Eldevik, S., Hastings, R. P., Jahr, E., & Hughes, C. J. (2012). Outcomes of behavioral intervention for children with autism in mainstream pre-school settings. Journal of Autism and Developmental Disorders, 42(2), 210-220.
Reviewed by Kathleen Moran, MA,
Caldwell University
Why research this topic?
An intervention for young children with autism that has been identified as “well established” is Early Intensive Behavioral Intervention (EIBI). EIBI is based on the principles of applied behavior analysis and is implemented by trained specialists in a one to one format. This intervention has been shown to increase cognitive and adaptive functioning and possibly reduce autism severity. Although many behavior analysts recommend conducting EIBI programs in the child’s home, research shows the intervention can be effective in a variety of settings. However, there is still a need to determine if EIBI is effective within a more typical setting on a larger scale, such as a mainstream preschool.
What did the researchers do?
The researchers compared outcomes on measures of intellectual functioning and adaptive functioning in children who received two years of EIBI within a mainstream preschool program or treatment as usual (TAU). The EIBI group included 31 children with autism. EIBI staff were supervised and trained by a Board Certified Behavior Analyst (BCBA). Training included workshops, weekly consultations and team meetings to review individual programs, explanation and modeling of all programs, and training sessions with feedback. Teaching procedures were based on the principles of applied behavior analysis and implemented by trained staff in a one to one format, with the goal of moving to a group setting with peers of typical development.
In the TAU group, 12 children received an eclectic intervention that included elements from a variety of interventions such as: alternative and augmentative communication, applied behavior analysis, total communication, sensory motor therapies, TEACCH, and personal experience. A special education teacher provided supervision and consultation one to two times a week. Each child had a different agency responsible for the supervision and training.
What did the research find?
The researchers found that the 31 children in the EIBI group made significantly larger gains in intelligence functioning and adaptive behavior than the 12 children in TAU. Changes in adaptive behavior occurred primarily in the communication and socialization domains. Individual scores were assessed for statistically reliable change. Only children in the EIBI showed a reliable change, with 19.4% of children (6) making reliable gains in IQ and 6.5% (2) in adaptive behavior.
What are the strengths and limitations of the study? What do the results mean?
Overall the study showed that EIBI within a mainstream preschool leads to a positive change in intellectual functioning and adaptive behavior in children with autism. Compared to TAU, EIBI can be effective in a typical community setting. There are, however, some limitations, notably a small number of outcome measures, no data on the number of TAU intervention hours or the specific time spent on each intervention type, and lack of data on generalization and maintenance. Results of this study show that EIBI can be effective when delivered in a community setting; however, research should assess the feasibility of implementing EIBI effectively in multiple community settings simultaneously. Potential barriers include the difficulty of fulfilling the recommended hours, competing demands on staff and the requirement for extensive, ongoing supervision of staff, child progress, quality of intervention, and program structure. Future studies should also include additional outcome measures to assess changes in language or features of autism, and to evaluate the generalization and maintenance of skills. In addition, program variations such as level of parent involvement and amount of intervention are important to investigate.
Citation for this article:
Moran, K. (2015). Review of Outcomes of behavioral intervention for children with autism in mainstream pre-school settings. Science in Autism Treatment, 12(4), 41-42.
