Abstract
We aimed to address a policy-relevant research area with high priority, namely disseminating early intervention for children on the autism spectrum into mainstream community settings. The study cohort comprised 47 children with a diagnosis of Autism Spectrum Disorder (ASD) receiving the Early Start Denver Model (ESDM) intervention: 23 children attending an Autism Specific Early Learning and Care Centre (ASELCC) and 24 children attending a mainstream preschool setting. Group comparisons revealed that the overall response to intervention was in the majority of cases not significantly different between settings. One difference was found in that children in the mainstream preschool setting showed a significant reduction in externalising behaviours compared to the children attending the autism-specific preschool. Intervention duration was found to influence outcomes with a one-month increase in duration found to improve expressive language skills. While the results need to be interpreted with caution due to the small sample size, these findings suggest that early intervention can be successfully delivered in both autism-specific and mainstream settings. However, those families needing additional parent support may be better served by a specialised service.
Highlights
The prevalence of Autism Spectrum Disorder (ASD) is increasing, with the rate progressing from 1 in 2500 people 40 years ago to the current prevalence rate estimate of 1 in 54 children in the United States in 2016 [1]
Australia has one of the highest reported prevalence rates in the world, with the rate increasing from a parent-reported adjusted prevalence estimate of ASD diagnosis among 10- to 11-year-olds of 2.4%
This in turn results in differences and deviations in the development of the neuronal circuitry responsible for social cognition and language development, with consequent adverse impacts on later behavioural and functional domains dependent on these early processes [5]. This model suggests the importance of early intervention for ASD and is supported by studies showing that the earlier the intervention, the better outcomes [6,7]
Summary
The prevalence of Autism Spectrum Disorder (ASD) is increasing, with the rate progressing from 1 in 2500 people 40 years ago to the current prevalence rate estimate of 1 in 54 children in the United States in 2016 [1]. Underpinned by a genetic vulnerability, ASD has been proposed to arise from a developmental cascade effect whereby a deficit in attention to social stimuli leads to impaired interactions with primary caregivers, thereby affecting the social communication domain of development [4]. This in turn results in differences and deviations in the development of the neuronal circuitry responsible for social cognition and language development, with consequent adverse impacts on later behavioural and functional domains dependent on these early processes [5]. Intervention is ideal as this can take advantage of brain plasticity in the early preschool years, enabling the establishment and reorganisation of neuronal networks
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