Become Related: FIAS, an Intensive Early Intervention for Young Children with Autism Spectrum Disorders

Abstract

Background: In autism spectrum disorders (ASDs), impairments in fundamental social abilities and a lack of interest in social stimuli become apparent early in life. These impairments are thought to negatively affect further brain and behavioural development. Early intensive interventions can help to attenuate social-development and other risk factors and, thus, to ameliorate the deficits associated with ASDs. We present FIAS, an intensive early intervention approach for young children with ASD, which aims at developing children's social motivation. During 18 days, therapists work continuously for 6 h a day with the affected child, involving the whole family in a day care setting. Follow-up care at home over 1 year as well as fresh-up interventions and inclusion in kindergarten or a play group should stabilise the effects and help to respond to further challenges. Material and Methods: Here, we present observations from the first 12 patients (25-48 months of age) treated according to the FIAS approach. We evaluated changes in core autistic symptoms and level of functioning after the 18 days of intensive intervention. Beyond standardised assessment, two innovative video-based instruments (Autism Behaviour Coding System and Evaluationsfragebogen) have been developed to assess autistic symptoms and interaction parameters during intervention. Results: Improvements were noted in most core autistic symptom domains, with the highest effect sizes in domains like eye contact, communication, repetitive behaviour, imitation, motivation and reciprocity. In addition, the level of functioning significantly improved. Conclusions: The first evaluation of the FIAS approach shows promising results, as the FIAS intervention appears to improve core autistic symptom domains as well as the level of everyday functioning. Limitations of this study are the small sample size and the lack of a control group. A more comprehensive and longitudinal evaluation is in progress; this will focus on the stability of the observed effects and will attempt to identify potential predictors of treatment response.

Process research in early intensive intervention in autism spectrum disorder: Sensitivity to change of the autism behavior coding system

“…Participants were 40 young children with autism according to DSM‐IV [American Psychiatric Association, ] and enrolled in the FIAS early intensive intervention approach [Herbrecht et al, ] between 2011 and 2017. They had been diagnosed using the ADOS‐2 Module 1 and the Autism Diagnostic Interview‐Revised [ADI‐R; Rutter, LeCouteur, & Lord, ; German version: Bölte, Rühl, Schmötzer, & Poustka, ].…”

“…FIAS focuses on the development of a reciprocal relationship between therapists and the child and offers social interaction opportunities without directly prompting behaviors or targeting isolated skills. Besides the reference therapist working most with the child, up to three additional therapists hold play sessions with the child, so that communication and interaction behaviors can be generalized to different persons [see Herbrecht et al, for details]. The majority of play sessions, each lasting between 75 and 90 min, are recorded for documentation and intervention planning, as well as for video analysis together with the parents.…”

“…FIAS is a play‐based, intensive early intervention approach for children with autism aged up to 5 years. It is intended to encourage children to take part in social interactions by increasing shared enjoyment and social motivation [see Herbrecht et al, for a detailed description]. FIAS treatment consists of an initial 18 day intervention period with the core family at the FIAS center, followed by 2 years of follow‐up.…”

Short-Term and Highly Intensive Early Intervention FIAS: Two-Year Outcome Results and Factors of Influence

“…In contrast with other early intervention programs that usually last from 1 to 2 years, FIAS focuses on a very high-intensity treatment period of about 100 h during the first 18 days, followed by less intensive follow-up care. During the follow-up period, the parents are encouraged to provide their child with play sessions of 1 to 2 h of per day in order to consolidate and amplify the gains made during the initial period [for details, see Herbrecht et al (13)].…”

Programas de intervenções comportamentais e de desenvolvimento intensivas precoces para crianças com TEA: uma revisão de literatura

“…Podem considerar como objetivo o desenvolvimento de comportamentos adaptativos, envolvendo flexibilidade comportamental, redução de comportamentos problemáticos (DEL SOL FORTEA; ESCANDELL; CASTRO, 2015). A motivação social da criança para interagir pode ser foco mais amplo e explícito de alguns programas de intervenção precoce para TEA (HERBRECHT et al, 2015).…”