Early Autism Intervention Research Articles

The effects of intellectual functioning and autism severity on outcome of early behavioral intervention for children with autism

This study assessed the relation between pre-intervention variables (cognition, socialization and communication) to outcome in young children with autism. Method Twenty five children with autism (20–32 months) were enrolled in intensive behavior intervention. The children were divided into groups based on their IQ scores and on the severity of their social interaction and communication deficits [per autism diagnostic observation schedule (ADOS) scores]. Six developmental-behavioral domains including, imitation, receptive language, expressive language, nonverbal communication skills, play skills and stereotyped behaviors were assessed at pre- and post-1 year of intervention times. Results Significant progress was noted in all the six developmental-behavioral domains after 1 year of intervention. Children with higher initial cognitive levels and children with fewer measured early social interaction deficits showed better acquisition of skills in three developmental areas, receptive language, expressive language and play skills. Both groups showed better progress in Receptive language skills. Better progress in expressive language was associated with the child's social abilities, while more significant progress in play skills was related to pre-intervention cognitive level. Conclusions These findings emphasize the importance of early intensive intervention in autism and the value of pre-intervention cognitive and social interaction levels for predicting outcome.

7. Language disorders and autism

Early diagnosis of language disorders and autism is important, and early intervention for autism and some language disorders makes a difference. Developmental surveillance of children to detect these disorders should be a routine part of medical practice. The persistence and pervasiveness of communication and socialising deficits differentiate children with autism from those with specific developmental language disorders. Hearing and vision assessment is essential in any communication disorder. Interventions, targeted to identified areas of need, should encompass communication enhancement, behavioural therapy, educational modification, parent education and family support. Pharmacological interventions have an important but discrete role in autism, but there are no magic bullets. It is important to remember that the normal childhood illnesses occur in children with developmental disorders. Parents should be directed to reliable websites on the Internet, and given information and books to read as well as phone numbers of relevant services (eg, autism associations). There is a need for increased government financial support for early intervention programs.

Early Intervention in Autism

We now know that professionals can diagnose children with autism when they are as young as 2 years of age (Lord, 1995). Screening and the role of the pediatrician have become even more critical as we have recognized the stability of early diagnosis over time and the importance of early intervention. At this point, experts working with children with autism agree that early intervention is critical. There is professional consensus about certain crucial aspects of treatment (intensity, family involvement, focus on generalization) and empirical evidence for certain intervention strategies. However, there are many programs developed for children with autism that differ in philosophy and a lack of research comparing the various intervention programs. Most of the programs for children with autism that exist are designed for children of preschool age, and not all are widely known or available. While outcome data are published for some of these programs, empirical studies comparing intervention programs are lacking. In this review, existing intervention programs and empirical studies on these programs will be reviewed, with a particular emphasis on the birth to 3 age group.

The verbal behavior approach to early and intensive behavioral intervention for autism: A call for additional empirical support.

Early and intensive behavioral intervention (EIBI) has been firmly established and disseminated as one of the most effective treatments for early childhood autism. Recently, a number of practitioners have employed a variant of this approach in which the language curriculum is organized and taught according to Skinner’s (1957) analysis of verbal behavior. In this commentary, we briefly describe the verbal-behavior approach to EIBI and summarize the existing data that support its use. Although the approach is conceptually sound and is supported by a modest literature on the acquisition of verbal operants, no outcome research currently exists to directly support the long-term application of the verbal-behavior approach to children with autism. Thus, we outline three steps that clinicians and researchers can take to collect and publish outcome data on the verbal-behavior approach so that correspondence between dissemination and empirical evidence can be better coordinated.

Early Intervention in Deafness and Autism

This article describes one family's experiences with the early intervention system in its treatment of their son, first diagnosed as deaf, later as autistic. Parents in both deafness and autism quickly find themselves mired in bitter disagreements, whether between sign language and speech advocates, or between believers in developmental versus behavioral approaches to autism. Experts in deafness, for all their squabbling, agree on early intervention's top priority: language. Specific methods and materials abound for teaching both sign and spoken language to deaf people. Autism intervention, dominated as it is by psychology/psychiatry gurus rather than educators, offers only the vaguest and the most schematic of intervention strategies. While often passed off as comprehensive curricula, these strategies fall far short of the specificity, practicability, and effectiveness of intervention materials for deaf children. Ultimately, parents realize that it is up to them to devise specific lessons for their children, and that it is up to all of us who work with autistic children directly—parents, teachers, and therapists—to compile, collectively, the truly comprehensive autism curriculum that we all so desperately need.

