Intervention for Optimal Outcome in Children and Adolescents with a History of Autism

Abstract

Objective Autism spectrum disorders (ASDs) were once considered lifelong disorders, but recent findings indicate that some children with ASDs no longer meet diagnostic criteria for any ASD and reach normal cognitive function. These children are considered to have achieved ‘optimal outcomes’ (OO). The present study aimed to retrospectively examine group differences in the intervention history of children and adolescents with OO and those with high-functioning autism (HFA) Method The current study examined intervention histories in 34 individuals with OO and 44 individuals with HFA (currently ages 8-21), who did not differ on age, sex, nonverbal IQ or family income. Intervention history was collected through detailed parent questionnaires. Results Children in the OO group had earlier parent concern, received earlier referrals to specialists, and earlier and more intensive intervention than those in the HFA group. Substantially more OO children received Applied Behavior Analysis (ABA) therapy than HFA children, although the intensity of ABA did not vary between groups. Children in the HFA group were more likely to have received medication, especially anti-psychotics and anti-depressants. There were no group differences in the percent of children receiving special diets or supplements. Conclusion These data suggest that OO individuals generally receive earlier, more intense interventions and more ABA, while HFA individuals receive more pharmacologic treatments. While the use of retrospective data is a clear limitation to the current study, the substantial differences in reported provision of early intervention, and ABA in particular, are highly suggestive and should be replicated in prospective studies.

Autism and ABA: The Gulf Between North America and Europe

“…In fact, there is a highly statistically significant relationship between ABA-based interventions and optimal outcomes (Fein et al 2013;Orinstein et al 2014). ABA-based interventions use a data-based decision making model of programme delivery to ensure that interventions are holistic and person-centred in the sense that appropriate principles of behaviour are harnessed to meet the needs of the programme for facilitating meaningful changes in the behaviour of the individual; this means that the choice of intervention depends on the specific outcomes to be achieved and on the progress attained at any point in time (Maurice et al 1996).…”

Improving Early Identification and Ongoing Care of Children With Autism Spectrum Disorder

“…8 Recent studies indicate that intensive behavioral therapy starting as early as 18 months of age is associated with decreases in core symptoms of ASD and improvement in cognition, language, and adaptive skills. 9,10 After diagnosis, children with ASD require ongoing care within a medical home to address associated medical conditions, coordinate care with specialists, and provide family support. 11 Pediatricians report low self-efficacy in meeting the medical needs of children with ASD and cite poor reimbursement, difficulty with care coordination, and insufficient training as barriers to providing care for children with ASD.…”

Applied behaviour analysis: What do teachers of students with autism spectrum disorder know

“…In fact, ABA-based early intensive interventions are statistically significantly related to optimal outcomes for children with ASD (Fein et al, 2013;Kelley, Naigles, & Fein, 2010;Orinstein et al, 2014) .…”