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| Treatment Outcome for Children with Autism: Longitudinal Treatment Comparisons, Cost-Benefit Analyses, and Measurement Issues |
| Saturday, May 28, 2005 |
| 1:00 PM–2:20 PM |
| Continental B (1st floor) |
| Area: AUT; Domain: Applied Research |
| Chair: Gerald E. Harris (University of Houston, Texas Young Autism Project) |
| Discussant: Gerald E. Harris (University of Houston, Texas Young Autism Project) |
| CE Instructor: Gerald E. Harris, Ph.D. |
| Abstract: There is a lack of research that addresses treatment outcome for children with autism, especially with regards to treatment comparison studies, cost analyses, and measurement issues. The symposium is comprised of presentations that discuss three data-based investigations. The first presentation discusses longitudinal data of an ongoing investigation that compares several different autism treatments in several different skill domains with a large sample size. Within the context of treatment effectiveness, the second presentation delves into the costs and benefits of utilizing behavioral intervention for children with autism relative to Special Education. The presentation not only includes a breakdown of budgeted and actual costs incurred to the State of Texas with Special Education versus behavioral intervention, it also includes specific strategies for approaching policy-makers and financial officers. The final presentation concerns the use of assessments when evaluating treatment outcome in children with autism. The characteristics of individuals with autism result in unique obstacles for using standardized tests. The implications of these obstacles are discussed within the context of reliability, validity, and interpretation. |
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| A Comparative Longitudinal Study of Treatments in Relation to Specific Outcomes for Children with Autism |
| GERALD E. HARRIS (University of Houston, Texas Young Autism Project), Wendy J. Neely (University of Houston, Texas Young Autism Project), Gregory Chasson (University of Houston, Texas Young Autism Project) |
| Abstract: There is a relative paucity of outcome research on autism treatments. Most studies primarily focus on one treatment type, typically with a narrow range of measures and a small sample size. In the illustrative study, over 100 young children with autism were recruited from three different treatment settings, including an intensive, in-home, discrete trial ABA program, an “eclectic” private school, and an ABA-oriented center-based program. Each child received an initial assessment of cognitive and motor abilities, language skills, adaptive behavior functioning, and autism symptomatology. This comprehensive assessment is readministered at 6 months, then yearly thereafter. Children in the in-home discrete trial condition have now provided data for over two years of treatment. Children in the other two conditions have been assessed through one year. A repeated measures analysis of the data shows differential benefits across treatments. The presentation discusses the implications of these results, as well as includes a review of the historical and present state of treatment outcome research on children with autism. In addition, the methodological and practical issues involved in conducting large-scale longitudinal research on this population, including issues involved in the early stages of such a study, are discussed. |
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| Costs and Benefits of ABA Intervention for Children with Autism in Texas |
| GREGORY CHASSON (University of Houston, Texas Young Autism Project), Gerald E. Harris (University of Houston, Texas Young Autism Project), Wendy J. Neely (University of Houston, Texas Young Autism Project) |
| Abstract: Lost in most discussions of intervention outcomes for children with autism is the cost associated with treatment. Additionally, recent epidemiological data reflects an explosion in the rates of autism diagnoses worldwide, with some regions of the United States experiencing an increase by as much as 634%. With this exponential rise of autism in mind, the current study consisted of a cost and benefit analysis of treatment expenses for children with autism in the state of Texas. The analysis compared the costs associated with providing Early Intensive Behavioral Intervention (EIBI) and the expenses associated with Special Education. Among other staggering estimates, using a specific formula with a conservative estimate of 10,000 children with autism in the state of Texas, approximately $2,175,000,000 could be saved over an 18-year span of education with the implementation of behavior intervention instead of Special Education. In addition to explicating the specific formula used to conduct the costs and benefits analysis, incorporating these findings into a proposed demonstration project are also discussed, including specific strategies for approaching state policy-makers and financial officers. Furthermore, implications for taxpayers and parents are discussed. |
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| The Measurement of Intelligence of Children with Autism: Issues Related to Instrumentation and Normative Samples |
| WENDY J. NEELY (University of Houston, Texas Young Autism Project), Gregory Chasson (University of Houston, Texas Young Autism Project), Gerald E. Harris (University of Houston, Texas Young Autism Project) |
| Abstract: Researchers and clinicians have long struggled with issues related to measuring the intelligence of individuals with autism. While Wechsler intelligence tests remain the most widely researched instruments of intelligence, there has been a great deal of controversy surrounding the validity of these measures when testing the autism population. Some research indicates there is a particular pattern of scores on the indices of the Wechsler tests that suggest an autism profile; however, the validity of interpreting specific strengths and weaknesses has been heavily challenged. In this study, a comprehensive literature review of the autism outcome literature was conducted to consolidate information on the most widely utilized measures of intelligence, the mean intelligence scores of the respective tests, the indices of variability, and the details of administration. The information obtained from the literature review was compared to available norming data and standardization information. Additionally, the results were compared to the data obtained from the Texas Young Autism Project’s longitudinal treatment outcome study. Evidence indicates there are common problems in the interpretation of these tests, such as discounting floor effects and disregarding |
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