Early intervention in 208 Swedish preschoolers with autism spectrum disorder. A prospective naturalistic study

Fernell, Elisabeth; Hedvall, Åsa; Westerlund, Joakim; Carlsson, Lotta Höglund; Eriksson, Mats; Olsson, Martina Barnevik; Holm, Anette; Norrelgen, Fritjof; Kjellmer, Liselotte; Gillberg, Christopher

doi:10.1016/j.ridd.2011.08.002

Cited by 122 publications

(119 citation statements)

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“…DSM-5 ASD research has found no specific effective pharmacotherapy or other medical treatment (Na Young and Findling 2015). The only broadly successful ASD treatment has been early behavioral intervention programs (Kasari 2015;Schreibman et al 2015;Smith and Iadarola 2015;), but these treatments are not unique to ASD (Losinski et al 2014), and the long-term effectiveness of these programs is not yet known (Fernell et al 2011. Researchers who studied infant siblings of children with ASD concluded no single early behavior could predict ASD diagnoses (Zwaigenbaum et al 2015), and ASD has been found with widely varied trajectories of development (Fountain et al 2012;Lord et al 2015) and varied life outcomes (Fein et al 2013;Helles et al 2015;Steinhausen et al 2016).…”

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confidence: 99%

ASD Validity

Waterhouse

London

Gillberg

2016

Rev J Autism Dev Disord

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ASD research is at an important crossroads. The ASD diagnosis is important for assigning a child to early behavioral intervention and explaining a child's condition. But ASD research has not provided a diagnosis-specific medical treatment, or a consistent early predictor, or a unified life course. If the ASD diagnosis also lacks biological and construct validity, a shift away from studying ASD-defined samples would be warranted. Consequently, this paper reviews recent findings for the neurobiological validity of ASD, the construct validity of ASD diagnostic criteria, and the construct validity of ASD spectrum features. The findings reviewed indicate that the ASD diagnosis lacks biological and construct validity. The paper concludes with proposals for research going forward.Keywords DSM-5 . ASD . Autism . Diagnosis . Validity . Comorbidity . HeterogeneityThe goal of the DSM-3 nosology (American Psychiatric Association 1980) was to create reliable and standard categorical psychiatric diagnoses (Robins and Guze 1970). However, in the past 30 years, clinical, genetics, and neuroscience findings have revealed that the DSM diagnoses are not biologically valid. The National Institutes of Mental Health (NIMH) responded by proposing the Research Domain Criteria (RDoC) framework for a brain-based transdiagnostic psychiatric symptom nosology (Cuthbert and Insel 2013;Insel et al. 2010;Lilienfeld and Treadway 2016). Peterson (2015) and Weinberger et al. (2015) argued that the RDoC could not replace the DSM-5 psychiatric nosology (American Psychiatric Association 2013) or the parallel International Classification of Diseases (ICD) psychiatric nosology (World Health Organization 2012). But BFor the foreseeable future, RDoC is not envisioned as a system of psychiatric classification in its own right. Instead, in the near term, RDoC and DSM-ICD are expected to coexist. Nevertheless, RDoC is intended to provide scaffolding for a large-scale research program that will ultimately yield an alternative to DSM-ICD^ (Lilienfeld and Treadway 2016, p. 445).RDoC advocates accept that DSM-5/ICD psychiatric categories remain necessary in clinical practice, but argue that researchers should shift to RDoC study designs immediately. They assert that studying psychiatric categories lacking biological validity blocks the discovery of brain bases for psychopathology and thus cannot lead to effective medical treatments for specific psychiatric symptoms (Cuthbert and Insel 2013;Insel et al. 2010;Lilienfeld and Treadway 2016;Yee et al. 2015). Against this RDoC imperative for biological validity, Weinberger et al. (2015) countered that current DSM-5 psychiatric behavioral diagnoses were valid when they yielded effective medical treatment, clear prognosis, and a life course specific to a diagnosis.Autism spectrum disorder (ASD) research has been productive (Dawson 2016;de la Torre-Ubieta et al. 2016;Szatmari et al. 2016), but no ASD research findings have met the validity criteria of Weinberger et al. (2015). DSM-5 ASD research has found no s...

