Improvement in cognitive and communicative ability of children with autistic spectrum disorder (ASD) was associated with improved quality of life of children and their parents. Previous studies have found that this improvement is possible through intensive treatment of multidisciplinary team which starts at a young age. However, it remains unclear what therapeutic framework provides a comparable improvement to special education setting.
Objectives:
The current study was planned to evaluate and compare the effectiveness of two different frameworks of treatment for young children with autism spectrum disorder (ASD) and overall developmental changes during one year of intervention:
- Special Education kindergarten framework, for children with communication deficits which enables adjustments to the unique needs of children with ASD all week long.
- Keshet- an inclusion program that enables participation of parents during individualized treatments of their children, including parental guidance in a triadic/ diaadic model, for one day and a half (ten hours). During rest of the week, children are attending a regular kindergarten, thus involving extensive exposure to the normative peers group during the week- designated as Advanced Health program (AH).
Methods:
Twenty nine children with ASD, between the ages of two to six years old, participated in one of two treatment programs. All children in both groups received intensive multidisciplinary treatments, with at least ten hours of individualized treatment per week and tailored according to their developmental level, resembling DENVER-STAART model, while the Keshet group received all treatments in the presence of their parents, and the SE group in individual setting with additional weekly parental guidance.
Children's IQ and ADOS-G scores were compared at the beginning of the intervention program and after completion of one year of participation.
Results:
Pre-intervention - children in both groups did not differ in their autism severity, cognitive abilities and age, at the date. After one year, both groups showed significant improvements in Full Scale IQ (FSIQ), verbal (VIQ) and ADOS-G imagination/creativity (AI) scores. The quantified improvement was not significantly different between the two intervention programs. However, separate analyses within each group, showed different trends of improvement; thus children in the SE framework improved significantly only in their AI scores, whereas children in the AH framework improved significantly only in their FSIQ scores.
Conclusions:
Choice of inclusion versus special intervention program at preschool age, was not guided by severity level. All children with ASD, regardless of treatment program, improved over one year of intensive intervention, mainly in their cognitive abilities, but not in overall autism severity as measured by ADOS. Intervention in an inclusive program demands parental training and effort, but bears the possibility of equal improvements to special education setting.