Toward a technology of treatment individualization for young children with autism spectrum disorders

Abstract

Although the etiology of autism spectrum disorders (ASD) and early development of the ASD are not yet well understood, recent research in the field of autism has heavily emphasized the importance of early intervention (i.e. treatment before the age of 4 years). Currently, several methods have been demonstrated to be efficacious with some children however no treatment completely ameliorates the symptoms of ASD or works for all children with the disorder. The heterogeneity and developmental nature of the disorder make it unlikely that one specific treatment will be best for all children, or will work for any one child throughout his or her educational career. Thus, this paper examines early research validating different technologies for individualizing treatment. A discussion of current research on pre-treatment characteristics associated with differential outcomes in treatment, including child, family, and practitioner variables; and how specific intervention techniques address each of those pre-treatment characteristics is provided. The ultimate goal of this line of research is to enable practitioners to prospectively tailor treatments to specific children and increase the overall rate of positives outcomes for children with autism. Research that furthers understanding of how to match clients with efficacious treatments will decrease the outcome variability that characterizes early intervention research at present, and provide for the most efficient allocation of resources during the critical early intervention time-period. This type of research is in its infancy, but is imperative if we are to determine a priori which treatment method will be most effective for a specific child.

Reporting of Cultural Factors in Autism Research Publications in Sweden: Application of the GAP-REACH Checklist

“…This may have direct implications for practice as it allows to (1) understand mechanisms underlying disproportionate diagnosis and access to services for ethnic minorities with ASD (Pierce et al 2014), (2) increase practitioners' awareness on impact of cultural factors on treatment outcomes (Chung et al 2014), and (3) design culturally competent, individualized interventions, tailored to meet unique needs of each person with ASD and his/her family members (Stahmer et al 2011). Those in turn can help eliminate existing disparities, and in combination with preventive interventions, may potentially lead to improved quality of life and life expectancy for individuals with ASD (Bishop-Fitzpatrick and Kind 2017).…”

There are Gains, But can we Tell for Whom and Why? Predictors of Treatment Response Following Group Early Start Denver Model Intervention in Preschool - Aged Children with Autism Spectrum Disorder

“…A systematic review of controlled studies of EIBI showed that, while EIBI resulted in improved outcomes for children with ASD compared to comparison cohorts at a group level, there was marked variability in outcome at an individual level with around half the children making positive gains with the other half showing varying degrees of progress including little to no improvement. [18,19].…”

“…Such research requires an understanding of the pre-treatment characteristics associated with differential response to treatment, including child and family variables, and how specific intervention techniques address each of these characteristics [19]. Warren et al, suggested the need for further investigation into predictors of treatment response to early intervention in ASD based on a systematic review, but to date there has only been limited research on individual differences linked to treatment outcomes [20,21].…”

“…That analysis suggested that higher intellectual level and receptive language abilities were perhaps most strongly associated with degree of improvement, with this pattern found in four/five and four/seven studies, respectively. Stahmer et al, remind us that family and service-level factors are also important to consider in prediction of treatment outcomes [19].…”

How relevant is the framework being used with autism spectrum disorders today?

“…Attempts are being made to develop implementation models that will facilitate community service providers in utilizing evidence-based interventions (e.g., Drahota, Aarons, & Stahmer, 2012). Other researchers are examining ideal methods for studying predictors of intervention response (Yoder & Compton, 2004) and individual predictors of intervention response (see Stahmer, Schreibman, & Cunningham, 2011 for a review). For example, Paul , Campbell, Gilbert and Tsiouri (2013) compared discrete trial and naturalistic language interventions for children with severe autism and minimal speech.…”