Abstract:BackgroundThe outcomes of psycho-educational interventions for Autism Spectrum Disorders (ASDs) comorbid with severe to moderate intellectual disability (ID) are insufficiently documented. In this prospective study, we examined a developmental individual, interactive and intensive approach, called the ‘3i method’, which is based on play therapy.MethodsTwenty DSM-IV-TR ASD subjects (mean chronological age 63.8 ± 37.8 months; mean developmental age 19.5 ± 6.6 months) were included and followed the 3i method for … Show more
“…Most of the participants received the intervention at home, wherever in France, whereas three of them followed the method in the Lud’eveil centre in Courbevoie (Courbevoie municipality had created a centre providing play-rooms for those families who can’t find a place to set one in their own home). At this stage, there is no evidence suggesting a difference in the effectiveness of the method between participants in home care or in educational centres [ 19 ]. Three participants who followed 3i refused evaluation.…”
Section: Methodsmentioning
confidence: 99%
“…The 19 oldest files were those of children previously included in the prospective study conducted on patients who began the intervention between January 2013 and December 2013. In this published study, patients were assessed with CARS and ADI-R but also with PEP-R and VABS at the beginning and after 2 years of 3i intervention [ 19 ]. Fig.…”
Section: Methodsmentioning
confidence: 99%
“…The 3i method was implemented as previously described [ 19 ]. 3i is an interactive, intensive and individual intervention for autistic children.…”
Section: Methodsmentioning
confidence: 99%
“…A prospective exploratory study was carried out to assess benefits for patients [ 19 ]. Twenty “3i” patients were followed-up with for 2 years, and their developmental skills progression towards communication, socialization and imitation was assessed using Vineland Adaptative Behavior Scale (VABS) [ 20 ], Nadel’s imitation scale, and the PsychoEducational Profile Revised (PEP-R); ASD severity was assessed by the Childhood Autism Rating Scale (CARS) and the Autism Diagnostic Interview-Revised (ADI-R).…”
Background
The Intensive, Interactive, and Individual (3i) intervention approach aims to decrease the severity of autism spectrum disorder (ASD) using intensive developmental play therapy (3i). We performed a retrospective study of 90 children who were enrolled for 2 years in the 3i approach to assess changes and predictors of changes in ASD severity at follow-up (FU).
Methods
The ASD severity of all patients (N = 119) who began 3i intervention between 2013 and 2018 was systematically measured using the childhood autism rating scale (CARS) and autism diagnosis interview-revised (ADI-R). Among them, 90 patients (mean age 5.6 ± 3.7 years) had a second assessment at the 2 year FU. CARS and ADI-R scores after 2 years of 3i intervention were compared to baseline scores using paired student’s t-tests. We used multiple linear regression models to assess the weight of baseline variables (e.g., age, oral language, sex, treatment intensity) on changes at the 2 year FU.
Results
Mean CARS and ADI-R subscores (interaction, communication, repetitive behaviour) decreased significantly by 20, 41, 27.5 and 25%, respectively (effect sizes: d > 0.8). Moreover, 55 and 46.7% of participants switched to a lower category of ASD severity based on the CARS scale and ADI-R interview, respectively. Multiple linear models showed that (i) a higher treatment intensity (more than 30 h per week) was significantly associated with a greater decrease (improvement) in the ADI-R interaction score; (ii) patients categorized as verbal subjects at baseline were associated with a better outcome, as ascertained by the CARS, ADI-R interaction and ADI-R communication scores; and (iii) older patients were significantly associated with a greater decrease in the ADI-R interaction score. However, we found no impact of sex, severity of ASD or comorbidities at baseline.
Conclusion
This study performed on 90 children suggests that 3i therapy may allow for a significant reduction in ASD severity with improvements in interaction, communication, and repetitive behaviours. A study using a control group is required to assess the efficacy of 3i play therapy compared to other interventions.
“…Most of the participants received the intervention at home, wherever in France, whereas three of them followed the method in the Lud’eveil centre in Courbevoie (Courbevoie municipality had created a centre providing play-rooms for those families who can’t find a place to set one in their own home). At this stage, there is no evidence suggesting a difference in the effectiveness of the method between participants in home care or in educational centres [ 19 ]. Three participants who followed 3i refused evaluation.…”
Section: Methodsmentioning
confidence: 99%
“…The 19 oldest files were those of children previously included in the prospective study conducted on patients who began the intervention between January 2013 and December 2013. In this published study, patients were assessed with CARS and ADI-R but also with PEP-R and VABS at the beginning and after 2 years of 3i intervention [ 19 ]. Fig.…”
Section: Methodsmentioning
confidence: 99%
“…The 3i method was implemented as previously described [ 19 ]. 3i is an interactive, intensive and individual intervention for autistic children.…”
Section: Methodsmentioning
confidence: 99%
“…A prospective exploratory study was carried out to assess benefits for patients [ 19 ]. Twenty “3i” patients were followed-up with for 2 years, and their developmental skills progression towards communication, socialization and imitation was assessed using Vineland Adaptative Behavior Scale (VABS) [ 20 ], Nadel’s imitation scale, and the PsychoEducational Profile Revised (PEP-R); ASD severity was assessed by the Childhood Autism Rating Scale (CARS) and the Autism Diagnostic Interview-Revised (ADI-R).…”
Background
The Intensive, Interactive, and Individual (3i) intervention approach aims to decrease the severity of autism spectrum disorder (ASD) using intensive developmental play therapy (3i). We performed a retrospective study of 90 children who were enrolled for 2 years in the 3i approach to assess changes and predictors of changes in ASD severity at follow-up (FU).
Methods
The ASD severity of all patients (N = 119) who began 3i intervention between 2013 and 2018 was systematically measured using the childhood autism rating scale (CARS) and autism diagnosis interview-revised (ADI-R). Among them, 90 patients (mean age 5.6 ± 3.7 years) had a second assessment at the 2 year FU. CARS and ADI-R scores after 2 years of 3i intervention were compared to baseline scores using paired student’s t-tests. We used multiple linear regression models to assess the weight of baseline variables (e.g., age, oral language, sex, treatment intensity) on changes at the 2 year FU.
Results
Mean CARS and ADI-R subscores (interaction, communication, repetitive behaviour) decreased significantly by 20, 41, 27.5 and 25%, respectively (effect sizes: d > 0.8). Moreover, 55 and 46.7% of participants switched to a lower category of ASD severity based on the CARS scale and ADI-R interview, respectively. Multiple linear models showed that (i) a higher treatment intensity (more than 30 h per week) was significantly associated with a greater decrease (improvement) in the ADI-R interaction score; (ii) patients categorized as verbal subjects at baseline were associated with a better outcome, as ascertained by the CARS, ADI-R interaction and ADI-R communication scores; and (iii) older patients were significantly associated with a greater decrease in the ADI-R interaction score. However, we found no impact of sex, severity of ASD or comorbidities at baseline.
Conclusion
This study performed on 90 children suggests that 3i therapy may allow for a significant reduction in ASD severity with improvements in interaction, communication, and repetitive behaviours. A study using a control group is required to assess the efficacy of 3i play therapy compared to other interventions.
“…ASD was diagnosed by one psychiatrist and one pediatric ASD specialist using the Autism Diagnostic Interview-Revised (ADI-R) and the Autism Diagnostic Observation Schedule (ADOS). ADI-R was usually used as a diagnostic instrument [12], while ADOS was useful for studying the longitudinal changes of core autism symptom severity.…”
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