Development and Evaluation of the Frankfurt Early Intervention Program

Background:  

The Frankfurt Early Intervention Program FFIP is a social pragmatic approach, which has been developed within the funding framework of public services in Germany. In FFIP, individual 2:1, behaviourally and developmentally based therapy with the child is combined with parent education and training of kindergarten teachers. Treatment frequency is 2 hrs / week. Methodological elements are classical, but highly individualised ABA approaches for very young children, combined with visual structuring, incidential teaching and natural learning paradigms for older children and eventually social learning within a small group of two children.

Objectives:  

We present 1- and 2-year follow up data on change in irritability, lethargy, stereotypy, hyperactivity, inappropriate behaviour and autistic symptoms.

Methods:  

Seventeen children with a diagnosis of autism, Asperger Syndrome or atypical autism according to ICD-10, aged 2-7 years old were enrolled into the study. Diagnosis was made by ADI-R and ADOS. Autistic Symptoms were measured by the SRS, irritability, lethargy, stereotypy, hyperactivity, inappropriate behaviour were measured by the Aberrant Behavior Checklist. ABC and SRS measures after one year (t2) were obtained from 16, after two years (t3) from 12 children. Difference measures were studied for change from 0 by t-tests.

Results:  

In the ABC, just a few behavioural changes were observed: A trend for a change in irritability was observed after two years of therapy (t3-t1; p=0.064), and hyperactivity decreased significantly after two years of therapy (t3-t1; p=0.019).

Autistic symptoms, as measured by the SRS, significantly decreased in the second year of therapy (p=0.006), but not in the first year (p=0.945); for t3-t1, a trend was observed (p=0.079).

Conclusions:  

Behavioural changes by the FFIP were not strong, but autism symptoms clearly decreased in the second year of therapy. The decrease in hyperactivity may either be caused by age effects or by therapy. Currently, a control group is collected to show the specific effects of the FFIP intervention.