Intensive Behavioral Treatment for Children with Autism: Four-Year Outcome and Predictors
Sallows, Glen O.; Graupner, Tamlynn D. (2005). American Journal on Mental Retardation, v110 n6 p417-438. Retrieved from: https://eric.ed.gov/?id=EJ743029
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examining23Students, gradePK
Lovaas Model of Applied Behavior Analysis Intervention Report - Early Childhood Education for Children with Disabilities
Review Details
Reviewed: August 2010
- Randomized Controlled Trial
- Meets WWC standards without reservations
This review may not reflect the full body of research evidence for this intervention.
Evidence Tier rating based solely on this study. This intervention may achieve a higher tier when combined with the full body of evidence.
Please see the WWC summary of evidence for Lovaas Model of Applied Behavior Analysis.
Findings
|
Outcome measure |
Comparison | Period | Sample |
Intervention mean |
Comparison mean |
Significant? |
Improvement index |
Evidence tier |
|---|---|---|---|---|---|---|---|---|
|
Vineland: Communication |
Lovaas Model of Applied Behavior Analysis vs. parent-directed EIBT intervention |
Posttest |
Full sample;
|
79.43 |
81.40 |
No |
-- | |
|
ADI-R: Communication |
Lovaas Model of Applied Behavior Analysis vs. parent-directed EIBT intervention |
Posttest |
Full sample;
|
8.13 |
8.80 |
No |
-- |
|
Outcome measure |
Comparison | Period | Sample |
Intervention mean |
Comparison mean |
Significant? |
Improvement index |
Evidence tier |
|---|---|---|---|---|---|---|---|---|
|
Vineland: Daily Living Skills |
Lovaas Model of Applied Behavior Analysis vs. parent-directed EIBT intervention |
Posttest |
Full sample;
|
66.51 |
64.20 |
No |
-- |
|
Outcome measure |
Comparison | Period | Sample |
Intervention mean |
Comparison mean |
Significant? |
Improvement index |
Evidence tier |
|---|---|---|---|---|---|---|---|---|
|
Vineland: Social Skills |
Lovaas Model of Applied Behavior Analysis vs. parent-directed EIBT intervention |
Posttest |
Full sample;
|
75.84 |
68.90 |
No |
-- | |
|
ADI-R: Ritual |
Lovaas Model of Applied Behavior Analysis vs. parent-directed EIBT intervention |
Posttest |
Full sample;
|
6.10 |
5.60 |
No |
-- | |
|
ADI-R: Social skills |
Lovaas Model of Applied Behavior Analysis vs. parent-directed EIBT intervention |
Posttest |
Full sample;
|
13.69 |
13.10 |
No |
-- |
Evidence Tier rating based solely on this study. This intervention may achieve a higher tier when combined with the full body of evidence.
Sample Characteristics
Characteristics of study sample as reported by study author.
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Female: 17%
Male: 83% -
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Wisconsin
Study Details
Setting
Madison, Wisconsin
Study sample
Children were recruited for the study through local birth to age 3 special education programs. Eligible children were (1) age 24 to 42 months at intake, (2) had a mental age divided by chronological age of the Mental Development Index equal to or greater than 35, (3) neurologically within “normal” limits, and (4) diagnosed with autism by an independent child psychiatrist. The parents of all eligible children agreed to participate. Thirteen children entered the study in 1996 and 11 in 1997. Twenty-four children were matched on pretest measures of IQ and randomly assigned to the treatment or comparison condition. One child dropped out of the study, resulting in an analytic sample of 23 children (13 in the treatment group and 10 in the comparison group).
Intervention Group
The program was based on the UCLA Lovaas Model, which initially focuses on one-on-one discrete trials and progresses from simpler to more complex skills. The therapist would engage the child in favorite activities, providing brief task instruction, such as “sit down” or making a request. Reinforcements, such as edibles or physical play, were given after each trial; in between, children were encouraged to generalize the lessons into more natural settings and develop social responsiveness. The program was intended to be 40 hours a week of direct treatment, although the averages for years 1 and 2 were 39 and 37 hours a week, respectively. The hours of treatment declined in subsequent years as the children began school. Children received 6 to 10 hours per week of in-home supervision from a senior therapist and weekly consultations with the senior author or clinic supervisor, during which the senior author/clinic supervisor observed the child and recommended appropriate changes to the program.
Comparison Group
Children in the comparison group received a parent-directed intervention consistent with the UCLA Lovaas Model. The parents in this group selected how many weekly treatment hours their children received from the therapist, averaging 32 hours in year 1 and 31 hours in year 2, with the exception of one family that chose to have 14 hours of treatment. The children received 6 hours per month of in-home supervision from a senior therapist and consultations every two months with the senior author or clinic supervisor, during which the senior author/clinic supervisor observed the child and recommended appropriate changes to the program.
Outcome descriptions
Communication/language competencies, social-emotional development and behavior, and functional abilities were assessed with the Vineland Adaptive Behavior Scales and the Autism Diagnostic Interview–Revised. Functional abilities also were assessed with the Vineland Adaptive Behavior Scales. For a more detailed description of these outcome measures, see Appendices A2.2–A2.4.
Support for implementation
Therapists had completed at least one year of college and attended 30 hours of training, at least 10 of which were one-on-one training and feedback while working with their assigned child. Therapists attended weekly or biweekly team meetings. Senior therapists had a minimum of a four-year degree, one year of experience as a therapist with two or more children, and a 16-week internship at the UCLA facility.
An indicator of the effect of the intervention, the improvement index can be interpreted as the expected change in percentile rank for an average comparison group student if that student had received the intervention.
For more, please see the WWC Glossary entry for improvement index.
An outcome is the knowledge, skills, and attitudes that are attained as a result of an activity. An outcome measures is an instrument, device, or method that provides data on the outcome.
A finding that is included in the effectiveness rating. Excluded findings may include subgroups and subscales.
The sample on which the analysis was conducted.
The group to which the intervention group is compared, which may include a different intervention, business as usual, or no services.
The timing of the post-intervention outcome measure.
The number of students included in the analysis.
The mean score of students in the intervention group.
The mean score of students in the comparison group.
The WWC considers a finding to be statistically significant if the likelihood that the finding is due to chance alone, rather than a real difference, is less than five percent.
The WWC reviews studies for WWC products, Department of Education grant competitions, and IES performance measures.
The name and version of the document used to guide the review of the study.
The version of the WWC design standards used to guide the review of the study.
The result of the WWC assessment of the study. The rating is based on the strength of evidence of the effectiveness of the intervention. Studies are given a rating of Meets WWC Design Standards without Reservations, Meets WWC Design Standards with Reservations, or >Does Not Meet WWC Design Standards.
A related publication that was reviewed alongside the main study of interest.
Study findings for this report.
Based on the direction, magnitude, and statistical significance of the findings within a domain, the WWC characterizes the findings from a study as one of the following: statistically significant positive effects, substantively important positive effects, indeterminate effects, substantively important negative effects, and statistically significant negative effects. For more, please see the WWC Handbook.
The WWC may review studies for multiple purposes, including different reports and re-reviews using updated standards. Each WWC review of this study is listed in the dropdown. Details on any review may be accessed by making a selection from the drop down list.
Tier 1 Strong indicates strong evidence of effectiveness,
Tier 2 Moderate indicates moderate evidence of effectiveness, and
Tier 3 Promising indicates promising evidence of effectiveness,
as defined in the
non-regulatory guidance for ESSA
and the regulations for ED discretionary grants (EDGAR Part 77).