Predicting Outcome of Community-Based Early Intensive Behavioral Intervention for Children with Autism

Abstract

We examined predictors of outcome (IQ, adaptive behavior, and ASD severity) after 12 and 24 months of early intensive behavioral intervention (EIBI) in 71, 20–59 months old children with autism spectrum disorder (ASD) who were enrolled in publicly-funded, community-based agencies. Predictors included social engagement (combining variables loading onto a single factor: social approach, joint attention, and imitation) and sensorimotor rituals. Younger age and higher IQ at intake predicted favorable outcomes at both 12 and 24 months. Adjusting for age, IQ, baseline predictor scores, EIBI hours, treatment site, and sensorimotor rituals, social engagement predicted superior later IQ and adaptive behavior. In contrast, sensorimotor rituals did not predict outcome. Although limited by the absence of a control group, the study indicates social engagement predicts some EIBI outcomes.

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Author Note

The project described in this publication was funded by U54 MH066397 (NIH/NIMH Genotype and Phenotype of Autism, Principal Investigator: Patricia Rodier). It was also supported by the University of Rochester CTSA award UL1 RR024160 from the National Center for Research Resources and the National Center for Advancing Translational Sciences of the National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

We thank the children and families who participated. We also thank Dr. Rodier (deceased) and Dr. Susan Hyman for their leadership of the STAART Center; Dr. Caroline Magyar and her staff for conducting intake assessments of participants; Dr. Christopher Stodgell for directing data management of the grant; Drs. Loisa Bennetto and Miron Zuckerman for their advice; and Dr. Hyman for reviewing an earlier draft of this manuscript.

We are grateful to the following agencies who referred participants to the study and advised us: Stepping Stones Learning Center (Mariellen Cupini, Director; Dr. John McEachin, EIBI Consultant); Summit Educational Resources (Tonawanda, NY; Drs. Stephen Anderson, Director; Amy Jablonski and Vicki Knapp, Collaborators); The Center for Autism and Related Disorders (Fairport, NY, branch, Director: Denise Rhine; Dr. Doreen Granpeesheh, Executive Director); Upstate Cerebral Palsy (Utica, NY; Dr. Helen Stepowany, Director; Jean Jacobson and Nancy Seller, Collaborators); and the Autism Spectrum Disorders (ASD) Program at the University of Rochester).

We benefited from consultation with Dr. Ronald Rogge and University of Rochester Biostatistics colleagues: Susan Messing, Jason Morrisette, and Hongqi Xue. We also appreciate the support of the University of Rochester Clinical and Translational Science Institute, Biomedical Informatics, in particular Philip Ng and Jason Englert. Arthur Loveland provided IT help.

We gratefully acknowledge the help of our research staff: Carol Stamm, Bryan Harrison, Carrie Hughes Hennessy, Courtney McGuire, Suzannah Iadarola, Amanda Smith, Jennifer Wick, and Michael Williams. Finally, we thank the parents and children who took part in the research.

Conflicts of Interest

The authors declare that they have no conflict of interest.

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Correspondence to Tristram Smith.

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Fig. A1
figure1

Distribution of change from intake to Year 1 (left two panels) and to Year 2 (right two panels) for the average of Mullen (MSEL) and Vineland (VABS) scales as a function of age at intake (top) and MSEL at intake (bottom). The best fitting line relating the variables is also plotted. (JPEG 2.71 mb)

Fig. A2
figure2

Distribution of change from intake to Year 1 (left two panels) and to Year 2 (right two panels) for the average of Mullen and Vineland scales as a function of the Sensorimotor Rituals and Social Engagement domains obtained at intake. The best fitting line relating the variables is also plotted. All measures were scored as standard scores based on the mean and standard deviation at the intake. (JPEG 2.81 mb)

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Smith, T., Klorman, R. & Mruzek, D.W. Predicting Outcome of Community-Based Early Intensive Behavioral Intervention for Children with Autism. J Abnorm Child Psychol 43, 1271–1282 (2015). https://doi.org/10.1007/s10802-015-0002-2

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Keywords

  • Autism
  • Applied behavior analysis
  • Early intervention
  • Treatment outcomes
  • Discrete trial training