practitioners and educators of behavior analysis, the content covered in master’s degree–level courses on the experimental analysis of behavior (EAB) can vary widely across university programs. The purpose of our study was to analyze the syllabi of master’s degree programs accredited by the Association for Behavior Analysis International to develop a list of common readings and topics in EAB coursework that might be useful for curricular development. We identified the most frequently cited references, journals, and participant characteristics. We found commonalities among the syllabi with regard to the types of readings assigned and the topics covered. We discussed our findings in terms of current trends in EAB and quality graduate training in behavior analysis.

A recent study described a synthesized treatment where a functional analysis was based on an open-ended interview and combined with functional communication and delay-tolerance training. The treatment resulted in a reduction in problem behaviors and an increase in appropriate requests. Most of the analysis and intervention were done in a clinic setting, and required weekly visits by the family. This present study is a systematic replication, where we conducted the same synthesized treatments, with a young child with Autism Spectrum Disorder (ASD) enrolled in a home-based Early Intensive Behavior Intervention program, EIBI. Outcomes were similar with a marked reduction in problem behaviors and an increase in appropriate requests. These findings suggest that it is possible to conduct this intervention in a home setting, with weekly consultations with parents. Our study show the utility of the synthesized treatment in an EIBI program in a home setting and how this can contribute to client time and costs.

Zusammenfassung. Fragestellung: Für Vorschulkinder mit Autismus-Spektrum-Störung (ASS) weist die frühe intensive Verhaltenstherapie die besten Lernerfolge auf. In dieser explorativen Studie wurden Ergebnisse eines Modells für ein Angebot auf kommunaler Ebene mit Eltern als aktive Therapeuten ausgewertet. Methodik: In einem Wartelisten-Kontrolldesign wurden 13 Kinder mit ASS, die zu Beginn der Intervention zwischen 2 und 5 Jahre alt waren, untersucht. Sie erhielten eine einjährige verhaltenstherapeutische Frühförderung von ca. 20 Wochenstunden im Elternhaus, größtenteils durchgeführt von ihren Eltern. Die Wartekontrollgruppe bestand aus sieben Kindern, die 6 Monate vor der Intervention untersucht wurden. Die Therapie wurde auf der Grundlage des University of California at Los Angeles Young Autism Project-Modells (UCLA YAP; Lovaas, 1981 , 1987 , 2003 ) durchgeführt. Zur Messung wurden die Testverfahren Psychoeducational Profile, Third Edition (PEP-3), Parenting Stress Index (PSI) und Childhood Autism Rating Scale, Second Edition (CARS2) eingesetzt. Aus dem Teilbereich Cognitive Verbal/Preverbal des PEP-3, der das mentale Entwicklungsalter misst, wurde zusätzlich ein mentaler Entwicklungsindex (MDI) errechnet. Ergebnisse: Nach einem Jahr intensiver Verhaltenstherapie wurden signifikant höhere PEP-3-Werte und ein signifikant höherer mentaler Entwicklungsindex gemessen. Es wurden außerdem signifikant niedrigere CARS2-Werte gemessen. Bei der Wartekontrollgruppe, gab es keine signifikanten Veränderungen. Das Stressniveau der Eltern veränderte sich nicht signifikant und sank insgesamt leicht. Schlussfolgerung: Diese Umsetzung der frühen intensiven Verhaltenstherapie ist vielversprechend. Die umfangreiche Elternbeteiligung an der Förderung zeigte keine besonderen Auswirkungen auf das Stresserleben der Eltern. Die Studie sollte mit einer größeren Stichprobe und einem verbesserten Design wiederholt werden.

A growing evidence base supports early intensive behavioral intervention (EIBI) for young children with autism spectrum disorder. We have found only one study exploring the outcome of EIBI for children with Rett syndrome, which reported little effect. It suggested that future studies should employ more fine-grained outcome measures. We provided EIBI for twin 3-year-old girls with Rett syndrome for a period of 3 years. We analyzed raw scores and standard scores from a measure of adaptive behavior and a detailed assessment of skills across 25 areas. We detected moderate but clinically meaningful gains in areas such as communication and self-help. Gains are discussed from a quality of life perspective and whether the moderate effects can justify the resources required in EIBI.

