Prediction of Treatment Outcomes and Longitudinal Analysis in Children with Autism Undergoing Intensive Behavioral Intervention

Article excerpt

KEYWORDS

Autism;

Predictors;

Applied behavior analysis;

Quasi-experiment (interrupted time-series with one group)

Abstract Outcome prediction is an important component of treatment planning and prognosis. However, reliable predictors of intensive behavioral intervention (IBI) have not been clearly established. IBI is an evidence-based approach to the systematic teaching of academic, social, verbal, and daily living skills to individuals with autism spectrum disorder. Incorporating longitudinal analysis to IBI outcome studies may help to identify outcome predictors of clinical value. Twenty-four children with autism underwent on average two years of IBI and completed language, daily living skills, cognitive, and motor assessments (Early Learning Accomplishment Profile and the Learning Accomplishment Profile-Diagnostic, 3rd edition) every six months. We used multilevel analysis to identify potential longitudinal predictors including gender, age, intervention intensity, intervention duration, total intervention time, and pre-intervention functioning. Results indicated that total intervention time, pre-intervention functioning, and age caused the greatest increase in goodness-of-fit of the longitudinal multilevel models. Longitudinal analysis is a promising analytical strategy to identify reliable predictors of the clinical outcome of IBI.

© 2012 Asociación Española de Psicología Conductual. Published by Elsevier España, S.L.

All rights reserved.

PALABRAS CLAVE

Autismo;

predictor

Análisis aplicado de la conducta;

Cuasi-experimento (serie temporal interrumpida con un grupo)

Resumen La predicción de resultados de tratamiento es un componente importante de la planificación clínica. No obstante, no se han hallado predictores fiables de los efectos de la in- tervención conductual intensiva en personas con trastorno del espectro autista. La incorpora- ción de análisis longitudinales a la investigación sobre resultados de tratamiento en este área puede contribuir a la identificación de predictores con valor clínico. En el presente estudio se evaluaron las habilidades verbales, cognitivas y de la vida diaria (Early Learning Accomplish- ment Profile y Learning Accomplishment Profile-Diagnostic, 3a ed.) de 24 niños con trastorno del espectro autista en un programa de intervención conductual intensiva. Las evaluaciones se rea- lizaron cada seis meses y durante un periodo medio de intervención de dos años. Mediante análisis multinivel se examinaron posibles predictores longitudinales incluyendo sexo, edad, intensidad y duración de la intervención, tiempo total de intervención y nivel de funcionamien- to previo a la intervención. Los resultados indicaron que el tiempo total de intervención, el funcionamiento previo y la edad causaban los mayores incrementos en bondad de ajuste de los modelos longitudinales. El análisis longitudinal es una estrategia analítica prometedora en la identificación de predictores fiables de la efectividad de la intervención conductual intensiva.

© 2012 Asociación Española de Psicología Conductual. Publicado por Elsevier España, S.L.

Todos los derechos reservados.

(ProQuest: ... denotes formulae omitted.)

Autism spectrum disorder (ASD) is a pervasive developmental disorder that affects 1 to 2.5% of children (Baio, 2012). A number of comprehensive psychosocial interventions for people with ASD have been developed for which preliminary evidence exists. These include the Early Start Denver model (ESDM, Dawson et al., 2010), the Treatment and Education of Autistic and Related Communication Handicapped Children (TEACCH, Welterlin, Turner-Brown, Harris, Mesibov, & Delmolino, 2012), and intensive behavioral intervention based on the UCLA Young Autism Project model and applied behavior analysis (IBI, Lovaas, 1987). Although there is no single approach to treatment for all individuals with ASD, IBI based on applied behavior analysis is among the few approaches to treatment that have been tested extensively using clinical trial methodology (Rogers & Vismara, 2008; Virués-Ortega, 2010; Wetherby & Woods, 2006). …