Therapies for Children With Autism Spectrum Disorders

social skills at outcome. Children with higher verbal comprehension scores who participated in
the Social Story intervention 145 made larger gains in the evaluated game play skills, while
children with extremely low verbal comprehension scores did not. Social Stories, an intervention
program that relies heavily on the child understanding information presented in a written format,
may not be as effective for children with low verbal comprehension abilities. In another study 139
pre-treatment communication skills, as measured by VABS Communication domain and Verbal
IQ, were associated with social skills at outcome (VABS Socialization) in both a Lego treatment
group and the treatment as usual control group (but more so in the Lego group).
Autism symptom severity. Some evidence indicates that specific constellations of symptoms
related to ASDs may be important in understanding response to treatment. Social responsiveness
and imitation skills have been suggested as skills that may predict improved treatment response
in UCLA/Lovaas-based approaches, 287 whereas “aloof” subtypes of ASDs have been suggested
to be associated with less robust changes in IQ, 107 and lower baseline symptom tallies have also
been demonstrated to be related to specific gains. 104 Other studies have seen specific
improvement with UCLA/Lovaas-based intervention for children with PDD-NOS vs. Autistic
Disorder diagnoses, 114 which may be indicative of baseline symptom differences. However,
many other studies have failed to find a relationship between autism symptoms and treatment
response.
Two social skills studies 139,148 looked at the diagnosis of participants (PDD-NOS vs. high
functioning autism vs. Asperger syndrome for one study, autistic disorder vs. Asperger/PDD-
NOS for the other) as a potential modifier of treatment effects and failed to find any significant
direct effects. However in the study evaluating the social adjustment enhancement curriculum, 139
the results on a measure of theory of mind were no longer significant when the one participant
with PDD-NOS was excluded.
Age at identification/initiation of treatment. Some evidence suggests that children initiating
treatment at earlier ages may benefit more from UCLA/Lovaas-based intervention; 115,129
however, other explicit comparisons have not found this same relationship for UCLA/Lovaasbased
approaches 121 and age at initiation of treatment may in fact be confounded by type of
treatment initiated. 129
Neurobiological and genetic variation. Only one of the included and reviewed studies examined
the relations between potential underlying neurobiological markers/variation and this study
simply indexed head circumference as a measurement within design 102 and this did not appear to
be related to outcome.
Family characteristics. Although family characteristics were rarely reported in the behavioral
literature, in one study of a parent-directed play interaction, change in child behavior was not
significantly predicted by whether parents perceived their child having a causal role in their own
behavior or the parent having a causal role in their child’s behavior, 154,161 but parent positive
affect, measured through behavioral coding was positively related to parental reports of child
adaptive behavior and negatively related to parental reports of child challenging behaviors.
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