Although early intensive behavioral intervention (EIBI) has been clearly shown to be evidence-based, there is very little information available regarding long-term outcomes, especially from community effectiveness studies. We present data on cognitive, adaptive, and autism severity measures from four time points (pre- and post-EIBI and two follow-up points) for a sample of 21 youth, currently aged 16 years on average (range = 13-20) who received EIBI as young children and who have been out of EIBI for a mean of 10 years (range = 8.5-14). Results show heterogeneous outcomes and a general pattern of stability since the end of EIBI, suggesting gains made in EIBI are maintained.
Background According to several comprehensive systematic and narrative reviews, interventions based on applied behaviour analysis principles, or behaviour analytic interventions, are considered evidence based for children with autism spectrum disorder (ASD). However, no comprehensive review of the literature related to behaviour analytic interventions for children with intellectual disability (ID) currently exists. Methods Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (registration ID: CRD42018099317), the purpose of this study was to conduct a systematic review of the relevant published literature on the use of behaviour analytic interventions to develop skills in young children (0-8 years) with ID (and without ASD). A preliminary search of the literature identified 1209 potential studies published between January 2000 and April 2020. The review process resulted in 48 articles consisting of 49 studies (i.e. one paper contained two studies) that met the inclusion criteria. Most used single-case research designs. Studies were evaluated on five dimensions of methodological quality based on the Scientific Merit Rating Scale developed by the National Autism Center (NAC). The NAC definitions were also used for the quantity and quality of research evidence required for interventions to be considered established or emerging. Results There were a number of limitations to the quality of the body of research. Nevertheless, various behaviour analytic interventions met criteria for being established interventions when used for targeting communication, adaptive and pre-academic skills in young children with ID. Behaviour analytic interventions targeting academic skills met criteria for emerging interventions. Conclusions Although the current literature is limited, results indicate that behaviour analytic interventions may be effectively used to support skill development in children with ID.
Communication deficits are one of the core symptoms of autism spectrum disorder (ASD). As such, individuals diagnosed with ASD are often taught to communicate using augmentative and alternative communication (AAC) systems. One of the most commonly used AAC systems is the Picture Exchange Communication System ® (PECS ® ). Despite the prevalent use of PECS within clinical and educational settings, there exists little empirical information about the use of PECS in community settings, such as summer camps. The present preliminary investigation explored the nature of participants' PECS use in a community setting using various sources of data from multiple respondents. Fidelity of PECS implementation was also examined. Twenty-two children and youth, the majority of whom scored substantially below average on standardized measures of cognitive and adaptive abilities and in the "severe" range of ASD symptomatology, were taught to use PECS within a therapeutic summer camp. Overall, results indicate that participants were reported to use PECS to request a diverse array of reinforcing items, across a variety of activities and environments. Increased PECS use and appropriate communicative behavior was observed, as well as reductions in contextually inappropriate behavior. Results were reported by parents to generalize to the home environment. Further, PECS was implemented with adequate fidelity by community implementors. Implications for communication training within community settings are discussed.
Research indicates that the Picture Exchange Communication System® (PECS®) is an evidence-based communication approach for children diagnosed with autism spectrum disorder (ASD). However, little is known about PECS-related parent training, treatment fidelity, or generalization and maintenance of skills. The purpose of the current study was to explore strategies to help parents support their child's PECS use at home. One child with ASD and both his parents participated. Researchers used behavioral skills training to teach target PECS skills and applied general case training strategies to actively program for generalization. A multiple baseline design across skills was used to monitor the primary parent trainee's fidelity during training sessions and a multiple probe design was embedded to monitor both parents' treatment fidelity in the natural environment with their child. The parent trainee demonstrated target PECS skills within the training setting. However, parents did not reliably demonstrate all target PECS skills in the generalization setting during follow-up.
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