We compared clinical outcomes in a treatment group of 98 individuals who received between 8 and 15 weekly hours ( M = 10.6; SD = 1.7) of applied behavior analysis (ABA) intervention with a comparison group of 73 individuals who received another provision, including some ABA, (between 1.4-8 weekly hours, M = 5.7; SD = 1.6). After 2 years, the treatment group made greater gains than the comparison group on language and social skills, and other areas assessed by the Verbal Behavior Milestones Assessment and Placement Program (VB-MAPP). We evaluated the outcome on adaptive skills for a smaller sample of participants using the Vineland Adaptive Behavior Scales II (VABS), but found no significant differences between the treatment ( n = 17) and comparison groups ( n = 11). Although the treatment group made important and clinically meaningful gains, the gains were moderate. These findings underline the importance of intervention intensity and provide further support for a dose–response relationship between ABA intervention hours and outcomes.

Early intensive behavioral intervention (EIBI) has proved to be an effective intervention for children with autism spectrum disorder (ASD). In this exploratory study, we evaluated the effects of a community-based service model with parents as active therapists.13 children with ASD between 2 and 5 years of age at intake participated in the study. A waiting-list control design was employed. The children received 1 year of home-based EIBI for approximately 20 hours a week, their parents functioning as primary therapists. The waiting-list control group consisted of seven children who were tested 6 months before the intervention commenced. The intervention was based on the University of California at Los Angeles Young Autism Project model (UCLA YAP; Lovaas, 1981, 1987, 2003). The Psychoeducational Profile (3rd ed., PEP-3), the Parenting Stress Index (PSI), and the Childhood Autism Rating Scale (2nd ed., CARS 2) were used to measure outcome. In addition, a mental developmental index (MDI) was calculated on the basis of the Cognitive Verbal/Preverbal subscale of the PEP-3.After 1 year of EIBI, we found a significant increase in the PEP-3 scores and MDI scores as well as a significant reduction in the CARS 2 scores. No significant changes were seen when participants were on the waiting list. The stress level of the parents did not change significantly and in fact showed overall a slight decrease.This model of providing EIBI appears to hold some promise. Comprehensive parental involvement did not affect their stress level. The study need to be replicated with a larger sample and an improved design.

This study investigated the effect of videoconferencing in training staff to implement discrete trial teaching in real life settings with children with autism. Fourteen participants were randomly assigned to two groups. One group received training on-site and the other group received training via videoconference. The participants in both groups received 3× 15 min of training on three different teaching programs: matching, receptive and expressive labeling. The results showed no significant differences between the groups in the post-test whilst both groups improved significantly following training. Although preliminary, these results suggest that videoconferencing can be a cost-saving way to train staff in how to implement discrete trial teaching.

Although Discrete-trial Teaching (DTT) is effective in teaching a many skills to children with autism, its proper implementation requires rigorous staff training. This study used an interactive computer simulation program ("DTkid") to teach staff relevant DTT skills. Participants (N = 12) completed two sets of pre-tests either once (n = 7) or twice (n = 5) before brief DTkid training. These evaluated (a) simulated interactive teaching using DTkid and (b) in vivo teaching of three basic skills (receptive and expressive labeling; verbal imitation) to children with autism. Post-tests showed that DTkid training, rather than repeated testing, was significantly associated with improvements in staff's ability to implement DTT both within the simulation and in vivo, and that the skills acquired showed both stimulus and response generalization.

We evaluated outcomes for 31 children with autism (2–6 years of age at intake) who received behavioral intervention in mainstream pre-school settings and a comparison group of 12 children receiving treatment as usual. After 2 years, children receiving behavioral intervention had higher IQ scores (Hedges g = 1.03 (95% CI = .34, 1.72) and adaptive behavior composite scores (Hedges g = .73 (95% CI = .05, 1.36). Despite probably fewer intervention hours, these group level outcomes were comparable to studies providing more intensive intervention. Individual child data also showed positive results with 19.4% achieving change at a reliable level for IQ; but a lower percentage than found in recent meta-analysis research. Strengths and weaknesses of the mainstream pre-school delivery model are discussed.

Prevalence of current comorbid DSM-IV disorders was assessed in a special school population of children and adolescents with ASD (N = 71, age 6.0-17.9 years), representing all cognitive levels and main ASD subgroups. Symptoms were assessed through parent interview and association to child characteristics was explored. Seventy-two percent was diagnosed with at least one comorbid disorder. Anxiety disorders (41%) and attention deficit/hyperactivity disorder (31%) were most prevalent. Obsessive-compulsive disorder was more common in older children, and oppositional defiant disorder/conduct disorder more prevalent in pervasive developmental disorder, not otherwise specified. Our results show high rates of comorbid DSM-IV disorders and underscore the importance of such evaluation in children ASD. However, diagnostic challenges are present and future research on the diagnostic validity of comorbid psychiatric disorders is needed.

