Outcome of Children with Autism and Intellectual Impairment Following an Intensive Treatment Program Including Edt

Background:  

Early diagnosis of autistic disorders has meant that young children with autism may be treated with several multidisciplinary and individualized therapies. However, understanding of the evolution is still incomplete as clinicians still have few appropriate evaluation tools that are sufficiently reliable for this complex developmental disorder.

Objectives:  

This study reports the psychological and behavioural outcomes of a group of children with autism enrolled in an intensive treatment program including Exchange and Developmental Therapy, EDT. The aim of this study was to investigate the development of children with basic disorders of infantile autism such as impairment in social interactions and communication and resistance to change, using a new and complete assessment battery.

Methods:  We selected 29 children, aged 2 to 8 years, with severe autism (DSM-IV T-R, APA, 2000, ADI-R, Le Couteur et al., 1989 and CARS, Childhood Autism Rating Scale, Schopler et al., 1986) and moderate to severe mental retardation (Brunet-Lézine scale-Revised, 1997 - French adaptation of Gesell scales, 1947). We examined cognitive and socio-emotional skills using a recently validated scale, the (SCEB) (Adrien, 2007 ; Thiébaut et al., 2010). Changes in autistic symptomatology were evaluated with the BSE scale (Behavioural Summarized Evaluation scale revised) (Barthélémy et al., 1997). The two types of assessment were performed at the beginning of treatment and then another developmental assessment was performed 10 months later, followed by behavioural evaluations every month. We compared clinical data at different times in the assessment process for each child

Results:  

The results showed that this combined developmental and behavioral assessment could reveal not only general progress in cognitive and socio-emotional skills but also decreases in autistic symptomatology. Progress was different from one child to another and seemed dependent on the initial severity of the mental retardation. Finally, although overall retardation did not change, significant reduction in autistic behaviours occurred with therapy.

Conclusions:  

These results confirmed previous studies (Rogers, 1996; Schreibman, 1996; Adrien et al., 2002-b; Blanc et al., 2003; Howlin, 2005, Magiati, 2007 ; Wallace and Rogers, 2010) and indicated the value of this assessment battery which explores both the cognitive and socio-emotional development of the child and also follows the evolution of the autistic symptomatology. Moreover, this study identified functions sensitive and resistant to the intensive programme including Exchange and Developmental Therapy, EDT, indicating directions for prevention and early intervention.