Long-Term Outcomes of Early Intervention in 6-Year-Old Children With Autism Spectrum Disorder - 16/06/15
, Jeffrey Munson, PhD a, Sally J. Rogers, PhD b, Jessica Greenson, PhD a, Jamie Winter, PhD c, Geraldine Dawson, PhD dAbstract |
Objective |
We prospectively examined evidence for the sustained effects of early intervention based on a follow-up study of 39 children with ASD who began participation in a randomized clinical trial testing the effectiveness of the Early Start Denver Model (ESDM) at age 18 to 30 months. The intervention, conducted at a high level of intensity in-home for 2 years, showed evidence of efficacy immediately posttreatment.
Method |
This group of children was assessed at age 6 years, 2 years after the intervention ended, across multiple domains of functioning by clinicians naive to previous intervention group status.
Results |
The ESDM group, on average, maintained gains made in early intervention during the 2-year follow-up period in overall intellectual ability, adaptive behavior, symptom severity, and challenging behavior. No group differences in core autism symptoms were found immediately posttreatment; however, 2 years later, the ESDM group demonstrated improved core autism symptoms and adaptive behavior as compared with the community-intervention-as-usual (COM) group. The 2 groups were not significantly different in terms of intellectual functioning at age 6 years. Both groups received equivalent intervention hours during the original study, but the ESDM group received fewer hours during the follow-up period.
Conclusion |
These results provide evidence that gains from early intensive intervention are maintained 2 years later. Notably, core autism symptoms improved in the ESDM group over the follow-up period relative to the COM group. This improvement occurred at the same time that the ESDM group received significantly fewer services. This is the first study to examine the role of early ESDM behavioral intervention initiated at less than 30 months of age in altering the longer-term developmental course of autism.
Le texte complet de cet article est disponible en PDF.Key Words : early, intervention, autism, long-term, outcomes
Plan
| Clinical guidance is available at the end of this article. |
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| This research was supported by grants from the National Institute of Mental Health, the National Institute of Child Health and Human Development (U19HD34565, P50HD066782, R01HD-55741), and the National Institute of Mental Health (U54MH066399). |
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| Dr. Munson served as the statistical expert for this research. |
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| The authors thank the children and parents who participated in this study and Lena Tsui, MS, of the University of Washington Autism Center, for her devotion to keeping in touch with these children and parents. |
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| Disclosure: Dr. Estes has received grant or research funding from the Simons Foundation, the National Institutes of Health, the National Institute of Mental Health, and the Autism Speaks Foundation. Dr. Rogers has received royalty payments and material fees related to the Early Start Denver Model (ESDM). She has also received occasional honoraria from Guilford Press for ESDM materials. She is a co-author of two books on early intervention: The Early Start Denver Model for Young Children With Autism: Promoting Language, Learning, and Engagement and An Early Start for Your Child With Autism, from which she has received royalties (Guilford Press). Dr. Dawson is a co-author of two books on early intervention: The Early Start Denver Model for Young Children With Autism: Promoting Language, Learning, and Engagement and An Early Start for Your Child With Autism, from which she has received royalties (Guilford Press). Drs. Munson, Greenson, and Winter report no biomedical financial interests or potential conflicts of interest. |
Vol 54 - N° 7
P. 580-587 - juillet 2015 Retour au numéro
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