Changes in Rates of Development for Preschool Children with ASD in Two Comprehensive Treatment Programs

Background:  A range of comprehensive treatment models (CTMs) have been developed for preschool children with ASD (Odom, Boyd, Hall, & Hume, 2010), but to date there have been few comparative treatment studies of such models.  The TEACCH and LEAP are two comprehensive treatment models (CTMs) with a long-standing history in the field of autism and that are based on different theoretical frameworks. In an initial study, significant development effects across time occurred for children in both models and in a high quality eclectic comparison set of classrooms with few between group differences (Boyd, Hume... Odom, 2012).  However this analysis did not control for the possible effects due to maturation.   

Objectives:  The objective of the current analysis was to examine differential changes in the rates of development as compared to pre-enrollment rates of development for preschool children with ASD enrolled in TEACCH, LEAP, and a high quality electic condition.  

Methods: A rigorous, quasi-experimental study involving n = 75 classrooms meeting inclusion criteria of high fidelity and quality (28 BAU, 22 LEAP, 25 TEACCH) and involving 205 children with ASD.  The Mullen Early Scales of Learning, the Preschool Language Scales (PLS), and the Vineland Adaptive Behavior Scale were collected on children at the beginning and end of children’s first year in intervention. Proportional Change Indices (PCI; Wolery 1983) were used to analyze rate of growth previous to the onset of the intervention to the rate of growth during the intervention. PCIs < 1 indicate that growth was slower while in intervention, =1 indicate that the rate of change was the same before and during intervention, and >1 indicate that the rate of growth of accelerated while enrolled in intervention.

Preliminary Results: Data analysis is ongoing, and will include analysis of the Vineland scores, moderating variables, and group comparisons. Initial analyses indicate that students in all conditions exhibited substantial changes in rates of development relative to their pre-treatment rates of development on most measures. Children in TEACCH classrooms had the highest rate of change in expressive language as measured by the Mullen EL (1.42 TEACCH, 1.22 BAU., 98 LEAP) and PLS EC (2.06 TEACCH, 1.82 LEAP, 1.94 BAU) when compared to students in LEAP and BAU.  Measures of receptive language indicated varied results, with BAU students demonstrating greater growth on the Mullen RL (1.58 BAU, 1.47 LEAP, 1.28 TEACCH), and TEACCH students showing greatest growth on the PLS AC subscale (3.09 TEACCH, 1.97 LEAP, 1.85 BAU). Students in LEAP classrooms demonstrated the greatest rate of change on the fine motor skills (1.02 LEAP, .86 BAU, .76 TEACCH) and students in TEACCH classrooms had the highest rate of growth on the Mullen visual reception subscale (VR=1.69, 1.4 BAU, .82 LEAP). 

Conclusions: In this preliminary analysis, the PCI scores indicate substantial growth above that which would be expected from pre-treatment rates of development on measures of receptive language, expressive language, and visual reception, with differential effects occurring on some measures.  Subsequent analyses now occurring will determine moderator effects and significance of differential PCI growth measures.