Academic journal article Education & Treatment of Children

A Program Description of a Community-Based Intensive Behavioral Intervention Program for Individuals with Autism Spectrum Disorders

Academic journal article Education & Treatment of Children

A Program Description of a Community-Based Intensive Behavioral Intervention Program for Individuals with Autism Spectrum Disorders

Article excerpt

Abstract

Autism Spectrum Disorders (ASD) impact all areas of a person's life resulting in deficits in language, social behavior, and intellectual abilities as well as the development of repetitive behaviors that can greatly restrict access to the community and quality of life. Intensive behavioral intervention (IBI) has repeatedly been shown to be effective in improving functional skills and intellectual scores as well as minimizing problem behaviors in individuals diagnosed with ASD. In previous studies, some children who received intensive behavioral intervention became indistinguishable from their peers and were served in typical educational environments with no supplemental supports. However, the majority of the published studies on this intervention describe university-affiliated grant funded programs. This program description provides details about a private community-based agency that provides IBI for children and adolescents with ASD. Information about staff training, the therapies implemented, the population served, and instructional and programmatic content is offered and a preliminary analysis is provided of the outcomes achieved for a subsample of the clients served (i.e., 64 of 181). These findings suggest that increases in functional skills and intellectual scores were achieved for all clients and that many clients met criteria similar to those established in prior landmark studies.

Keywords: applied behavior analysis, autism, behavioral intervention, discrete trial teaching, outcome, program description

Autism spectrum disorder (ASD), the term which is increasingly used to refer to severe disturbances of childhood that come under the umbrella of Pervasive Developmental Disorder (American Psychiatric Association, 2000), is characterized by impaired language, play, cognitive, social and adaptive functioning. Although the diagnostic criteria have evolved over time and the terminology has varied (e.g. autistic disorder), the prognosis has consistently been one of children falling farther and farther behind their peers, ultimately having a severe impact on overall adjustment and quality of life as adults (Lockyer & Rutter, 1970; Ballaban-Gill, Rapin, Tuchman, & Shinnar, 1996; Howlin, Mawhood, & Rutter, 2000). Intensive Behavioral intervention (TBI), a treatment approach that is based on the principles of applied behavior analysis (ABA), has the strongest body of empirical support demonstrating efficacy for improving the functioning of children diagnosed with ASD (Leaf, McEachin, & Taubman 2008; New York State Department of Health, 1999; Simpson, 2005).

One of the first major reports detailing the outcomes of children diagnosed with autism who received IBI was the UCLA Young Autism Project (Lovaas, 1987). Lovaas (1987) compared 19 children diagnosed with autism who received IBI treatment to 19 children who received less intensive behavioral treatment combined with other treatment approaches. The 19 participants who were quasi-randomly assigned to the treatment group received an average of 40 hrs of IBI per week for two years or longer using exclusively IBI treatment. The treatment emphasized the use of positive reinforcement, but occasionally punishment procedures were also implemented. The 19 participants who were quasi-randomly assigned to the control condition received an average of 10 hrs of behavioral treatment per week. Those 10 hrs per week did not include the use of punishment procedures and various other non-behavioral therapies were also implemented (e.g., occupational therapy, speech therapy, traditional special education).

Lovaas (1987) categorized the resulting observed outcomes as either "best outcome", "fair outcome" or "poor outcome". In "best outcome" children ultimately scored within the normal range on standardized intelligence tests, were placed in general education classes without supports, and no longer exhibited symptoms of ASD. …

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