Objectives: This pilot study addresses this gap in the early intervention literature by evaluating the utility of APPS relative to ABA for improving social skills in young children with LFA.
Methods: An alternating treatments design with a multiple baseline served to evaluate ABA and APPS interventions across twelve participants, ages 2 to 6 (M= 3.6), on four social skills: eye contact, smiling, functional play and helping others. All participants completed a four-week training program and received ABA for two social skills and APPS intervention for the alternate two social skills. A free-choice paradigm was employed to measure intrinsic motivation to interact with the respective interventions.
Results: A one-way repeated-measures ANOVA revealed significant improvements for both APPS and ABA interventions on eye contact measures, F (3, 30) = 9.47, p < .001, ƞ2 = .49, smiling measures, F (3, 30) = 5.83, p < .05, ƞ2 = .37, helping behaviour, F (3, 30) = 17.42, p < .001, ƞ2 = .63, and functional play, F (3, 30) = 24.17, p < .001, ƞ2 = .71. Independent t-tests demonstrated that interventions did not differ significantly with respect to skill acquisition and skill maintenance. No significant difference was observed between skill transfer from APPS to face-to-face social interaction and ABA skill maintenance. However, paired dependent samples t-tests showed skill transfer from APPS to face-to-face social interaction to be significantly greater than baseline level for eye contact, t (5) = 3.44, p < .05, helping behaviour, t (5) = 4.56, p < .05 and functional play, t (5) = 5.05, p < .05. A binomial test revealed APPS to be significantly more intrinsically motivating for participants than ABA, p= .039.
Conclusions: This study offers the first test of the efficacy of APPS for improving the social skills of young children with LFA. Taken together, the findings that APPS assisted with improving social skills and were intrinsically motivating to participants opens the door to interesting and exciting possibilities for the future of early intervention. The paper argues that, as there is no existing treatment that completely addresses the needs of children with ASD, a combination of eclectic, evidence-based strategies is advisable. Given the necessity of interacting with others for improving social skills, it is recommended that future investigations consider incorporating APPS into early intervention as an augmentative tool, rather than an alternative therapy.
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