Download PDF
Journal of Pediatric Neurology 2017; 15(03): 129-133
DOI: 10.1055/s-0037-1601444
Review Article
Georg Thieme Verlag KG Stuttgart · New York

Variables Affecting Outcome of Early Intervention in Autism Spectrum Disorder

Ditza A. Zachor
1   Department of Pediatrics, Tel Aviv University, Sackler Faculty of Medicine, The Autism Center, Assaf Harofeh Medical Center, Zerifin, Israel
,
Esther Ben-Itzchak
2   Department of Communication Disorders, Ariel University, Ariel, Israel
› Author Affiliations
Further Information

Publication History

24 December 2016

05 February 2017

Publication Date:
04 April 2017 (online)

    Permissions and Reprints

Abstract

Heterogeneity in autism spectrum disorder (ASD) is reflected in the child's characteristics, including clinical variability in the severity of autism symptoms, cognitive ability, and language skills. Also, substantial individual differences are apparent about treatment outcomes. The effects of early intervention in ASD constitute one of the important questions ASD researchers face today. To what extent do factors such as child and family characteristics, intervention approach, and specific treatment components, influence outcome? This review focused on which preintervention factors better predicted outcome in each of the different outcome measures used most frequently in ASD research, including autism severity, cognitive ability, and adaptive behavior skills. For outcome in autism severity, predictors included child's baseline age, cognitive ability, autism severity, and the type of treatment approach used. For cognitive gains, predictors included baseline autism severity, maternal and educational level, and the type and intensity of the treatment. For outcome in adaptive behavior skills, predictors included baseline cognitive ability, autism severity, maternal age, and the treatment approach and intensity. Future studies in this field should expand the scope of factors, look for more specific behaviors, and investigate the interplay between a child's characteristics, familial factors, and various treatment aspects that might affect the outcome of the intervention.

Keywords

autism spectrum disorder - predictors - early intervention - autism severity - cognitive gains - adaptive behavior
 

