A Results Driven Approach to Evaluating Progress for Toddlers with ASD Participating in a State Early Intervention Program

Background: States must report annually to the U.S. Department of Education on child outcome indicators for toddlers exiting Part C Early Intervention (EI) Programs. Data are aggregated across the heterogeneous group of children in EI for reporting purposes. In New York State, children with ASD represent approximately 11% of children receiving EI. However, outcomes are not reported separately for this group.

Objectives: To evaluate outcomes of Part C EI services, using federal outcome indicators, for toddlers with ASD in New York State’s EI Program (NYSEIP).

Methods: Early intervention and preschool special education evaluation records were obtained for 160 children with ASD in the NYSEIP. Trained reviewers completed the Child Outcome Summary (COS) rating (National Early Childhood Outcomes Center, 2005) in three federal outcome areas: social emotional development, including positive social relationships; acquisition and use of knowledge and skills, including early language and literacy; and use of appropriate behaviors to meet needs. Ratings within each outcome area were derived from evaluations conducted on entry to EI and exit to preschool special education. Standardized test scores in all developmental areas were used to determine COS ratings, except in a few instances where scores were not available and descriptive developmental information was used instead. Based on entry and exit ratings, children were classified into 3 groups: (a) received the same score at both time points (consistent delay compared to typically developing [TD] peers), (b) had a higher score on exit than on entry (moved closer to TD peers), or (c) had a lower score on exit than on entry (lost ground compared to TD peers).

Results:  In the area of social-emotional development, 42% of toddlers with ASD moved closer to TD peers, 25% maintained a consistent delay, and 31% lost ground compared to TD peers. In the area of acquisition and use of knowledge and skills, 55% moved closer to TD peers, 29% maintained a consistent delay, and 16% lost ground. In the area of using appropriate behaviors to meet needs, 23% moved closer to TD peers, 30% maintained a consistent delay, and 48% lost ground compared to TD peers.

Conclusions: Most studies examining the effect of EI on young children with ASD can be characterized as efficacy studies conducted in controlled research environments (Weitlauf et. al.,2014). This study is unique in evaluating outcomes for children with ASD participating in community-based services delivered through a state Part C EI program. The majority of toddlers with ASD participating in the NYSEIP moved closer to the skill level of TD peers in the area of acquisition and use of knowledge and skills (55%). A smaller percentage showed acceleration of skill development in social-emotional development (42%) and using appropriate behavior to meet their needs (23%). These findings are consistent with those from controlled studies, suggesting EI services delivered through state Part C programs are effective in improving outcomes for children with ASD. Examination of service delivery characteristics associated with positive outcomes can inform development of more effective services for toddlers with ASD and their families.