Facteurs liés à l’évolution des compétences adaptatives chez 77 jeunes enfants avec troubles du spectre autistique (TSA)

Abstract

BackgroundIn the literature, most studies about the effectiveness of interventions for children with Autism Spectrum Disorders (ASD) are based on intensive behavioral approaches. Cohort studies, using a more ecological setting, are still rare. The goal of this study is to describe children with ASD's evolution as regards adaptive behaviors. MethodsThis is a prospective and multicenter study including 77 children from 3 to 5 years of age, followed during a one-year period. Adaptive behaviors, weekly hours of intervention in specialized settings (in day-care units) and inclusion in ordinary settings are collected, in order to study the relationship between the children's evolution and the type and amount of interventions they receive. A multivariate analysis is also conducted in order to identify the potential risk and protective factors. ResultsResults show that developmental progress in adaptive behaviors are related to clinical variables such as symptom intensity (CARS), challenging behaviors (ABC) and the initial level in the communication domain (Vineland scale), but also to the hours of weekly interventions. Results indicate that the children who benefited from more hours of inclusion in ordinary settings had a better evolution in the daily living skills domain, whereas children who had more hours of intervention in specialized settings showed more progress in the socialization domain. There was no relationship between the evolution in the communication domain and the hours of intervention in our sample of children. ConclusionThose results yield the influence of ontogenetic processes and environmental factors, such as inclusion in ordinary settings and specialized interventions, in the development and outcome of young children with autism. They argue for the necessity to conduct further research on the effectiveness of interventions through follow-up or cohort studies.