  • References

  • 1 Zwaigenbaum L, Bauman ML, Choueiri R. , et al. Early intervention for children with autism spectrum disorder under 3 years of age: recommendations for practice and research. Pediatrics 2015; 136 (Suppl. 01) S60-S81
    CrossrefPubMedGoogle Scholar
  • 2 Magiati I, Tay XW, Howlin P. Early comprehensive behaviorally based interventions for children with autism spectrum disorders: A summary of findings from recent reviews and meta-analyses. Neuropsychiatry 2012; 2 (06) 543-570
    CrossrefPubMedGoogle Scholar
  • 3 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5. Arlington, VA: American Psychiatric Association; 2013
    Google Scholar
  • 4 Dawson M, Soulières I, Gernsbacher MA, Mottron L. The level and nature of autistic intelligence. Psychol Sci 2007; 18 (08) 657-662
    CrossrefPubMedGoogle Scholar
  • 5 Anderson DK, Lord C, Risi S. , et al. Patterns of growth in verbal abilities among children with autism spectrum disorder. J Consult Clin Psychol 2007; 75 (04) 594-604
    CrossrefPubMedGoogle Scholar
  • 6 Howlin P, Magiati I, Charman T. Systematic review of early intensive behavioral interventions for children with autism. Am J Intellect Dev Disabil 2009; 114 (01) 23-41
    CrossrefPubMedGoogle Scholar
  • 7 Johnson NL, Giarelli E, Lewis C, Rice CE. Genomics and autism spectrum disorder. J Nurs Scholarsh 2013; 45 (01) 69-78
    CrossrefPubMedGoogle Scholar
  • 8 Schaaf CP, Zoghbi HY. Solving the autism puzzle a few pieces at a time. Neuron 2011; 70 (05) 806-808
    CrossrefPubMedGoogle Scholar
  • 9 Ebrahimi-Fakhari D, Sahin M. Autism and the synapse: emerging mechanisms and mechanism-based therapies. Curr Opin Neurol 2015; 28 (02) 91-102
    CrossrefPubMedGoogle Scholar
  • 10 Nicolson R, Szatmari P. Genetic and neurodevelopmental influences in autistic disorder. Can J Psychiatry 2003; 48 (08) 526-537
    CrossrefPubMedGoogle Scholar
  • 11 Lord C, Rutter M, DiLavore PC, Risi S. Autism Diagnostic Observation Schedule. Los Angeles, CA: Western Psychological Services; 2001
    Google Scholar
  • 12 Zachor DA, Ben-Itzchak E, Rabinovitch A, Lahat E. Change in autism core symptoms with intervention. Res Autism Spectr Disord 2007; 1 (04) 304-317
    CrossrefPubMedGoogle Scholar
  • 13 Ben Itzchak E, Zachor DA. Change in autism classification with early intervention: predictors and outcomes. Res Autism Spectr Disord 2009; 3: 967-976
    CrossrefPubMedGoogle Scholar
  • 14 Chawarska K, Klin A, Paul R, Macari S, Volkmar F. A prospective study of toddlers with ASD: short-term diagnostic and cognitive outcomes. J Child Psychol Psychiatry 2009; 50 (10) 1235-1245
    CrossrefPubMedGoogle Scholar
  • 15 Szatmari P, Bryson SE, Boyle MH, Streiner DL, Duku E. Predictors of outcome among high functioning children with autism and Asperger syndrome. J Child Psychol Psychiatry 2003; 44 (04) 520-528
    CrossrefPubMedGoogle Scholar
  • 16 Eldevik S, Hastings RP, Jahr E, Hughes JC. Outcomes of behavioral intervention for children with autism in mainstream pre-school settings. J Autism Dev Disord 2012; 42 (02) 210-220
    CrossrefPubMedGoogle Scholar
  • 17 Muratori F, Narzisi A. ; IDIA Group. Exploratory study describing 6 month outcomes for young children with autism who receive treatment as usual in Italy. Neuropsychiatr Dis Treat 2014; 10: 577-586
    PubMedGoogle Scholar
  • 18 Kamio Y, Haraguchi H, Miyake A, Hiraiwa M. Brief report: large individual variation in outcomes of autistic children receiving low-intensity behavioral interventions in community settings. Child Adolesc Psychiatry Ment Health 2015; 9: 6 Doi: 10.1186/s13034-015-0039-6
    CrossrefPubMedGoogle Scholar
  • 19 Kuppens S, Onghena P. Sequential meta-analysis to determine the sufficiency of cumulative knowledge: the case of early intensive behavioral intervention for children with autism spectrum disorders. Res Autism Spectr Disord 2012; 6: 168-176
    CrossrefPubMedGoogle Scholar
  • 20 Peters-Scheffer N, Didden R, Korzilius H, Sturmey P. A meta-analytic study on the effectiveness of comprehensive ABA-based early intervention programs for children with autism spectrum disorders. Res Autism Spectr Disord 2011; 5: 60-69
    CrossrefPubMedGoogle Scholar
  • 21 Eldevik S, Hastings RP, Hughes JC, Jahr E, Eikeseth S, Cross S. Using participant data to extend the evidence base for intensive behavioral intervention for children with autism. Am J Intellect Dev Disabil 2010; 115 (05) 381-405
    CrossrefPubMedGoogle Scholar
  • 22 Makrygianni MK, Reed P. A meta-analytic review of the effectiveness of behavioural early intervention programs for children with autistic spectrum disorders. Res Autism Spectr Disord 2010; 4: 577-593
    CrossrefPubMedGoogle Scholar
  • 23 Virués-Ortega J. Applied behavior analytic intervention for autism in early childhood: meta-analysis, meta-regression and dose-response meta-analysis of multiple outcomes. Clin Psychol Rev 2010; 30 (04) 387-399
    CrossrefPubMedGoogle Scholar
  • 24 Eldevik S, Hastings RP, Hughes JC, Jahr E, Eikeseth S, Cross S. Meta-analysis of early intensive behavioral intervention for children with autism. J Clin Child Adolesc Psychol 2009; 38 (03) 439-450
