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| Int'l Paper Session - Defining and Measuring Behavioral Treatment Intensity in Autism |
| Saturday, May 28, 2005 |
| 2:30 PM–3:50 PM |
| Continental C (1st floor) |
| Area: AUT |
| Chair: Erik Jahr (Akershus University Hospital, Norway) |
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| Early Detection of Differential Responsiveness to Intensive and Long-Term Behavior Treatment in Children with Autism |
| Domain: Applied Research |
| ERIK JAHR (Akershus University Hospital, Norway), Francesca Degli Espinosa (University of Southampton, UK), Hanna Kovshoff (University of Southampton, UK), Bob Remington (University of Southampton, UK), Richard P. Hastings (University of Southampton, UK) |
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| Abstract: Children with autism do not constitute a uniform group in terms of responsiveness and long term benefit following intensive behavioural treatment. Earlier studies and reviews suggests that after long term treatment, children may divide into tree groups in terms of outcome, with one group showing exceptional improvements into normal functioning, one group with intermediate improvements and a remaining group showing few or no improvements despite intensive efforts. Early identification of these groups may be immensely important in order to improve programming and thereby increase the effectiveness of the intervention but also to be able to offer alternative approaches at an early stage for children with minimal progression. In a recent project (Southampton Childhood Autism Programme; SCAmP) a uniform assessment of skills (ASK) covering basic, intermediate and advanced areas was conducted with the participating children at intake and after 6, 12, 18 and 24 months of intensive treatment. Results show a clear division into tree groups in terms of progression on the assessment after 6 months and the groups remained divided on all subsequent tests. Furthermore a strong significant relationship between change on the skill assessment after 6 months and changes in IQ and adaptive (Vineland) skills after 12 and 24 months were identified. Furthermore, improvement on curtain sub skill areas on the assessment tended to be significantly related to later improvement on both the assessment and the standardized assessments. |
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| Operationally Defining "Intensity" of Services for Children with Autism |
| Domain: Applied Research |
| DANIEL COHEN-ALMEIDA (Melmark New England), Katherine A. Johnson (Advances, Inc.), Brian C. Liu-Constant (Melmark New England) |
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| Abstract: Behavioral Intervention for children with autism is typically referred to as "intensive" services. However, "intensity" does not have universal interpretation. Individualized Educational Plans typically define intensity in structural terms: number of hours of instruction, staffing ratios, and teaching environments. However, these definitions do not adequately capture the meaningfulness of the services for the individual receiving the services. In this paper, we will review, from several sources, the established definitions of intensity as they relate to the special education field, and propose several other indices of intensity that are based upon the direct observation of student performance and teacher behavior. It will be argued that these direct measures are a more valid indicator of intensity of educational programs. |
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| Start Out Strong: Early Treatment Intensity Predicts Outcome |
| Domain: Applied Research |
| JENNIFER HARRIS (FirstSteps for Kids, Inc.) |
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| Abstract: Behavioral intervention has proven to be a powerful tool in the treatment of autism. Although the approach is generally recommended, the intensity with which it is applied remains controversial. The present study investigated the specific impact of first year treatment intensity on improvement and outcome hypothesizing that the initial treatment period may be of particular significance. Archival data were analyzed for 79 participants diagnosed with autism, under 49 months of age at intake, who received three years of ABA intervention. Participants were divided into high (>25) and low (=25) first year intensity groups. Consistent with current behavioral research, participants demonstrated statistically significant improvements in language, cognitive ability, adaptive behavior, and overall pathology following three years of treatment. Further, first year treatment intensity was highly predictive of outcome, with 60% of HighY1 children achieving normal cognitive, behavioral and educational functioning following three years of treatment compared to 20% for LowY1 children. Importantly, aggregate (3 year) intensity was not significantly correlated with improvement or outcome, further supporting the crucial role of first year intensity. Results suggest that high intensity in the first year may result in faster and more successful mainstreaming and reductions in overall treatment costs. |
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