The Real-World Effectiveness of Early Teaching Interventions for Children with Autism Spectrum Disorder

Abstract

The effectiveness of 3 early teaching interventions (applied behavior analysis [ABA], special nursery placement, and portage) for children with autism spectrum disorder was studied in a community-based sample over 10 months. Measures of autism severity as well as intellectual, educational, and adaptive behavioral function were administered. In contrast to reports in some previous research (Lovaas, 1987), there was no evidence of recovery from autism. Children in the ABA condition made greater intellectual and educational gains than children in the portage program. They also made greater educational gains than students in the nursery program. Furthermore, the nursery program produced larger gains than the portage program in adaptive functioning.

A Pilot Study of the Effects of an Australian Centre-Based Early Intervention Program for Children with Autism

“…Data indicate that children made gains greater than would be expected by maturation in these areas. These findings are consistent with previous investigations into early learning undertaken by Reed et al, [22,23] who also found significant gains on the previous edition of the PEP.…”

“…This finding is consistent with those reported by Zachor et al, [26] who found reductions in ASD symptoms on the ADOS social interaction scale for children attending an "eclectic" autism-specific preschool. However, this finding is in contrast to some other evaluations of educationally-based interventions that failed to find improvement in symptoms [22,23,27].…”

“…This is because these programs typically do not subscribe to a single program, philosophy, or theoretical approach, but instead aim to be comprehensive and offer a range of teaching strategies such as Picture Exchange Communication Systems [19], activities drawn from the Treatment and Education of Autistic and Related Communication Handicapped Children (TEACCH) [20], and positive behaviour support [21]. Examples of programs which have received attention are special nursery placement [22,23], autism-specific nursery [24], eclectic autismspecific preschools [25], eclectic-developmental autismspecific preschools [26], and autism-specific primary schools or units for children under six years [27]. These programs share in common an autism-specific focus, structuring their teaching in nursery, preschool, or kindergarten classrooms, and incorporate elements of educational programs such as circle time, individual education plans, and a positive approach to challenging behaviour.…”

“…A blend of evidence-based strategies drawn from established treatments and interventions are used. Strategies include the antecedent package, behavioural package, behavioural treatment, joint attention intervention, modelling, naturalistic teaching strategies, pivotal response treatment, schedules, self-management, and story-based Reed et al [23] • Significant improvement for "special nursery placement" on gross motor, cognitive and verbal subscales • Significant improvement for "Autism-specific special nursery" on the overall PEP-R score BAS-II Reed et al [22] • Significant improvement for "special nursery placement" on picture matching, naming, and early number skills subscales Cognitive Skills…”

Discrete Trial Training

“…Twenty-two total studies were reviewed here. Thirteen studies between 2000 and 2012 directly compared DTT to eclectic models or treatment as usual (Ben-Itzchak, Lahat, Burgin, & Zachor, 2008 ;Cohen, Amerine-Dickens, & Smith, 2006 ;Eikeseth, Klintwall, Jahr, & Karlsson, 2012 ;Eikeseth, Smith, Jahr, & Eldevik, 2002Eldevik, Eikeseth, Jahr, & Smith, 2006 ;Eldevik, Hastings, Jahr, & Hughes, 2012 ;Fava et al, 2011 ;Howard, Sparkman, Cohen, Green, & Stanislaw, 2005 ;Magiati, Charman, & Howlin, 2007 ;Remington et al, 2007 ;Sheinkopf & Siegel, 1998 ;Strauss et al, 2012 ), four studies compared higher intensity DTT (i.e., greater number of hours) to lower intensity DTT (i.e., lesser hours) (Downs, Conley-Downs, Fossum, & Rau, 2008 ;Reed, Osborne, & Corness, 2007a, 2007bSmith, Eikeseth, Klevstrand, & Lovaas, 1997 ;Smith, Groen, & Wynn, 2000 ), two studies compared DTT to no treatment at all (Birnbrauer & Leach, 1993 ;Flanagan, Perry, & Freeman, 2012 ), one study compared clinic-directed versus parent-directed DTT (Sallows & Graupner, 2005 ) and two studies compared high intensity DTT, low intensity DTT, and a no-treatment control (Lovaas, 1987 ;Reed et al, 2007aReed et al, , 2007b.…”