Data from Norway were analyzed to evaluate early behavioral intervention for children with intellectual disabilities. The intervention group ( n = 11) received approximately 10 hours per week of behavioral intervention; the eclectic comparison group ( n = 14) received treatment as usual. After 1 year, changes in intelligence and adaptive behavior scores were statistically significant in favor of the behavioral intervention group (effect sizes of 1.13 for Intelligence quotient (IQ) change and .95 for change in adaptive behavior composite). Approximately 64% of the children in the behavioral intervention group met objective criteria for reliable change in IQ, whereas 14% in the eclectic comparison group did so. These results suggest that children with intellectual disability may profit from behavioral intervention typically provided for children with autism.

A systematic literature search for studies reporting effects of Early Intensive Behavioral Intervention identified 34 studies, 9 of which were controlled designs having either a comparison or a control group. We completed a meta-analysis yielding a standardized mean difference effect size for two available outcome measures: change in full-scale intelligence and/or adaptive behavior composite. Effect sizes were computed using Hedges's g. The average effect size was 1.10 for change in full-scale intelligence (95% confidence interval = .87, 1.34) and .66 (95% confidence interval = .41, .90) for change in adaptive behavior composite. These effect sizes are generally considered to be large and moderate, respectively. Our results support the clinical implication that at present, and in the absence of other interventions with established efficacy, Early Intensive Behavioral Intervention should be an intervention of choice for children with autism.

This study investigated whether response variability and turn taking were controlled by the play partner's responding. Variability and turn taking was assessed in two conditions following an ABA experimental design. Participants were three preschool aged children with autism and eight nondisabled preschool aged children. During the A-condition, the partner emitted play responses that were topically related to the participant's preceding play response, and during the B-condition, the partner emitted play responses that were topically unrelated to the participant's preceding play response. Results showed marked reduction in play variability and turn taking during the B-condition for all participants, demonstrating that variability and turn taking in cooperative play may be affected by the partner's play during the interaction. Key Words: cooperative play, variability, turn taking, typical children and children with autism. Introduction The analysis of social interaction in terms of both structural and functional properties is critical as a basis for understanding the occurrence of enduring social interaction and for the development of effective programs to facilitate social interaction in people with limited skills in this area. Behaviors that are evoked and maintained by properties of one or several other persons behavior are usually considered social, and the contingencies in which these behaviors are evoked are usually labeled social interaction (Skinner, 1957). Reciprocity, as an overarching concept, is said to be the nature of such interaction (Strain, Shores, & Timm, 1977) indicating a dependent relation between the responses involved. Functional aspects of social interaction have been discussed by several researchers, and often within the context of cooperation (e.g., Guerin, 1994; Hake, & Olvera, 1978; Schmitt, 1984). A cooperative contingency is according to Hake and Olvera (1978) identified when the reinforcers for each person involved is at least partially dependent upon the other person's responses. Reaching such a conclusion however, may require a further analysis of structural features of response patterns that occurs between the partners involved. Especially since an interaction as such seldom involves arbitrary reinforcers (e.g., food or money) but idiosyncratic responses, supposedly containing both reinforcing and discriminative stimulus functions. Jahr, Eldevik and Eikeseth (2000) argued that response alternation and response variability constitute some of the structural properties of a cooperative contingency from which functional properties may be derived. In this study, a procedure to establish cooperative play in children with autism was investigated and later replicated with typical children as participants (Jahr & Eldevik, 2002). The training elements included verbal description and imitation of modeled play episodes, utilizing a multiple exemplar strategy. Following training, participants in both studies could initiate play episodes and sustain episodes initiated by their play partner, and they were able to take turns in play episodes that contained a larger number of play responses than were practiced during training. Moreover, a considerable increase in play variability was evident for each child. Hence, the children seldom repeated their own play responses or persevered on specific objects. Instead they utilized a variety of play materials and their play responses were usually an adequate supplement to their play partners' responses and thereby a thematic extension of the play episode. That the children and their partner were playing within the same topic was confirmed by independent raters during social validity measures. The observed increase in turn taking and the emergent ability to vary responding in accordance to both the play partners' response and own previously emitted responses was assumed to indicate a functional relationship between the responses involved (Jahr et al. …