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confidence: 99%

ASD Validity

Waterhouse

London

Gillberg

2016

Rev J Autism Dev Disord

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“…This phenomenon shows a level of academic discipline that has rarely occurred in the treatment literature. All the studies reviewed employ standard ABA methods such as discrete trial training, modeling, prompting, social and edible reinforcers, fading, and shaping (Bibby et al 2002;Cohen et al 2006;Eikeseth et al 2007;Eikeseth et al 2012;Eldevik et al 2006;Eldevik et al 2012;Fava et al 2011;Fernell et al 2011;Flanagan et al 2012;Green et al 2002;Grindle et al 2012;Hayward et al 2009a, b;Howard et al 2005;Lovaas 1987;McGarrell et al 2009;Perry et al 2008;Remington et al 2007;Sallows and Graupner 2005;Sheinkopf and Sigel 1998;Smith et al 2000b;Zachor and Itzchak 2010). Early studies also used punishments such as shouting at the child and contingent thigh slaps.…”

Section: Resultsmentioning

confidence: 99%

The Most Commonly Reported Behavior Analytic Methods in Early Intensive Autism Treatments

Matson

Jang

2013

Rev J Autism Dev Disord

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Early intensive behavioral interventions have become a very popular treatment in the field of autism spectrum disorders. Given the rapidly expanding use of these methods and the amount of money and resources being devoted to these programs, analyses of these practices is warranted. This paper looks at treatment studies on the topic. The children treated were largely diagnosed with pervasive developmental disorder not otherwise specified or autism diagnoses. One-to-one training was typical as were structured curriculums. The implications of these practices are discussed along with assertions about future direction for research.

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“…The control group in this trial received "individualized eclectic treatment" of the same magnitude as and parallel to the EIBI group. In the other study that did not demonstrate better outcomes after high-intensity EIBI treatment, the control group received low-intensity EIBI treatment (37). However, in this design, the study groups were not comparable, the study lacked both the control of what was actually administered and the quantity (number of hours) of the treatment, and the health care professionals were not comprehensively trained in EIBI techniques.…”

Section: Early Intensive Behavioral Interventionmentioning

confidence: 97%

A Systematic Review of Social Communication and Interaction Interventions for Patients with Autism Spectrum Disorder

Hirvikoski

Jönsson

Halldner

et al. 2014

Scandinavian Journal of Child and Adolescent Psychiatry and Psychology

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Background: Autism spectrum disorder (ASD) is currently not curable, but it may be malleable to varying degrees in response to different interventions to improve outcomes. Objective: We conducted a systematic review of interventions aimed at ameliorating social communication impairments in patients with ASD. This study was registered in the International Prospective Register of Systematic Reviews (no. CRD42013003780). Methods: We focused on the ASD interventions that are frequently applied in Swedish clincial practice to address ASD. To ensure stakeholder involvement, we also conducted two surveys with three major Swedish ASD interest organizations to assess perceived research priorities for ASD treatment. With the use of this rationale for selection, Early Intensive Behavioral Intervention [EIBI], Treatment and Education of Autistic and Related Communication Handicapped Children [TEACCH], social skills training groups, and interventions that involved significant others were reviewed. A bibliographic search was conducted via five databases: Medline, PubMed, PsycInfo, CINAHL, and ERIC. Identified articles were screened for relevance by two independent reviewers, who also assessed the risk of bias in randomized controlled trials using systematic checklists. Results: A total of 7264 citations were identified as being published before February 2013, and 109 studies (18 of EIBI, 18 of social skills training, 4 of TEACCH, and 69 of interventions involving significant others) were included in the analysis. The included studies provided some support for the positive effects of each of the interventions; this is especially true if the most recently published research (March 2013 through August 2015) is considered, and a crude updated search for relevant randomized controlled trials was performed. The interventions that involve the significant others of individuals with ASD form a heterogenous area of treatment strategies that require subcategorization for future review. Conclusions: These findings provide preliminary support for treatments that are commonly used in clinical practice for the treatment of ASD in Sweden. However, larger and more rigorously designed and controlled studies are still needed before definitive conclusions regarding their effects can be made.

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Early intervention in 208 Swedish preschoolers with autism spectrum disorder. A prospective naturalistic study

Cited by 122 publications

References 28 publications

ASD Validity

ASD Validity

The Most Commonly Reported Behavior Analytic Methods in Early Intensive Autism Treatments

A Systematic Review of Social Communication and Interaction Interventions for Patients with Autism Spectrum Disorder

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