Comparison of Different Treatment Methods on Social Communicative Abilities in Young Children with Autism Spectrum Disorders

Background:  Impairments in social communicative abilities are among the first signals of an autism spectrum disorder (ASD). Because of their importance for the social and language development these abilities are crucial intervention targets for young children with ASD. Although there is much research on autism intervention, research that directly compares several treatment methods is rare.

Objectives:  The aim of the present study was to compare the effect that different methods of intervention have on social communicative abilities in young children with autism. More specifically intervention based on Applied Behavior Analysis (ABA) was compared to treatment with a more specific intervention program targeting imitation and joint attention and to treatment as usual (TAU).

Methods:  50 children with ASD or a working diagnosis participated in this study. They were between 25 and 72 months at initial assessment and had an IQ between 50 and 118. At initial assessment the ABA group (n=11) had an average age of 50 months (SD=17) and a mean IQ of 66 (SD=15). They all received multidisciplinary therapy. The imitation/JA group (n=19) were on average 57 months old (SD=9) at initial assessment and had a mean IQ of 69 (SD=18). The TAU group (n=20) had an average age at the pretest of 47 months (SD=13) and an average IQ of 73 (SD=19). The children were tested in the therapy centers with the same instruments twice with a therapy period of 6 months in between. The Preschool Imitation and Praxis Scale, Early Social Communicative Scales, Test of Pretend Play. Reynell Developmental Language Scales and Autism Diagnostic Observation Scale were used to assess imitation, joint attention, symbolic play, language and symptoms of autism. Questionnaires were used to evaluate the progress children made at home and in school.

Results:  At the moment only the data for imitation, symbolic play and language are processed.  Results for the other variables will be presented at the meeting. In all three groups children improved during the 6-month-period on most measures (as is shown by several univariate repeated measures ANOVAs).When we directly compare the groups (with several univariate repeated measures ANOVAs and age and IQ as covariates) we find little difference between them. The only significant difference between the groups is that the ABA group improved more on procedural imitation than the other groups did (F(2)=3.2; p=0.048).

Conclusions:  Children with ASD who receive multidisciplinary therapy show a substantial improvement in social communicative abilities after a 6 month-period. Comparing the different treatment methods only shows a larger improvement on procedural imitation in the ABA group. There is no difference in improvement between the groups on measures of gestural imitation, symbolic play, language comprehension and expressive language. However, these results are preliminary and should be interpreted with caution.