The purpose of this study was to identify potential collateral changes in solitary play following the acquisition of cooperative play in three children with autism. An approach combining observation, verbal description and imitation of modeled interactive play, utilizing a multiple exemplar strategy, was applied to establish cooperative play. Both the number of consecutive play responses and the extent of response variability in the children's solitary play were assessed prior to, and immediately after criterion for mastery were met for cooperative play. A corresponding change in solitary play was found, both in terms of episode length and variability following mastery of cooperative play. The results were maintained at 3 and 14 months follow-up measures. Key Words: solitary functional play, cooperative play, response variability, children with autism. Introduction Descriptive accounts on the progression of play behavior in typical development are numerous, and the results on both sequencing of play forms and at what age one can expect different play forms to appear are fairly consistent across studies. During the first year of infancy, play is predominantly characterized by simple manipulation of objects such as mouthing, banging, sucking and throwing (e.g., Fenson, Kagan, Kearsley, & Zelazo, 1976). Functional play, which involves the capacity to handle objects as their function denotes (e.g., Libby, Powel, Messer, & Jordan, 1998), tends to emerge in the beginning of the second year and the number of functional acts increases linearly with increasing age (e.g., Belsky & Most, 1981; Largo & Howard, 1979). The ability to combine or relate objects into topic related sequences appears by the end of the second year and is a regular part of the child's play repertoire when around 30 months of age (e.g., Largo & Howard, 1979; Sinclear, 1970). Children with autism will not necessarily follow the transition from single play acts towards combinatorial functional play as seen in typical children. In fact, numerous studies have revealed deficits in functional play in this group (e.g., Jarrold, Boucher, & Smith, 1996; Lewis & Boucher, 1988; Sigman & Ungerer, 1984; Stone, Lemanek, Fichel, Fernandez, & Altmeier, 1990). Studies show that spontaneous functional play in children with autism is reduced compared to typical children (e.g., Jarrold et al., 1996; Lewis & Boucher, 1988; Ungerer & Sigman, 1981), but also compared to children with other conditions such as moderate learning difficulties (Jarrold et al., 1996). When functional play occurs, it appears to be less varied with more repetitions than novelty, consisting predominantly of single acts involving single objects (Boucher, 1977; Sigman & Ungerer, 1984; Williams, Reddy, & Costall, 2001). Hence, elaborated functional play that involves several objects in integrated chains of actions is less likely to be observed with these children (e.g., Williams et al., 2001). Although children with autism show a reduction in spontaneous functional play with multiple objects, they show no impairment compared with controls when provided with cues, either in terms of specific instructions (e.g., "Give the dolly a drink of juice") or "open prompts" (e.g., "What can you do with these?") (Charman & Baron-Cohen, 1997; Jarrold et al., 1996). Since children with autism are able to carry out elaborated functional play under cued circumstances, but show difficulties doing so spontaneously, it has been suggested that the difficulty relates to the ability to generate actions and to produce available skills (Jarrold et al., 1996). A potential outcome of such a deficit could be a predominance of repetitive responding over novelty and variability (Jarrold, 1997). Others have suggested that the very tendency to persevere interferes with the production of novel play responses (e.g., Lewis & Boucher, 1988). …

This study was designed to evaluate 1 year of intensive treatment for 4- to 7-year-old children with autism. An independent clinician assigned children to either behavioral treatment (n = 13) or eclectic treatment (n = 12). Assignment was based on availability of personnel to supervise treatment and was not influenced by child characteristics or family preference.The two treatment groups received similar amounts of treatment (M = 28.52 hours per week at the child’s school). Children in the behavioral treatment group made significantly larger gains on standardized tests than did children in the eclectic treatment group. Results suggest that some 4- to 7-year-olds may make large gains with intensive behavioral treatment, that such treatment can be successfully implemented in school settings, and that specific aspects of behavioral treatment (not just its intensity) may account for favorable outcomes.

This study investigated the acquisition of cooperative play in three typical children. The differential effectiveness of two different modeling conditions was compared, where in the first condition the children were trained to observe and imitate modeled cooperative play. In the second condition the children observed and described the modeled play prior to imitation. During training, modeled play episodes varied across play topics. The criterion for mastery in training was correct responding on first trial with new modeled play episodes. The results showed that the children became able to take turns in novel episodes of cooperative play and to show play variability only after including verbal description as part of the modeling procedure. Copyright © 2002 John Wiley & Sons, Ltd.

