Bcri: A Family-Based Early Behavioral Intervention Program for Children with Autism Spectrum Disorders in Chinese Population

Background: Autism Spectrum Disorder (ASD) is considered to be an early onset neurodevelopmental disorders characterized by qualitative social interaction impairments and repetitive stereotyped behaviors/restricted interests. However, strong evidence shows that promoting a structural early-intervention model may positively influence outcomes of ASD as well as reduce the burdens of lifetime care demands for society.

Objectives: BCRI intervention program aims to empower the parents to master appropriated approaches and strategies of BCRI early behavioral intervention, and provide positive affects to the clinical outcome for children with ASD.

Methods: 130 children diagnosed with ASD between the ages of 18 and 30 months were randomly assigned to the early BCRI group and CI group (community intervention). Both BCRI group and CI group participate in a two-day ASD seminar to receive basic knowledge about behavioral intervention in Phase-one. In Phase-two, BCRI group participate in a 24-halfday workshop to gain hands-on experience and one-on-one training from master trainers, then these family take another 11 months to implement BCRI intervention to their children in home settings, and CI group receives community service. Psycho-educational Profile-3rd Edition (PEP-3) assessment indexes were collected, and single and multiple Wilcoxon signed rank test were performed for statistical analysis.

Results: 85 participants (53 in BCRI group, 32 in CI group) completed primary endpoint at one year after enrollment. Statistically significant post-intervention improvements were found in BCRI group, which included Cognitive Verbal/Proverbial (CVP), Expressive Language (EL), and Receptive Language (RL) subsets in the Communication domain (p<0.05). By Comparison of pre- and post-intervention between BCRI and CI group, significant improvements were reported in combined score of Communication domain (CVP, EL, RL) plus Fine motor (FM) subset (p<0.05), and in combined score of Visual Motor Imitation (VMI) subset and FM subset (p<0.05).

Conclusions: It’s the initial large sample randomized controlled study for family-based early behavioral intervention for ASD. We suggest that BCRI Intervention model have positive effects for children with ASD, to develop early communication skills as well as visual motor Imitation and fine motor skills. BCRI model emphasize the initial appliance of behavior management and problem solving strategies, which following by structural teaching infrastructure with appropriate level of education. BCRI also emphasize to emerge ‘relationship elements’ as part of social interaction intervention throughout every step of BCRI model, to Improve social skills of children with ASD. The study indicated that BCRI model is an effective early behavioral intervention method for child with ASD, and the feasibility to implement in middle-income countries.