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In a previous study, we compared the effects of just over one year of intensive behavior analytic intervention (IBT) provided to 29 young children diagnosed with autism with two eclectic (i.e., mixed-method) interventions (Howard, Sparkman, Cohen, Green,& Stanislaw, 2005). One eclectic intervention (autism programming; AP) was designed specifically for children with autism and was intensive in that it was delivered for an average of 25-30 h per week (n = 16). The other eclectic intervention (generic programming; GP) was delivered to 16 children with a variety of diagnoses and needs for an average of 15-17 h per week. This paper reports outcomes for children in all three groups after two additional years of intervention. With few exceptions, the benefits of IBT documented in our first study were sustained throughout Years 2 and 3. At their final assessment, children who received IBT were more than twice as likely to score in the normal range on measures of cognitive, language, and adaptive functioning than were children who received either form of eclectic intervention. Significantly more children in the IBT group than in the other two groups had IQ, language, and adaptive behavior test scores that increased by at least one standard deviation from intake to final assessment. Although the largest improvements for children in the IBT group generally occurred during Year 1, many children in that group whose scores were below the normal range after the first year of intervention attained scores in the normal range of functioning with one or two years of additional intervention. In contrast, children in the two eclectic treatment groups were unlikely to attain scores in the normal range after the first year of intervention, and many of those who had scores in the normal range in the first year fell out of the normal range in subsequent years. There were no consistent differences in outcomes at Years 2 and 3 between the two groups who received eclectic interventions. These results provide further evidence that intensive behavior analytic intervention delivered at an early age is more likely to produce substantial improvements in young children with autism than common eclectic interventions, even when the latter are intensive.

Although previous studies have shown favorable results with early intensive behavioral treatment (EIBT) for children with autism, it remains important to replicate these findings, particularly in community settings. The authors conducted a 3-year prospective outcome study that compared 2 groups: (1) 21 children who received 35 to 40 hours per week of EIBT from a community agency that replicated Lovaas' model of EIBT and (2) 21 age- and IQ-matched children in special education classes at local public schools. A quasi-experimental design was used, with assignment to groups based on parental preference. Assessments were conducted by independent examiners for IQ (Bayley Scales of Infant Development or Wechsler Preschool and Primary Scales of Intelligence), language (Reynell Developmental Language Scales), nonverbal skill (Merrill-Palmer Scale of Mental Tests), and adaptive behavior (Vineland Adaptive Behavior Scales). Analyses of covariance, with baseline scores as covariates and Year 1-3 assessments as repeated measures, revealed that, with treatment, the EIBT group obtained significantly higher IQ (F = 5.21, p = .03) and adaptive behavior scores (F = 7.84, p = .01) than did the comparison group. No difference between groups was found in either language comprehension (F = 3.82, p = .06) or nonverbal skill. Six of the 21 EIBT children were fully included into regular education without assistance at Year 3, and 11 others were included with support; in contrast, only 1 comparison child was placed primarily in regular education. Although the study was limited by the nonrandom assignment to groups, it does provide evidence that EIBT can be successfully implemented in a community setting.

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Recent legislation and litigation have focused considerable clinical attention on the social Integration of people with handicaps into the community msinstream. Measures of adaptive behavior have played an increasingly important part in this endeavor. They serve two primary functions: classification/placement and program planningltreatment. This paper traces the conceptual origins of adaptive bchavior from state res~dential institutions to its role in the complex process of community integration. A framework for evaluating and selecting adaptive behavior scales is presented along with a review of current trends in measurement. The last seclion discusses conceptual and methodological issues that presently confront the adaptive behavior lield.The demand for ways to measure adaptive behavior has recently escalated dramatically. Spreat, Roszkowski and Isett (1983) estimate that well over 200 instruments purporting to measure adaptive behavior have emerged in the last 20 years. Many of these are "home grown," target specific populations (e.g., severely to profoundly mentally retarded), have limited utility, and do not meet even minimal technical standards fo: assessment instruments (Meyers, Nihira, & Zetlin, 1979). Yet, legislation and litigation, primarily in the 1970s, fueled by sweeping changes in public attitudes toward treatment of individuals with handicaps, have iiterally compelled the usage of adaptive behavior scales in the school, community, residential institution, and other treatment settings. Choosing from among such a wide variety of exktlng adaptive behavior tools Howard G. Cohen is affiliated with the \'dllcy Mountain Regional Center, 701 Dundee Way, Stockton, CA 95210. 0 1988 by The Haworth Prcss, lnc. All rights reserved.. 7 7 Downloaded by [University of Sussex Library] at 16:11 05 February 2015 38 Tronsirioning Erceprinnal Children and Youth iqto the Communi!yor, alternatively, deciding to create one to meet unique requirements of a treatment setting can be a confusing and ovsnvhelming task.The purpose of this chapter is two-fold: (a) to develop a framework for understanding the concept of adaptive behavior as it has evolved and is currently applied in the diagnosis and treatment of individuals with handicaps and (b) to provide technical assistance in making sound selections of instruments to measure adaptive behavior. The chapter will be divided into two major sections.The first part will review significant sociopolitical forces that have propelled adaptive behavior to the forefront and focus on assessment and habilitation efforts with handicapped individuals. The conceptual foundations of adaptive behavior and attempts to quantify and measure it will be delineated. Its origins in state residential institutions for the mentally retarded from the middle 1930s to the 1960s will be reviewed. A discussion of the ascendancy and refinement of adaptive behavior instruments during the deinstitutionalization era of the 1960s and 1970s will follow. The second section will focus on three topics: presentatio...