    CrossrefPubMedGoogle Scholar
  • 25 Reichow B, Wolery M. Comprehensive synthesis of early intensive behavioral interventions for young children with autism based on the UCLA young autism project model. J Autism Dev Disord 2009; 39 (01) 23-41
    CrossrefPubMedGoogle Scholar
  • 26 Warren Z, McPheeters ML, Sathe N, Foss-Feig JH, Glasser A, Veenstra-Vanderweele J. A systematic review of early intensive intervention for autism spectrum disorders. Pediatrics 2011; 127 (05) e1303-e1311
    CrossrefPubMedGoogle Scholar
  • 27 Eikeseth S. Outcome of comprehensive psycho-educational interventions for young children with autism. Res Dev Disabil 2009; 30 (01) 158-178
    CrossrefPubMedGoogle Scholar
  • 28 Seida JK, Ospina MB, Karkhaneh M, Hartling L, Smith V, Clark B. Systematic reviews of psychosocial interventions for autism: an umbrella review. Dev Med Child Neurol 2009; 51 (02) 95-104
    CrossrefPubMedGoogle Scholar
  • 29 Spreckley M, Boyd R. Efficacy of applied behavioral intervention in preschool children with autism for improving cognitive, language, and adaptive behavior: a systematic review and meta-analysis. J Pediatr 2009; 154 (03) 338-344
    CrossrefPubMedGoogle Scholar
  • 30 Grindle CF, Hastings RP, Saville M. , et al. Outcomes of a behavioral education model for children with autism in a mainstream school setting. Behav Modif 2012; 36 (03) 298-319
    CrossrefPubMedGoogle Scholar
  • 31 Strain PS, Bovey EH. Randomized, controlled trial of the LEAP model of early intervention for young children with autism spectrum disorders. Top Early Child Spec Educ 2011; 31: 133-154
    CrossrefPubMedGoogle Scholar
  • 32 Dawson G, Rogers S, Munson J. , et al. Randomized, controlled trial of an intervention for toddlers with autism: the Early Start Denver Model. Pediatrics 2010; 125 (01) e17-e23
    CrossrefPubMedGoogle Scholar
  • 33 Zachor DA, Ben Itzchak E. Treatment approach, autism severity and intervention outcomes in young children. Res Autism Spectr Disord 2010; 4 (03) 425-432
    CrossrefPubMedGoogle Scholar
  • 34 Hayward D, Eikeseth S, Gale C, Morgan S. Assessing progress during treatment for young children with autism receiving intensive behavioural interventions. Autism 2009; 13 (06) 613-633
    CrossrefPubMedGoogle Scholar
  • 35 Klintwall L, Eldevik S, Eikeseth S. Narrowing the gap: effects of intervention on developmental trajectories in autism. Autism 2015; 19 (01) 53-63
    CrossrefPubMedGoogle Scholar
  • 36 Ben Itzchak E, Zachor DA. Who benefits from early intervention in autism spectrum disorder?. Res Autism Spectr Disord 2011; 5 (01) 345-350
    CrossrefPubMedGoogle Scholar
  • 37 Ospina MB, Krebs Seida J, Clark B. , et al. Behavioural and developmental interventions for autism spectrum disorder: a clinical systematic review. PLoS One 2008; 3 (11) e3755 Doi: 10.1371/journal.pone.0003755
    CrossrefPubMedGoogle Scholar
  • 38 Peters-Scheffer N, Didden R, Mulders M, Korzilius H. Low intensity behavioral treatment supplementing preschool services for young children with autism spectrum disorders and severe to mild intellectual disability. Res Dev Disabil 2010; 31 (06) 1678-1684
    CrossrefPubMedGoogle Scholar
  • 39 Magiati I, Charman T, Howlin P. A two-year prospective follow-up study of community-based early intensive behavioural intervention and specialist nursery provision for children with autism spectrum disorders. J Child Psychol Psychiatry 2007; 48 (08) 803-812
    CrossrefPubMedGoogle Scholar
  • 40 Sparrow SS, Balla DA, Cicchetti DV. Vineland Adaptive Behavior Scales Interview Edition Survey Form Manual. Circle Pines, MN: American Guidance Services, Inc; 1984
    Google Scholar
  • 41 Fernell E, Hedvall Å, Westerlund J. , et al. Early intervention in 208 Swedish preschoolers with autism spectrum disorder. A prospective naturalistic study. Res Dev Disabil 2011; 32 (06) 2092-2101
    CrossrefPubMedGoogle Scholar
  • 42 Munson J, Faja S, Meltzoff A, Abbott R, Dawson G. Neurocognitive predictors of social and communicative developmental trajectories in preschoolers with autism spectrum disorders. J Int Neuropsychol Soc 2008; 14 (06) 956-966
    CrossrefPubMedGoogle Scholar
  • 43 Ben-Itzchak E, Watson LR, Zachor DA. Cognitive ability is associated with different outcome trajectories in autism spectrum disorders. J Autism Dev Disord 2014; 44 (09) 2221-2229
    CrossrefPubMedGoogle Scholar
  • 44 Reichow B. Overview of meta-analyses on early intensive behavioral intervention for young children with autism spectrum disorders. J Autism Dev Disord 2012; 42 (04) 512-520
    CrossrefPubMedGoogle Scholar
  • 45 Eikeseth S, Klintwall L, Jahr E, Karlsson P. Outcome for children with autism receiving early and intensive behavioral intervention in mainstream preschool and kindergarten settings. Res Autism Spectr Disord 2012; 6: 829-835
    CrossrefPubMedGoogle Scholar
  • 46 Vivanti G, Prior M, Williams K, Dissanayake C. Predictors of outcomes in autism early intervention: why don't we know more?. Front Pediatr 2014; 2: 58 Doi: 10.3389/fped.2014.00058
    PubMedGoogle Scholar