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Thursday, May 15, 2008
Champagne Terrace/Bordeaux (Novotel London West)
Background: Recent research has demonstrated the short-term effectiveness of early, intensive, behaviourally based interventions for children with ASD, but very few studies have examined longer term outcomes.
Objectives: The aim of this prospectiveUK study was to assess children’s outcomes immediately following a 2-year early intensive intervention (either home- or school-based) and to assess progress 7 years later.
Methods: 36 children with ASD participated (22 originally enrolled in an early intensive behavioural intervention (EIBI) home-based programmes in the community and 14 in intensive specialist preschool provisions). Participants were initially assessed at a mean age of 3 years; followed up after 2 years (mean age 5 years) and again at mean age of 10 years. Standardised assessments of cognitive, language and adaptive behaviour abilities and severity of autism-related difficulties were available at each time point.
Results: There was a significant increase in mental age over time (MA T1= 26.3, T2: 35.8, T3: 67.1) but a decline in IQ scores over this period (IQ T1= 64.4, T2: 53.7, T3: 52.6). ADI-R scores showed a slight improvement (ADI-R total mean T1= 37.4, T2: 31.5, T3: 31.8). However, individual children showed very different trajectories of change. Based on an overall composite change score, 28% showed little or no improvement; 32% showed small but continued improvements and 22% made significant and steady improvement over time. One child showed little improvement during intensive intervention but much greater change thereafter. Two children made moderate progress during early intervention but little progress thereafter. Variables associated with these different patterns of change will be explored.
Conclusions: Changes in mean scores following intervention do not provide information on outcome in individual children, which can vary widely over time. There is a need to attend more to individual trajectories following intervention and to the variables that may be associated with different degrees and patterns of change.
Objectives: The aim of this prospective
Methods: 36 children with ASD participated (22 originally enrolled in an early intensive behavioural intervention (EIBI) home-based programmes in the community and 14 in intensive specialist preschool provisions). Participants were initially assessed at a mean age of 3 years; followed up after 2 years (mean age 5 years) and again at mean age of 10 years. Standardised assessments of cognitive, language and adaptive behaviour abilities and severity of autism-related difficulties were available at each time point.
Results: There was a significant increase in mental age over time (MA T1= 26.3, T2: 35.8, T3: 67.1) but a decline in IQ scores over this period (IQ T1= 64.4, T2: 53.7, T3: 52.6). ADI-R scores showed a slight improvement (ADI-R total mean T1= 37.4, T2: 31.5, T3: 31.8). However, individual children showed very different trajectories of change. Based on an overall composite change score, 28% showed little or no improvement; 32% showed small but continued improvements and 22% made significant and steady improvement over time. One child showed little improvement during intensive intervention but much greater change thereafter. Two children made moderate progress during early intervention but little progress thereafter. Variables associated with these different patterns of change will be explored.
Conclusions: Changes in mean scores following intervention do not provide information on outcome in individual children, which can vary widely over time. There is a need to attend more to individual trajectories following intervention and to the variables that may be associated with different degrees and patterns of change.