Therapies for Children With Autism Spectrum Disorders

gains. 104 Other studies have seen specific improvement in early intensive 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.
In the medical literature, some characteristics of the family and child were found to be
associated with treatment success, including a history of psychiatric diagnoses in the family and
early verbal skills in the child correlating with treatment response to fluoxetine in a case
series. 224 One pharmacogenetic study assessed variation in the serotonin transporter gene for
predicting lack of treatment response to escitalopram; although replication will be required to
confirm the initial findings. 223 Several studies of stimulant use highlighted differences in
effectiveness by diagnosis type 228-230,232,233 finding that children with Asperger syndrome were
typically more responsive to psychostimulant treatment than those with autistic disorder. The
presence of co-morbid intellectual disability was associated with lower response to
psychostimulant treatment in one study. 232
KQ3. Early Results in the Treatment Phase That Predict Outcomes
Information about early response to treatment, or lack thereof, could guide treatment
selection, implementation, and modification. The reviewed literature offers almost no
information about what specific observations of children might be made early in treatment to
predict long-term outcome and response. Some evidence suggests that changes in IQ over the
first year of treatment with UCLA/Lovaas-based approaches and ESDM predicts, or accounts
for, longer-term change in IQ. 287,290 However, findings also suggest that while gains in the
cognitive domain might be accounted for primarily within the first year of treatment, changes in
adaptive behavior in response to these same interventions may occur over a longer time
frame 110,133,287,290 if they occur at all. 105
KQ4. End of Treatment Effects That Predict Outcomes
Few studies assess end of treatment effects that may predict outcomes; however, this type of
research is feasible as exemplified in one study which assessed language development and joint
attention and play skills in 3 to 4 year old children with ASDs. 155,156 Children in the symbolic
play and joint attention intervention groups showed significantly greater growth in expressive
language, initiation of joint attention, and duration of child-initiated joint attention over time than
did participants in the control group (p