Early intervention in 208 Swedish preschoolers with autism spectrum disorder: A prospective naturalistic study
2011 (English)In: Journal of Research in Developmental Disabilities, ISSN 0891-4222, E-ISSN 1873-3379, Vol. 32, no 6, 2092-2101 p.Article in journal (Refereed) Published
Early intervention has been reported to improve outcome in children with autism spectrum disorders (ASDs). Several studies in the field have been randomized controlled trials (RCTs). The aim of this study was to assess ASD outcome in a large naturalistic study. Two hundred and eight children, aged 20–54 months, with a clinical diagnosis of ASD were given intervention and monitored prospectively in a naturalistic fashion over a period of 2 years. The toddlers were considered representative of all but the most severely multiple disabled preschool children with ASD in Stockholm county. They fell into three cognitive subgroups: one with learning disability, one with developmental delay, and one with normal intellectual functioning. Data on intervention type and intensity were gathered prospectively in a systematic fashion. Intervention was classified into intensive applied behaviour analysis (ABA) and non-intensive, targeted interventions, also based on ABA principles. Children were comprehensively assessed by a research team before the onset of intervention, and then, again, 2 years later. Change in Vineland adaptive behaviour scales composite scores from intake (T1) to leaving the study (T2) was set as the primary outcome variable. The research team remained blind to the type and intensity of interventions provided. One hundred and ninety-eight (95%) of the original samples stayed in the study throughout the whole 2-year period and 192 children had a complete Vineland composite score results both at T1 and T2. Vineland composite scores increased over the 2-year period. This increase was accounted for by the subgroup with normal cognitive functioning. There was no significant difference between the intensive and non-intensive groups. Individual variation was considerable, but no child in the study was “problem-free” at follow-up. Our data do not support that children with ASD generally benefit more from the most intensive ABA intervention programs than from less intensive interventions or targeted interventions based on ABA.
Place, publisher, year, edition, pages
Elsevier, 2011. Vol. 32, no 6, 2092-2101 p.
autism spectrum disorder, early intervention, Vineland, naturalistic study
Research subject Psychology
IdentifiersURN: urn:nbn:se:su:diva-70434DOI: 10.1016/j.ridd.2011.08.002ISI: 000296304000009OAI: oai:DiVA.org:su-70434DiVA: diva2:481247
The authors are very grateful to all parents and children participating in the study. We are also indebted to research coordinator Siv Jägerlöv, and to psychologist Ingrid Adolfsson for her work in the initial part of the study. The collaboration with the personnel at the Autism Centre for Young Children and at the Private Centre in Stockholm has been much appreciated. Other persons to be acknowledged are Kerstin Dahlström and David Edfelt at Karolinska University Hospital and Methe Axén and Hans Wermeling at Habilitation and Health, Stockholm county.
The project was financially supported by the Swedish Inheritance Fund, Stockholm County Council, Habilitation and Health in Stockholm, the Gillberg Neuropsychiatry Centre, the Research and Development Centre at Skaraborgs Hospital (EF), the Wilhelm and Martina Lundgren Foundation (EF) and by a grant for Christopher Gillberg under the ALF-agreement and from the Swedish Medical Research Council.2012-01-202012-01-202012-02-01Bibliographically approved