Behavioral treatment and normal educational and intellectual functioning in young autistic children.

Abstract

Autism is a serious psychological disorder with onset in early childhood. Autistic children show minimal emotional attachment, absent or abnormal speech, retarded IQ, ritualistic behaviors, aggression, and self-injury. The prognosis is very poor, and medical therapies have not proven effective. This article reports the results of behavior modification treatment for two groups of similarly constituted, young autistic children. Follow-up data from an intensive, long-term experimental treatment group (n = 19) showed that 47% achieved normal intellectual and educational functioning, with normal-range IQ scores and successful first grade performance in public schools. Another 40% were mildly retarded and assigned to special classes for the language delayed, and only 10% were profoundly retarded and assigned to classes for the autistic/retarded. In contrast, only 2% of the controlgroup children (n = 40) achieved normal educational and intellectual functioning; 45% were mildly retarded and placed in language-delayed classes, and 53% were severely retarded and placed in autistic/retarded classes. Kanner (1943) defined autistic children as children who exhibit (a) serious failure to develop relationships with other people before 30 months of age, (b) problems in development of normal language, (c) ritualistic and obsessional behaviors ("insistence on sameness"), and (d) potential for normal intelligence. A more complete behavioral definition has been provided elsewhere (Lovaas, Koegel, Simmons, & Long, 1973). The etiology of autism is not known, and the outcome is very poor. In a follow-up study on young autistic children, Rutter (1970) reported that only 1.5% of his group (n = 63) had achieved normat functioning. About 35% showed fair or good adjustment, usually required some degree of supervision, experienced some diffaculties with people, had no personal friends, and showed minor oddities of behavior. The majority (more than 60%) remained severely handicapped and were living in hospitals for mentally retarded or psychotic individuals or in other protective settings. Initial IQ scores appeared stable over time. Other studies (Brown, 1969;

Stability and change of IQ scores in preschool children diagnosed with autistic spectrum disorder

“…An increase in IQ score has been reported in several intervention studies [15,16,27] and is sometimes claimed to be a result of intervention. Due to methodological problems, the actual impact of interventions has not been proven [17,18].…”

Comorbid psychopathology with autism spectrum disorder in children: An overview

“…Initial attempts to systematically develop assessments and treatments for the disorder have been more recent (LeCouteur et al, 1989;Lovaas, 1987). Other ASDs have received even less attention with the development and criteria of assessment instruments only recently emerging (Ehlers & Gillberg, 1993).…”

Toward Effective and Preferred Programming: A Case for the Objective Measurement of Social Validity with Recipients of Behavior-Change Programs

“…We are confident that EIBI based on the principles and procedures of behavior analysis works. We still have a lot of refining to do with regard to the most efficacious aspects of EIBI, and we still have not identified all of the moderators of the effects of EIBI (Herbert, Sharp, & Gaudiano, 2002;Rogers & Vismara, 2008;Smith et al, 2006), but the intervention improves the developmental trajectories of those who receive it (Campbell, 2003;Cohen, Amerine-Dickens, & Smith, 2006;Eldevik, Eikeseth, Jahr, & Smith, 2006;Helt et al, 2008;Howard, Sparkman, Cohen, Green, & Stanislaw, 2005;Lovaas, 1987;Morris, 2009, National Institute of Mental Health, 2007Odom et al, 2003;Smith, Groen, & Wynn, 2000). We know much less, however, about the acceptability of various components of EIBI to the children experiencing them (e.g., most-to-least or least-to-most prompting, amount and pace of prompting, amount of teacher directedness during instruction, types of error correction procedures, highly structured versus more naturalistic instructional conditions, types of motivational systems).…”