Therapies for Children With Autism Spectrum Disorders

on the Ankara Developmental Screening Inventory in total development score, languagecognitive
subscale, social and self-care subscale, fine motor subscale, and gross motor subscale.
The teacher training program was targeted to slightly older children (mean age 10 years), and
evaluated effectiveness with a study-designed tool (the Classroom Child Behavioral Symptoms
questionnaire), which was completed by their teachers at baseline and post-treatment (nine
months later). Scores decreased from a mean pretest score of 106.4 to a post-test score of 100.8,
representing a medium range effect size (d = 0.66).
Broad-Based Educational Approaches
Classroom and center-based approaches include a blend of teaching strategies that rely on
ABA principles and techniques including reinforcement-based procedures such as incidental
teaching, discrete trial training, and pivotal response training. Other interventions, such as
TEACCH and language development interventions may also be incorporated in center-based
treatment.
Content of the literature. Eight papers evaluated a variety of broad-based educational
strategies. 191-199 One study in this category was good, four were fair quality, and three were poor.
Summary of the literature. Several studies have investigated outcomes of children receiving
specific or general instruction within early intervention centers or other classroom environment
either within a specific curriculum or across multiple types of interventions (e.g., speech therapy,
parent education, ABA instruction) (Table 15). A nonrandomized controlled trial 197 compared a
developmentally based early intervention (N=12, mean age = 42.6 months) to no treatment (N=5,
mean age = 37.7 months). The Scottish Centre for Autism developed an individualized treatment
program for preschool aged children with ASDs focusing on social, communicative, play, and
adaptive behaviors and included a parent training component focusing on behavior management
and teaching new skills. After approximately 11 months of treatment, adaptive behavior scores
(VABS for socialization, daily living skills, motor, and composite) improved significantly for the
intervention group compared with controls. The intervention group also showed a statistically
significant improvement in imitation scores on the Pre-Verbal Communication Schedule, as well
as joint attention scores, and social interaction skills measured on the Early Social
Communication Scales.
One prospective cohort study compared an early intensive, home-based intervention using
discrete trial techniques (and Verbal Behavior) (N=28) to a nursery school-based eclectic
intervention (based in autism-specific classrooms) (N=16), which included components of
TEACCH, the Picture Exchange Communication System (PECS), and other developmental and
behavioral teaching strategies. 195 The early intensive home-based intervention group and the
nursery school-based intervention group had a mean age of 38 and 42.5 months, respectively.
Nonverbal intelligence, cognitive ability, language skills, academic achievement/aptitude, and
adaptive behavior were evaluated twice, with a 23-27 month interval between assessments.
No statistically significant differences were identified between the groups post-intervention
on any of the measures, although both groups demonstrated improvement across measurements
on average. A majority of the children demonstrating improvement had initial IQs above 70 and
all but one were verbal at pre-treatment. Initial IQ and receptive language scores were correlated
with progress over time.
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