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

Abstract

Background: Comprehensive behaviorally or developmentally based early intervention programs have been shown to be effective in improving cognitive, social communicative, and adaptive skills of children with autism spectrum disorder (ASD). Besides the definition of relevant outcome predictors, the question of whether early intensive intervention positively changes core autism symptoms in children, as well as their long-term outcome, is an important issue for current research. The primary objective of the current study was to examine whether symptomatic and behavioral changes in children up to 4.5 years with ASD were sustained one and two years after an initial 18 days of intensive FIAS (Frühintervention bei autistischen Störungen) intervention. Methods: We analyzed the data of 32 young children with moderately severe to severe ASD who had been treated at the FIAS center between January 2011 and July 2017 and who had completed their 2-year follow-up in summer 2019. Results: ADOS total scores decreased significantly from baseline to the 1-year follow-up and from baseline to the 2-year follow-up (p < 0.01), with the most prominent change being from baseline to 2-year follow-up. The DD-C-GAS, a global scale used to assess four areas of everyday functioning, showed highly significant improvements on all subdomains. We found mostly significant correlations between results on both rating instruments at all time points, yet mostly no meaningful correlation between their changes over time. There was a close and statistically significant relationship between parents' treatment adherence and ADOS scores, indicating that the better parents' treatment adherence, the lower the children scored on the ADOS at 1-and 2-year follow-up. Overall, improvement on both scales was virtually independent of age and autism symptom severity at baseline, suggesting that older (>43 months) and more severely affected children (ADOS total score >20) may benefit from the FIAS intervention to the same extent as younger children do. Conclusions: The results of the study indicate that the FIAS approach of providing an initial highly intensive 18-day intervention period, followed by 2 years of less intensive

Clinical utility of the standardized observation tool Autism Behavior Coding System for early intervention research in autism spectrum disorder

“…As in our previous studies (Dima et al, 2017; Herbrecht et al, 2020), we used the DD‐CGAS, an ASD‐adapted version of the Children's Global Assessment Scale (Schaffer et al, 1983), as an independent measure of the children's level of functioning. Reliability and validity data of the DD‐CGAS were reported by Wagner et al (2007); due to its simple use and high ecological validity no specific reliability training was made in our study.…”

“…The ADOS repetitive behavior score, which corresponds materially to the repetitive behavior score of the ABCS, was also included. Previous analyses of DD-CGAS data have shown that its four subdomain scores were highly intercorrelated (Herbrecht et al, 2020). Consequently, and since the focus of FIAS interventions is on communication and social interaction, only the two respective DD-CGAS scores (communication, social behavior) were analyzed, keeping in mind that they are highly intercorrelated, too.…”