Home-Based Skills Therapy for Autism Better Than Preschool


MONTREAL — Home-based intensive skills therapy for autism appears to be a more effective early intervention than integration into mainstream preschool classrooms, according to preliminary findings of a small pilot study reported at the 5th International Meeting for Autism Research.

In an effort to evaluate the success of community-based early intervention services for preschool children with autism, Amanda Morgan, a PhD candidate in the department of psychology at the University of New Brunswick in Fredericton, Canada, and her colleagues compared the 12-month outcomes of two groups of children diagnosed with an autism spectrum disorder. The mean age of the children at the start of the study was 33 months, ranging from 24 to 43 months.

One group, consisting of six children, received a minimum of 20 hours per week of one-on-one home-based interventions based on the applied behavior analysis (ABA) therapy model, whereas the second group of four children attended integrated preschool classrooms with teacher's assistants.

ABA is a highly structured, skills-based therapy that teaches by breaking an objective down into multiple small steps, encouraging the mastery of one step at a time, and rewarding correct responses. Integrating autistic children into regular classrooms is, by comparison, a less structured approach.

“The [thinking is] that by integrating children with autism into typical classrooms, they will benefit by learning to model 'typical' social behaviors, although studies are showing that this is not necessarily the case,” commented Ms. Morgan in a poster presentation.

All of the children in the study underwent standardized testing at baseline and at 12 months thereafter. Such evaluation included the Child Development Index (CDI), the Childhood Autism Rating Scale, the Vineland Adaptive Behavior Scales: Survey Form, and the Psychoeducational Profile-Revised (PEP-R). At baseline, the mean scores on all the tests were similar in both groups. After 12 months, “mean improvement scores across the PEP-R, CDI, and Vineland measures were 15.9 months for the ABA group, compared with 5.5 months for the preschool groups,” Ms. Morgan reported.

Although the statistically significant findings add substance to the growing body of literature demonstrating the efficacy of intensive skills-based therapies over classroom integration, “the results cannot be generalized to all school-based efforts, because some may incorporate elements of [ABA or other skills-based] approaches that would close the gap,” said Ms. Morgan. “We need more information before making definitive statements.”

In particular, a larger study population and a more controlled comparison of the important features of both types of interventions would be useful, she said.

Ms. Morgan reported no conflict of interest with respect to her presentation.

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