Objectives: To compare the effectiveness of home-based and centre based early intervention programs for young children with autism and their families in Australia.
Methods: The study specifically compared the effectiveness of the Building Blocks™ centre based (CB) and home based (HB) programs compared with a matched group of children who were not in the Building Blocks™ program. The CB program provides a weekly parent training program concurrently with a structured play based program for a small groups of children. The HB program provides a fortnightly session. Both programs operate for 12 months. In this paper outcomes for three groups are compared: CB, HB and a comparison (wait list) group. Program variables of interest include intensity, individual versus small group focus, context (HB versus CB), type of parent education and support. Three participant groups were recruited in 2006-7 - HB (n=31), CB (n=28), and waitlist/control (n=28). All participants were administered pre and post assessment measures. Treatment groups received intervention for 12 months. Formal and non-standardised assessments were used to measure social, communication and independent functioning outcomes for children and parent stress and quality of life.
Results: This paper reports on child and parent outcomes. Dependent variables included: Child; autism (ADOS), cognition (Griffiths), communication, (Reynell & Pragmatics Profile), independent functioning (Vineland), Developmental Behaviour Checklist (DBC): Parent/family: stress (PSI), Quality of life (Beach), and perception of competence.
Strengths of the project included: random assignment of participants to the treatment groups, a non-treatment comparison group, verification of diagnosis of autism (ADOS), pre and post measures by staff blind to the participant status, verification of treatment fidelity and recording information about additional interventions throughout the study.
Conclusions: The cost analysis suggests that the CB group program is the more cost effective with regard to outcomes, however it is important to note that a CB group was not an option for all children referred to the program. This is an important consideration given that parents and their professional advisors endeavour to choose interventions that match both child and family characteristics. Given that Building Blocks® offers a range of options and that the two treatment conditions compared in this study are similarly cost effective then this research provides support for a flexible range of programs as provided by Building Blocks®.