THE EFFECTIVENESS OF COMMUNITY-BASED EARLY INTENSIVE BEHAVIOURAL INTERVENTION: A WAITLIST COMPARISON STUDY

Background: Early Intensive Behavioural Intervention (EIBI) has been recognized as the treatment of choice for young children with autism. However, additional research is needed that examines treatment benefits in large community samples using comparison groups.

Objectives: 1) To examine the impact of community-based EIBI on autism severity, adaptive functioning and cognitive skills using a well-matched waitlist comparison group; 2) To determine whether younger age and higher initial skill level predict greater improvement.   

Methods: Information was obtained through file review at a treatment agency providing publicly funded EIBI to a diverse urban population. Sixty-four preschool-aged children on a waitlist for treatment were individually matched to 64 children receiving EIBI (initial age within 4 months). Although random assignment was not possible, a standardized waitlist management system was used that did not include any prioritization other than time of referral. Prior to the treatment/waitlist period, autism severity and adaptive functioning were assessed and diagnosis (autism or PDD-NOS) was confirmed. Measures were re-administered following the treatment/waitlist period and cognitive skills were evaluated (available at time 2 only). The treatment period tended to be longer than the waitlist period and this difference was controlled in analyses.

Results: Prior to the treatment/waitlist period, groups did not differ with respect to age, autism severity, adaptive functioning, and parent stress. Children in the treatment group experienced greater improvement in autism severity and adaptive functioning. In addition, they had higher cognitive skills following the treatment/waitlist period. Initial age and skill level predicted outcome in some domains but not others.

Conclusions: This research supports the effectiveness of community-based EIBI for preschool-aged children with autism.