International Meeting for Autism Research: The Importance of Early Intensive Behavioral Intervention in Very Young Children with ASDs for Core Symptoms and Cognitive Development

The Importance of Early Intensive Behavioral Intervention in Very Young Children with ASDs for Core Symptoms and Cognitive Development

Friday, May 21, 2010
Franklin Hall B Level 4 (Philadelphia Marriott Downtown)
1:00 PM
M. Foscoliano , Center for Pervasive Developmental Disorders, A.O. Brotzu, Cagliari, Italy
P. M. Peruzzi , Center for Pervasive Developmental Disorders, A.O. Brotzu, Cagliari, Italy
F. Casano , Center for Pervasive Developmental Disorders, A.O. Brotzu, Cagliari, Italy
L. Ferretti , Center for Pervasive Developmental Disorders, A.O. Brotzu, Cagliari, Italy
R. Fadda , Department of Psychology, University of Sheffield, Sheffield, United Kingdom
G. Doneddu , Center for Pervasive Developmental Disorders, Azienda Ospedaliera Brotzu, Cagliari, Italy
Background: Most studies on the outcomes of behavioural techniques have investigated the gains on standardized tests of children with Autism after 4 years (McEachin et al., 1993; Sheinkopf & Siegel, 1998; Eikeset et al., 2002). However, due to advances in diagnosing Autism Spectrum Disorders (ASDs) in children as young as 1 – 2 years old, there has now been an increased diagnosis rate of ASDs followed by early intensive intervention in very young children with ASDs (Cox et al., 1999; Itzachak et al., 2009; Lord et al., 1995). It has been assumed that very early intervention would yield improved outcomes because plasticity of neural systems in young children permits significant changes in the central nervous system (Dawson et al., 2000). However, evidence about the effect of interventions in very young children has been limited due to the scarcity of follow-up outcome studies in this population.

Objectives: The current study investigated the effect of early intensive Applied Behavioural Analysis intervention (ABA-int) in very young children with ASDs on standardized tests of cognitive performance (Leiter-R) and adaptive behavior (Vineland Adaptive Behavior Scale – VABS). We also analysed changes in severity of ASDs core symptoms as defined in the ADOS.

Methods: 27 children with ASDs (20M: 7F), age range 23 - 65 mths (mean age = 37 mths; SD = 12), received ABA-int (10 hrs of ABA in DTT form and 5 hrs of speech therapy at week), were compared with 16 children with ASDs, age range 23-73 mths (mean age = 43 mths; SD = 13) that received Eclectic interventions (play group, psicomotricity, music therapy, for an average of 4 hours - week). All the children were tested twice (T1-T2 = 12 months) with the Leiter-R scale, with the VABS and with the ADOS.

Results: The groups were equivalent at T1 for Leiter-R scale and VABS scores. After 6 months, there was a 23 point IQ gain in the ABA-int group (t = -3,85;df = 26; p<0,05) while the Eclectic group did not show any significant change in standardized test scores (t = -1,05; df = 15; p>0,05). VABS scores increased significantly both in the ABA-int (+ 7 mths; t = -3,31;df = 26; p<0,05) and in the Ecletic group (+ 6 mths; t = -3,86; df = 15; p<0,05). The children in the ABA-int group scored significantly lower on the ADOS (t = 5,34; df = 26; p<0,05) while the severity of ASDs symptoms in the Ecletic group remained stable.

Conclusions: Our results point to the effectiveness of early intensive behavioural intervention in very young children with ASDs for cognitive development and in reducing symptoms severity. At same time, as ABA early intervention seems to does not appear to influence adaptive abilities, these findings highlight the importance of generalization in intervention programs in order for children to be successful in daily routines.

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