WWC review of this study

Intensive behavioral treatment for children with autism: Four-year outcome and predictors.

Sallows, G. O., & Graupner, T. D. (2005).  American Journal on Mental Retardation, 110(6), 417–438. Retrieved from: https://eric.ed.gov/?id=EJ743029

  • Randomized Controlled Trial
     examining 
    23
     Students
    , grade
    PK
No statistically significant positive
findings
Meets WWC standards without reservations
Communication/ Language outcomes—Indeterminate effects found
Outcome
measure
Comparison Period Sample Intervention
mean
Comparison
mean
Significant? Improvement
index

Vineland: Communication

Lovaas Model of Applied Behavior Analysis vs. parent-directed EIBT intervention

Posttest

Full sample;
23 students

79.43

81.4

No

--
More Outcomes

ADI-R: Communication

Lovaas Model of Applied Behavior Analysis vs. parent-directed EIBT intervention

Posttest

Full sample;
23 students

8.13

8.8

No

--
Functional abilities outcomes—Indeterminate effects found
Outcome
measure
Comparison Period Sample Intervention
mean
Comparison
mean
Significant? Improvement
index

Vineland: Daily Living Skills

Lovaas Model of Applied Behavior Analysis vs. parent-directed EIBT intervention

Posttest

Full sample;
23 students

66.51

64.2

No

--
Social-emotional development outcomes—Indeterminate effects found
Outcome
measure
Comparison Period Sample Intervention
mean
Comparison
mean
Significant? Improvement
index

Vineland: Social Skills

Lovaas Model of Applied Behavior Analysis vs. parent-directed EIBT intervention

Posttest

Full sample;
23 students

75.84

68.9

No

 
 
14
More Outcomes

ADI-R: Ritual

Lovaas Model of Applied Behavior Analysis vs. parent-directed EIBT intervention

Posttest

Full sample;
23 students

6.1

5.6

No

--

ADI-R: Social skills

Lovaas Model of Applied Behavior Analysis vs. parent-directed EIBT intervention

Posttest

Full sample;
23 students

13.69

13.1

No

--

Characteristics of study sample as reported by study author.


  • Female: 17%
    Male: 83%

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    Wisconsin

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.

 

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