Evidence-Based Comprehensive Treatments for Early Autism
Rogers, S.J., ∓ Vismara, L.A. (2008). Evidence-based comprehensive treatments for early autism. Journal of Clinical Child and Adolescent Psychology, 37, 8-38.
Reviewed by Kathleen Moran, MA
Why study this topic?Studies show that early intervention programs improve developmental functioning and decrease maladaptive behavior and autism symptom severity. However, systematic reviews are needed to determine whether these studies provide enough reliable information to classify programs as evidence-based.
What did the researchers do?
The authors looked at the evidence supporting the effectiveness of different models of early intervention for young children with autism and characteristics that appear to influence the child's response to treatment. Twenty-two studies were analyzed and separated by quality into different classes or "types" using criteria established by Nathan and Gorman (2002). Type 1 (4 studies) studies had strong scientific designs such as random assignment of children into either an intervention group or a control group that did not receive the intervention. Type 2 studies (6 studies) had few significant flaws, but nonetheless yielded interpretable findings about outcomes. Type 3 studies (11 studies) had significant flaws such as the absence of a control group.
What did the researchers find?
The authors categorized most studies on early intervention programs as Type 2 or 3. However, the Lovaas model of Early Intervention was considered "well-established," supported by Type 1 studies. Increases were seen in a variety of areas, including language, communication, and IQ. In addition, the authors found many Type 2 studies on Pivotal Response Training (PRT), indicating that the intervention is "possibly effective". However, they concluded that no other comprehensive early intervention program for children with autism could be classified as evidence-based. Characteristics that influence response to treatment are currently unclear but may include, age, IQ before treatment, amount of treatment, family influence, and biological variables. Limitations of studies on early intervention programs include small numbers of participants, lack of comparisons between different treatments, wide variations across studies in the amount of treatment that children received, and use of different measures of outcomes in different studies.
What were the strengths and limitations of the study? What do the results mean?
Overall, the authors concluded that benefits of early intervention programs had been reported in both short-term and long-term studies but that only the Lovaas model had been established as effective, with PRT also having preliminary support. The review highlighted a need for more studies with strong research designs to evaluate early intervention programs for children with autism.