Meta-Evaluation of Comprehensive Model Treatment Programs for Children

Background:

With increases in prevalence of ASD, the need to establish comprehensive treatment program models (CTP) is great. A variety of programs exist, but little evidence exists about the quality of the models.

Objectives:

The purpose of this study was to evaluate the critical features of CTPs for children and youth with ASD on six dimensions: 1) Operationalization, 2) Fidelity of treatment, 3) Replication, 4) Outcome data presented, 5) Quality of the research design, and 6) Related evidence from focused intervention studies of component features.

Methods:

Using objective inclusion criteria (i.e., published description, manualization, theoretical or conceptual framework, addressed multiple development domains or core features, intensity), authors identified CTPS through an exhaustive review of the professional literature. A standardized evaluation form containing the six dimensions noted previously was completed by two raters for portfolios of evidence assembled, initial inter-rater agreement was calculated, and final ratings were based on consensus.

Results:

Twenty-eight CTPs were identified and categorized as: ABA Clinic or Home-Based, ABA Center-Based, ABA-Inclusive, Developmental, and Other. On the poster presentation, evaluation for each of the CTPs on each of the dimensions will be displayed. CTPs were strongest on the Operationalization and Replication strands of the evaluation, with some also providing strong fidelity information. Few CTPs, with several notable exceptions (e.g., Lovaas Institute), provided RCT or quasi-experimental design efficacy data, although several supplemented evidence for efficacy through focused intervention studies of their model components.

Conclusions:

A different models for CTPs have been developed and are cohesive enough to be replicated by service providers, with training. Evidence for the efficacy of these models is emerging, although still lacking for many CTPs. The next step in this program of research needs to be systematic efficacy trials of the most promising models with examination of moderators and mediators of treatment effects.