Therapies for Children With Autism Spectrum Disorders

Evidence Table. Therapies for children with ASD
Study
Description Intervention
Author:
Howard et al.,
2005
Country:
US
Practice
setting:
Academic
Intervention
setting:
G1: Home,
School, and
Community
G2: School
G3: School
Enrollment
period:
1996-2003
Funding:
Valley Mountain
Regional Center
Region 6 Autism
Connection and
California State
University,
Stanislaus
Author industry
relationship
disclosures:
NR
Design:
Prospective cohort
Intervention:
Intensive behavior
analytic treatment with
individualized goals and
objectives
25-30 hours/week 1:1
intervention for children
3 years of age
50-100 learning
opportunities/hour via
discrete trial, incidental
teaching, and other
behavior analytic
procedures
Parents received training
in basic behavior analytic
strategies and
implemented programs
with children outside
regular intervention hours,
with agency staff meeting
1-2 times/month.
Assessments
Conducted by
experienced
psychologists and speech
and language
pathologists who were
independent contractors
Inclusion/Exclusion
Criteria/Population
Inclusion criteria:
• Diagnosed with autistic
disorder or PDD-NOS
according to DSM-IV
criteria by qualified
independent examiner
prior to 48 months of age
• Entry in an intervention
program prior to 48
months of age
• English as primary
spoken language in
child’s home
• No significant medical
condition other than
autistic disorder or PDD-
NOS
• No prior treatment >100
hours.
• Referred from non-profit
agencies (“regional
centers’) under contract
with CA dept of
Developmental services
for developmental
disability case
management
Exclusion criteria:
See inclusion criteria
Age, mean/months ± SD:
At diagnosis:
G1: 30.48 ± 5.96
G2: 39.31 ± 5.52
G3: 34.94 ± 5.18
At intake:
C-306
Baseline
Measures Outcomes
Intake conducted
within 2 months of
treatment entry
Overall ratings:
Composite Standard
Scores, mean ± SD:
G1: 70.46 ± 11.85
G2: 69.81 ± 10.48
G3: 71.62 ± 10.47
Social skills:
Standard Scores,
mean ± SD:
G1: 72.79 ± 11.26
G2: 75.50 ± 14.25
G3: 75.07 ± 12.09
Age equivalents
(months), mean ±
SD:
G1: 16.39 ± 4.89
G2: 22.06 ± 10.62
G3: 19.60 ± 5.68
Learning rates prior
to intake, mean age
equivalents per year
± SD:
G1: 0.54 ± 0.18
G2: 0.58 ± 0.23
G3: 0.58 ± 0.19
Communication/
language:
Standard Scores,
mean ± SD:
G1: 66.18 ±10.02
Weight gain:
Fluoxetine: 0/39 (0)
Placebo: 1/36 (2.8)
Anorexia:
Fluoxetine: 6/39
(15.4)
Placebo: 4/36 (11.1)
Proportion of
subjects having
dosage reduction
on the two treatment
due to AEs was not
statistically
significant (P =
0.289)
Modifiers:
NR
Follow-up testing
conducted at an
average 14
months after
treatment entry
Overall ratings:
Composite
Standard Scores,
mean ± SD:
G1: 81.32 ± 11.14
(P < 0.01
compared to
G2/G3 mean)
G2: 69.25 ± 12.91
G3: 68.25 ± 9.86
Social skills:
Standard Scores,
mean ± SD:
G1: 82.08 ± 11.73
(P < 0.01
compared to
G2/G3 mean)
G2: 75.00 ± 18.01
G3: 70.56 ± 11.77
Age equivalents
(months), mean ±
SD:
G1: 32.04 ± 10.23
(P < 0.05
compared to
G2/G3 mean)
G2: 30.06 ± 16.10
G3: 24.81 ± 7.23
Learning rates