Abstract
BackgroundDespite widespread awareness of the necessity of early intervention for children with autism spectrum disorders (ASDs), evidence is still limited, in part, due to the complex nature of ASDs. This exploratory study aimed to examine the change across time in young children with autism and their mothers, who received less intensive early interventions with and without applied behavior analysis (ABA) methods in community settings in Japan.MethodsEighteen children with autism (mean age: 45.7 months; range: 28–64 months) received ABA-based treatment (a median of 3.5 hours per week; an interquartile range of 2–5.6 hours per week) and/or eclectic treatment-as-usual (TAU) (a median of 3.1 hours per week; an interquartile range of 2–5.6 hours per week). Children’s outcomes were the severity of autistic symptoms, cognitive functioning, internalizing and externalizing behavior after 6 months (a median of 192 days; an interquartile range of 178–206 days). In addition, maternal parenting stress at 6-month follow-up, and maternal depression at 1.5-year follow-up (a median of 512 days; an interquartile range of 358–545 days) were also examined.ResultsLarge individual variations were observed for a broad range of children’s and mothers’ outcomes. Neither ABA nor TAU hours per week were significantly associated with an improvement in core autistic symptoms. A significant improvement was observed only for internalizing problems, irrespective of the type, intensity or monthly cost of treatment received. Higher ABA cost per month (a median of 1,188 USD; an interquartile range of 538–1,888 USD) was associated with less improvement in language-social DQ (a median of 9; an interquartile range of −6.75-23.75).ConclusionsTo determine an optimal program for each child with ASD in areas with poor ASD resources, further controlled studies are needed that assess a broad range of predictive and outcome variables focusing on both individual characteristics and treatment components.
Highlights
Despite widespread awareness of the necessity of early intervention for children with autism spectrum disorders (ASDs), evidence is still limited, in part, due to the complex nature of ASDs
A recent systematic review of early intensive intervention concluded that Lovaas-based approaches, early intensive behavioral intervention variants and the early intensive comprehensive approach resulted in some improvement in cognitive, language, and adaptive functioning in some young children with ASD compared with broadly defined eclectic treatments [1]
Three research volunteer families were contacted because they lived near the National Center of Neurology and Psychiatry (NCNP)
Summary
Despite widespread awareness of the necessity of early intervention for children with autism spectrum disorders (ASDs), evidence is still limited, in part, due to the complex nature of ASDs. Autism spectrum disorders (ASDs) are persistent disabling neurodevelopmental disorders that are clinically evident from early in life. Early identification and subsequent intervention for ASDs are considered key issues. A recent systematic review of early intensive intervention concluded that Lovaas-based approaches, early intensive behavioral intervention variants and the early intensive comprehensive approach (the Early Start Denver Model) resulted in some improvement in cognitive, language, and adaptive functioning in some young children with ASD compared with broadly defined eclectic treatments [1]. The growing body of evidence on early interventions for children with ASD suggests that there is great variability in children’s response to treatment [1,2,3,4,5,6]. The responder’s characteristics for each treatment have not
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