Outcome of Comprehensive Psycho-educational Interventions for Young Children with Autism
Eikeseth, S. (2009). Outcome of comprehensive psycho-educational interventions for young children with autism. Research in Developmental Disabilities, 30 (1), 158-178.
Reviewed by Kathleen Moran, MA,
Why study this topic?
With the causes of autism currently unknown, psycho-educational treatments are the primary interventions for individuals with autism. However, while many psycho-educational interventions have become popular, systematic evaluations are needed to determine the extent to which they have scientific support.
What did the researchers do?
The researchers in this study conducted a search of the scientific literature to find articles evaluating comprehensive psycho-educational interventions in children under the age of six. Twenty-six studies were reviewed and rated according to their scientific strength as well as the significance of the results that were seen in the individual studies. Twenty-one of the studies evaluated applied behavior analytic (ABA) treatment; 3 studies evaluated TEACCH and 2 studies evaluated the Denver Model developed at the Colorado Health Sciences Project. ABA treatments aim to improve socially important behavior by using interventions that are based upon principles of learning theory and that have been evaluated in experiments. TEACCH ((Treatment and Education of Autistic and related Communication handicapped Children) is designed to accommodate the learning styles characteristic of children with autism through strategies such as presenting visual cues and setting up distraction-free work stations. The Denver Model is a developmental therapy that emphasizes promoting social communication during ongoing playful interactions between a therapist or parent and a child with autism. The quality of the science was broken down into 4 levels based on scientific rigor, from Level 1 (strong research design with random assignment of participants to a treatment group and a control group, monitoring of the quality of treatment, and comprehensive outcome assessments) to Insufficient Scientific Value (studies with significant scientific flaws, such as not using a comparison or control group). The magnitude of improvements was also broken down into 4 levels, with Level 1 referring to studies that showed significant differences between the treatment group and control group in both IQ and adaptive functioning, and Level 4 studies observing improvements only between pre and post intervention.
What did the researchers find?
While only 1 of the twenty-six studies achieved a scientific quality score of 1, and only 4 others achieved a rating of 2, all 5 of these studies were on ABA interventions. Additionally, ABA studies received all four Level 1 scores for the significance of results, as well as three of the studies receiving Level 2 ratings. This indicates that children receiving ABA improved significantly in IQ, adaptive functioning, and language skills, as compared to the control groups in their respective studies. It can also be noted that studies on TEACCH and the Denver model only achieved Levels 3 or ISV in this review with regard to scientific quality. Based on these results, the author classified ABA as a "well established" intervention, according to guidelines set forth by Chambliss and colleagues. The TEACCH approach and the Colorado Health Science model did not meet criteria as "well established" or "probably efficacious" by these same standards.
What were the strengths and limitations of the study? What do the results mean?
The author concluded that ABA can be considered an effective psycho-educational intervention for children with autism spectrum disorders. He highlighted a need for additional high quality empirical research on other treatments and outcomes.