OBJECTIVES: To examine long-term outcomes of toddlers with autism spectrum disorder (ASD) who received a 6-month early intervention at age 2.METHODS: Forty-eight toddlers diagnosed with an ASD received a 6-month evidence-based intervention. Cognitive (IQ) and communication ability, as well as severity of autism symptoms, were assessed by using standardized measures at preintervention (Time 1 [T1]; mean [M] age = 27 months), postintervention (T2; M age = 35 months), short-term follow-up (T3; M age = 41 months), and long-term followup (T4; M age = 72 months).
RESULTS:From pre-to postintervention, significant gains in IQ and Vineland Communication domain standard scores as well as a reduction in ASD severity were achieved (all P , .01). Between T2 and T3, the 6-month period immediately after completion of the intervention, IQ and Communication scores stabilized and ASD severity increased significantly (P , .05). During the long-term follow-up period (T3-T4), IQ and Communication scores significantly increased again, but ASD severity increased significantly as well (all P , .05). For overall trajectory (T1-T4), robust gains were observed for both IQ and communication; ASD severity did not change.
CONCLUSIONS:Findings highlight the potential for positive long-term outcomes in toddlers with ASD. Additional research is needed to understand the relation between early exposure to uninterrupted intervention and developmental gains, and whether initial reduction in ASD symptom severity can be sustained through targeted intervention. Pediatrics 2012;130:S186-S190 Mounting empirical evidence suggests evidence-based early intervention for children with autism spectrum disorders (ASDs) is associated with cognitive, language, and/or social gains 1-8 ; however, little is known about the durability of such gains after transition from early intervention into the preschool and elementary educational years. Research surrounding sustainability of intervention effects has clinical, economic, and quality-of-life implications. Four published reports have followed 2-or 3-year-olds with ASD for at least 6 months after completion of an early intervention program. In 2 studies, 2-year-olds who received short-term intervention showed sustained social, 4,5 language, 4 and nonverbal cognitive 4 gains through a 6-4 to 12-month 5 followup period. Two other studies reported on longer-term outcomes of 2-and 3-year-olds exposed to a 2-year comprehensive intervention. 6,7 Kovshoff and colleagues 6 reported that IQ, but not Vineland Adaptive Behavior Composite (VABC), 9 increased during receipt of 1:1 applied behavior analysis (ABA) intervention. No IQ or VABC gains were observed from pre-to postintervention in the comparison group receiving public special education. 8 During the postintervention follow-up period, no increases in IQ or VABC scores occurred in either group. 6,8 Outcomes were particularly unfavorable for children in the ABA group whose preintervention IQ was low, as their IQ scores declined significantly during follow-up. 6 Fi...