Outcomes for Children Receiving the Early Start Denver Model in a Mainstream Versus Autism-Specific Setting: A Pilot Randomized Controlled Trial

Background:  The U.N. Convention on the Rights of Persons with Disabilities (United Nations, 2006) has articulated a human right for access to early intervention for young children with disabilities, which should be provided in the least restrictive environment suitable to meet children’s needs, including consistent opportunities for interaction with typically developing peers. To date, there is little scientific research testing the benefits and disadvantages of providing early intervention within mainstream versus autism-specific settings. The aim in our study is to address this gap.

Objectives:  To examine the outcomes of an evidence based early intervention program provided in a community childcare center for children in an autism versus mainstream setting.

Methods: We conducted a sequential multiple assignment randomized trial (SMART RCT) involving 32 toddlers with ASD. Half participants were randomly assigned to receiving an evidence-based early intervention program (the Early Start Denver Model) in a playroom that only includes children with ASD (autism-specific setting group), and the other half (social inclusion group) received the same intervention within a mainstream setting with neurotypical peers. Participants’ communication, adaptive behaviour and autism symptoms was measured at baseline and after 1 year post-intervention.

Results: Preliminary analyses including 8 children in each group revealed that both groups equally improved in their communication from baseline to post-treatment, as assessed through the Mullen Scales (Repeated Measures ANOVA, F (1, 14) = 8.3, p =.01, η_p2 = .37), and experienced a reduction of ASD symptoms, as assessed through the Social Communication Questionnaire ((F (1, 14) = 9.73, p <.01, η_p2 = .40). While both groups significantly improved in their adaptive behaviour as assessed through the Vineland ((F (1, 14) = 12.46, p <.005, η_p2 = .47), there was a trend suggesting superior gains in the social inclusion group ((F (1, 14) = 3.11, p =.09, η_p2 = .18).

Conclusions: Preliminary results suggest that receiving early intervention in a mainstream setting has the potential to be equally beneficial, and potentially more beneficial, than receiving the same intervention in an autism-specific setting.