EFFECTIVENESS OF EARLY INTERVENTION ON AUTISM

Effectiveness of Early Intervention On Autism



Effectiveness of Early Intervention On Autism

Area of focus

Early intervention for children with autism is currently a focus in both the research literature, popular literature, and in practice. A number of reviews exist that examine studies of comprehensive interventions and targeted interventions, including those that examine environmental variables, participant and interventionist variables, methods of instruction, and non responders. The variability in outcomes observed in home-based early intensive behavioral intervention for children with autism is likely in part to be the result of the quality of therapist performance. Therapist behavior in this context, however, is poorly understood. To achieve such an understanding, it will be necessary to specify how factors such as therapist, child and intervention program characteristics, as well as supervision and training provision, influence therapists' interactions with children.

This study identified facilitating factors and barriers that therapists considered to influence their capacity to deliver early intensive behavioral intervention to young children with autism. Nineteen therapists associated with various service providers in the South of England will be interviewed. In general, responses represented opposite poles of the same construct. For example, child factors such as compliance and competence will be considered to facilitate instruction, whereas challenging behavior and lack of progress will be perceived to hinder it. These issues are considered in the light of previous research on staff behavior in related contexts. The factors identified suggest specific avenues for questionnaire and experimental research to validate these findings, have implications for routine service provision and may help improve the outcomes of children receiving early intensive behavioral intervention.

Research has shown that young children with autism and related disorders can benefit considerably from home-based early intensive behavioral intervention (EIBI) founded on the principles of applied behavior analysis (ABA) (Anderson, Avery, Dipietro, Edwards, & Christian, 1987; Birnbrauer & Leach, 1993; Green, Brennan, & Fein, 2002; Lovaas, 1987; McEachin, Smith, & Lovaas, 1993; Perry, Cohen, & DeCarlo, 1995; Sheinkopf & Seigel, 1998; Weiss, 1999). Model examples of intervention describe teams of trained therapists and, in many cases, parents providing one-to-one intervention for a significant time period each week, often for several years. Consultants in behavior analysis, supported by supervisory staff, regularly review child progress, modify interventions as required and provide guidance and feedback to therapists regarding instructional performance (Smith, Donahoe, & Davis, 2000b). Despite the potential for improvement in many areas of children's functioning, variability in outcome is commonplace (Bibby, Eikeseth, Martin, Mudford, & Reeves, 2002; Dawson & Osterling, 1997; Smith, 1999) and at most only 50% of children achieve the high levels of functioning reported for best outcome children (Lovaas, 1987 and McEachin et al., 1993).

Allen and Warzak (2000) identify a “necessary triad of features” (p. 373) they regard as critical to successful intervention outcome in ABA. According to their analysis, inconsistent outcome may stem from an insufficiently powerful behavioral technology, poor intervention integrity or poor procedural fidelity. Technology may be considered powerful if, in internally valid experimental settings, reliable effects upon behavior ...