Outcomes for Families of Children with Autism Spectrum Disorder Involved in Early Intervention

Background: The importance of family outcomes is broadly acknowledged in the literature (Bailey, et al, 2006) however there is skepticism and confusion about typologies of outcomes, how they should be measured, and their usefulness in early intervention.  A family outcome is defined as a benefit experienced by families as a result of services and supports received. It is also what happens as a result of services provided by families to their children with autism spectrum disorder  (Harbin & Neal, 2004). To date, there is little research on the effects and/or benefits of specific interventions on family outcomes.

Objectives: The purpose of this research was to examine parental perceptions on the effects of DIR/Floortime intervention on family outcomes and to compare this data to a comparison group of parents whose children received community based interventions.  I wanted to determine whether the DIR/Floortime early intervention program promoted more positive family outcomes as compared to families whose children received a variety of community based interventions.  Other questions that were addressed included: a) What outcomes are the children and families experiencing? and  b) how do family outcomes relate to variations in child and family characteristics and the services provided? The objective was to identify and document the full range of family benefits that might be expecteded from early intervention along with any possible drawbacks.  In my comparative analysis of the two parent groups I measured the effects of intervention on specific family outcomes (as outlined in the Autism Spectrum Disorder Family Outcomes Questionnaire, ASDFOQ, a new tool for measuring family outcomes). 

Methods: Thirty-eight families from Ontario who are currently involved in a larger DIR/Floortime early intervention study through the Milton and Ethel Harris Research Initiative at York University participated in this study.  Parents in both the DIR/Floortime intervention program and community based intervention program rated their perception of family status on a set of outcomes identified in the literature as expected or reported benefits of participation in early intervention upon entry and then after nine months of intervention vis a vis the Autism Spectrum Disorder Family Outcomes Questionnaire. Parents also responded to 3 open ended questions (both pre and post intervention) pertaining to family resiliency which were analyzed qualitatively using NVivo.

Results: Data analyses involved conducting a within and between groups pre and post assessment of family outcomes.  Families in the DIR/Floortime group demonstrated more positive family outcomes (with the greatest impact on family quality of life, relationships with family members, and ability to integrate in community activities).  Parent perceptions about the child's level of functioning after intervention significantly improved in the DIR/Floortime group with parental reports revealing greater child affect, responsiveness and engagement.

Conclusions: The DIR/Floortime intervention approach (with its focus on parents as the primary interventionists and where the goal is to train parents in strategies to improve the social, emotional and communicative reciprocal relationship) produced  more positive family outcomes than families in the comparison group receiving a combination of community based interventions.  The findings provide a description of how families are doing overall in outcome areas after exiting early intervention.