Initial Results of a Continuous Intervention Program for Children with ASD

Background: Treatment programs for children with ASD focus on early and intensive intervention reported to last usually two years. The question raised is what happens to these children beyond the intensive treatment period.

Objectives:  The present report is on children with ASD who after an intensive treatment period for two years continued to be treated and followed up well into the primary school years. What was the outcome.

Methods:

Treatment program: It consists of three stage interventions provided at the Day Centre for Children with Developmental Disorders:                 

 1. Intensive individual (behavior, speech, and occupation) therapy and family intervention. The individual sessions (4 to 6 per week) may last two years or longer depending on the case. The treatment objectives are set, by having first drawn a detailed assessment of the developmental profile of the child, and second by addressing the deficits with behavior methods (ABA and PRT).

2. Intensive socialization group therapyup to 12 hours a week for one year or longer. It consists of group work by two therapists with up to four children, who may also continue receiving individual therapy sessions in selected areas e.g. speech-language therapy.

3. Attendance at regular kindergarten in the community while continuing a less intensive program at the Day Centre. Entry to primary public school follows. Older children who have successfully progressed through the previous stages continue with group therapy (including community outings) in the afternoon. Focused support and therapy continues well into the primary school years depending on needs. Children who do not develop adequate cognitive skills enter special schools (for the mentally retarded).

Subjects:Ten (10) children, out of 22 with ASD, completed the program (age 6-10) and are now attending regular public school classes. Their progress is examined. The child’s growing ability to cope with the demands of a regular school environment was considered the criterion of substantial cognitive and psychosocial improvement. The school classroom teachers have been, with exceptions, not flexible dealing with our subjects, and some parents avoided even informing them on the developmental history of their child. The outcome was also assessed on a batery of tests and questionnaires (ADOS, ADIR, RAVEN, SDQ, VINELAND, PPVT-III, CELF-4, DELV, Academic Skills-Porpodas).

Results:  

The outcome varied in behavior and cognitive abilities. The academic progress was adequate. Most children scored within the ADOS range. While most showed improved social behavior their pragmatic skills remained low.

Conclusions:  

This ongoing project shows that children with ASD, despite great progress made which allowed them to attend regular school classes, might continue to present with some cognitive and behavior deficits which require continuing attention.