Abstract
BackgroundThe outcomes of psycho-educational interventions for Autism Spectrum Disorders (ASDs) comorbid with severe to moderate intellectual disability (ID) are insufficiently documented. In this prospective study, we examined a developmental individual, interactive and intensive approach, called the ‘3i method’, which is based on play therapy.MethodsTwenty DSM-IV-TR ASD subjects (mean chronological age 63.8 ± 37.8 months; mean developmental age 19.5 ± 6.6 months) were included and followed the 3i method for 24 months. Developmental and behavioural skills were assessed at baseline and after 24 months using the VABS, PEP-R and Nadel Imitation scale. Autism severity was evaluated using the Child Autism Rating Scale (CARS) and the Autism Diagnostic Interview (ADI-R).ResultsAfter 2 years of the 3i method, our 3 primary outcome variables significantly increased (VABS developmental age of socialization increased by 83%, age of communication by 34%, and Nadel Imitation score by 53%). Almost all VABS and PEP-R domains significantly improved. Additionally, increases in the VABS socialization score were positively correlated with the total number of treatment hours and CARS score; all ADI-R areas significantly decreased; and diagnoses had changed in 47.5% of the subjects (37% for PDD-NOS and even 10.5% for ID without PDD).ConclusionChildren who followed the 3i method for 2 years had significantly improved behavioural and developmental skills and showed a clear decrease in autism severity. These results suggest that the 3i method may be useful for autistic children by improving their daily interactions with their social environment.Trial registrationwas retrospectively registered on May 20th, 2014 by the French Agency for drug and health (ANSM) under number ID-RCB 2014-A00542–45, reference: B148558–31.
Highlights
The outcomes of psycho-educational interventions for Autism Spectrum Disorders (ASDs) comorbid with severe to moderate intellectual disability (ID) are insufficiently documented
Autism spectrum disorder (ASD) is a life-long neurodevelopmental disorder characterized by early impairments in socio-communicative skills that are associated with a set of restricted interests and/or repetitive stereotypical behaviour [1]
The inclusion criteria were as follows: being diagnosed with ASD based on the Autism Diagnostic Interview, Revised (ADI-R) and the Childhood Autism Rating Scale (CARS); initiating the 3i method at some point between January 2013 and December 2013; residing in an environment that allowed for the correct application of the 3i method; not receiving any other ASD intervention treatment method (e.g., Applied Behaviour Analysis (ABA) or TEACCH); and having French as their maternal language
Summary
The outcomes of psycho-educational interventions for Autism Spectrum Disorders (ASDs) comorbid with severe to moderate intellectual disability (ID) are insufficiently documented. In this prospective study, we examined a developmental individual, interactive and intensive approach, called the ‘3i method’, which is based on play therapy. One example is the Son-Rise Program®, developed in the early eighties, which was essentially based on “joining” the child, playing with him and following his cues. This program has been followed by tens of thousands of families in the U. The DIR method recommends following the child’s lead and supporting his/her initiative; focusing on joint attention; closing circles of communication; creating semistructured problem solving approaches; contrasting repetitiveness with playful obstruction; supporting visual attention; and working on imitation [16, 17]
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