Monitoring and Reviewing Early Behavioural Intervention in Autism (Lovaas)

This article reviews relevant literature and methodological issues concerning home-based intensive behavioural programmes (Lovaas). It describes, via an examination of case work, the dilemmas presented when a local education authority is asked to fund programmes. Suggestions for review procedures are offered.

Educational advocacy for children with autism

AbstractThere exists a great divide between parents' demands for intensive behavioral interventions for their children with autism and the public education system's reluctance to support early intensive behavioral intervention programs. More and more, professionals with expertise in applied behavior analysis are being asked to advocate for effective, early behavioral intervention for autism in education litigation brought about by frustrated parents. The progress made in recent years in the behavioral treatment of children with autism and the schools' lack of adherence to the requirements of IDEA have made it possible for educational policy change through effective advocacy by behavioral interventionists. This paper discusses preparing for educational advocacy on behalf of young children with autism. We explore the personal and emotional reasons why parents choose to engage in the financially risky endeavor of educational litigation. We then outline an approach to developing expert testimony based upon evaluation of the target child and his/her educational history. Issues related to assessment, training, and ethical practice are addressed. Copyright © 2002 John Wiley & Sons, Ltd.

A selective overview of issues on classification, causation, and early intensive behavioral intervention for autism.

Autism is a behaviorally defined disorder that comprises a controversial diagnostic category due to heterogeneity in symptomatology, causation, and etiology and significant variance in response to intervention. In this article, the authors provide a brief overview of the clinical category and a summary of diagnostic developments with respect to the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders. Regarding causation and etiology, they briefly discuss selected perspectives from the fields of cognitive neuroscience and neuropsychology. The article concludes with a summary of effective behavioral strategies for the treatment of children with autism. This section highlights the importance of early intensive behavioral intervention and includes a discussion of some important aspects of this approach.

Parent-managed behavioral treatment for preschool children with autism: some characteristics of UK programs

Early intensive behavioral intervention for autism has attracted controversy since Lovaas (1987) reported that 47% of his experimental group attained normal functioning. We summarize child and program data from 75 children receiving EIBI in the UK. The majority of children (57%) started treatment later than in Lovaas (1987), and 16% did not exceed his minimum IQ criterion. Children experienced fewer hours of treatment (mean of 32 hours vs. 40 hours per week), and their programs received relatively infrequent supervision. 21% of programs received supervision from individuals currently accredited as competent to provide Lovaas’s treatment. No child started early enough, and received 40 hours per week, and had accredited supervision. Due to these variations from his model, Lovaas (1987) findings are unlikely to be replicated for this sample of children.

Early intensive behavioral intervention: Emergence of a consumer-driven service model

Parents are becoming influential stimulators and shapers of public policy in regard to educational services for their children. Increasingly, this advocacy has created a controversy about the role of applied behavior analysis as a foundation for early intensive behavioral intervention in autism. Uncertainties exist in policy regarding the role of behavior analysis in early intervention and the capacity of behavior analysis to field a trained work force. Based on contacts with parents of children with autism and information available in a variety of forms on the Internet, there is a rising demand for fundamentally better early intervention services that are available and accessible, provide active intervention, and are based on principles of behavior analysis. Contemporary movements in special and early education, however, appear to be nonconducive to scientifically based treatments, and school districts seem hostile to an increasing role for behavior analysis and to the establishment of services that are responsive to changing parental priorities for the education of their children with autism and related disorders.

Differential rates of skill acquisition and outcomes of early intensive behavioral intervention for autism

Intensive behavioral intervention for very young children with autism has received increased attention in recent years. Researchers have documented unprecedented success in educating some young children with autism, although not every child makes dramatic developmental gains. It might be useful to identify early in treatment those children who will benefit most from the current methodology and who might require slight variations in instructional format or curricular focus. The present study suggests that initial learning rates are moderately correlated with treatment outcomes after two years. Among 20 children receiving early, intensive behavioral intervention, initial acquisition of skills was correlated with later learning rates, severity of autism symptomatology and adaptive behavior profiles two years into treatment. Implications are discussed, especially in light of the universal need for intensive intervention in this population. Copyright © 1999 John Wiley & Sons, Ltd.