This study investigated the acquisition, transfer, and maintenance of cooperative play in six children with autism. Two approaches were compared. In one approach, the participants observed two models engaging in cooperative play, before taking the place of one of the models while the play episode just observed was repeated. The second approach was identical to the first except that the participants were now required to verbally describe the modeled play episode before taking the place of one of the models. During training, modeled play episodes varied across play topics, and the criterion for mastery was first trial learning of novel play episodes. A nonconcurrent multiple baseline design across participants was applied. The results showed that the participants failed to acquire cooperative play until the verbal description was included in the training procedure. Following training with verbal description, all participants: a) could initiate episodes and sustain episodes initiated by their play partner; b) were able to take turns in episodes that were considerably longer than the episodes practiced during training; c) varied their play within and between play episodes; and, d) transferred those skills across play partners, settings, and time.

Although still a matter of some debate, there is a growing body of research supporting Early and Intensive Behavioral Intervention as the intervention of choice for children with autism. Learning rate is an alternative to change in standard scores as an outcome measure in studies of early intervention. Learning rates can be displayed graphically as developmental trajectories, which are easy to understand and avoid some of the counter-intuitive properties of changes in standard scores. The data used in this analysis were from 453 children with autism, previously described by Eldevik et al. Children receiving Early and Intensive Behavioral Intervention exhibited significantly steeper developmental trajectories than children in the control group, in both intelligence and adaptive behaviors. However, there was a considerable variability in individual learning rates within the group receiving Early and Intensive Behavioral Intervention. This variability could partly be explained by the intensity of the treatment, partly by children’s intake intelligence quotient age-equivalents. Age at intake did not co-vary with learning rate.

We gathered individual participant data from 16 group design studies on behavioral intervention for children with autism. In these studies, 309 children received behavioral intervention, 39 received comparison interventions, and 105 were in a control group. More children who underwent behavioral intervention achieved reliable change in IQ (29.8%) compared with 2.6% and 8.7% for comparison and control groups, respectively, and reliable change in adaptive behavior was achieved for 20.6% versus 5.7% and 5.1%, respectively. These results equated to a number needed to treat of 5 for IQ and 7 for adaptive behavior and absolute risk reduction of 23% and 16%, respectively. Within the behavioral intervention sample, IQ and adaptive behavior at intake predicted gains in adaptive behavior. Intensity of intervention predicted gains in both IQ and adaptive behavior.

This study asked whether intensity of supervision is associated with outcome in preschool aged children with autism (N = 20) who received intensive and early behavioral intervention. Intensity of supervision ranged from 2.9 to 7.8 hours per month per child. Results show a significant correlation between intensity of supervision and improvement in IQ. Thus, intensity of supervision was reliably associated with amount of IQ change between intake and follow-up. These findings add to existing literature by suggesting that intensity of supervision together with intensity of treatment, treatment method, and pre treatment functioning are variables that may affect outcome for children with autism who receive early and intensive behavioral intervention. UK Young Autism Project, London

This study investigated the frequency and latency of naturally occurring social interaction with typically developing children and those with autism in inclusive kindergarten settings. The children with autism were also subdivided into two groups according to intellectual functioning in order to analyze frequency and latency of social interaction in relation to degree of disability. The results showed a significant difference in frequency of social interaction between the typical children and those with autism. There was no difference between the groups on latency to initiate interaction. However, shorter latency was associated with higher frequency in the typical group but not in the group of children with autism. Significant differences in IQ and adaptive functioning were found between the children with autism who showed interaction and those who did not. The results for the typical children may be used as benchmark values for the assessment of treatment outcome for children with autism.

This study extends findings on the effects of intensive applied behavior analytic treatment for children with autism who began treatment at a mean age of 5.5 years. The behavioral treatment group ( n = 13, 8 boys) was compared to an eclectic treatment group ( n = 12, 11 boys). Assignment to groups was made independently based on the availability of qualified supervisors. Both behavioral and eclectic treatment took place in public kindergartens and elementary schools for typically developing children. At a mean age of 8 years, 2 months, the behavioral treatment group showed larger increases in IQ and adaptive functioning than did the eclectic group. The behavioral treatment group also displayed fewer aberrant behaviors and social problems at follow-up. Results suggest that behavioral treatment was effective for children with autism in the study.

We retrospectively compared 2 groups of children receiving either behavioral treatment (n = 13) or eclectic treatment (n = 15) for an average of 12 hours per week. Children were assessed on intelligence, language, adaptive functioning and maladaptive behavior at pretreatment and 2 years into treatment. The groups did not differ significantly at pretreatment. After 2 years of treatment, the behavioral group made larger gains than the eclectic group in most areas. However, gains were more modest than those reported in previous studies with children receiving more intensive behavioral treatment, and it is questionable whether they were clinically significant.