Predictors of Treatment Outcome in Preschoolers with Autism Spectrum Disorder: An Observational Study in the Greater Gen
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ORIGINAL PAPER
Predictors of Treatment Outcome in Preschoolers with Autism Spectrum Disorder: An Observational Study in the Greater Geneva Area, Switzerland François Robain1 · Martina Franchini1,2 · Nada Kojovic1 · Hilary Wood de Wilde1 · Marie Schaer1
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract This study aims to identify predictors of treatment outcome in young children with ASD within a European context, where service provision of intervention remains sporadic. We investigated whether a child’s age at baseline, intensity of the intervention provided, type of intervention, child’s level of social orienting and cognitive skills at baseline predicted changes in autistic symptoms and cognitive development after 1 year of intervention, in a sample of 60 children with ASD. Our results strongly support early and intensive intervention. We also observed that lower cognitive skills at baseline were related to greater cognitive gains. Finally, we show that a child’s interest in social stimuli may contribute to intervention outcome. Keywords Predictors · Early intervention · Intensity of intervention · Social orienting · Early Start Denver Model · Community treatment
Introduction Autism spectrum disorder (ASD) is a group of pervasive neurodevelopmental disorders characterized by impairments in communication, social interactions and the presence of restricted and repetitive behaviors (DSM-5; American Psychiatric Association 2013). The main aim of an effective therapeutic intervention for individuals with ASD is to reduce symptom severity, while increasing cognitive functioning and adaptive skills. Over the past decade, naturalistic developmental behavioral interventions (NDBI), which * François Robain [email protected] Martina Franchini martina.franchini@pole‑autisme.ch Nada Kojovic [email protected] Marie Schaer [email protected] 1
Office Médico‑Pédagogique, Department of Psychiatry, University of Geneva School of Medicine, Geneva, Switzerland
Department of Pediatrics, IWK Hospital, Autism Research Centre, Halifax, Canada
2
emphasize a child’s early development of social communication by using developmentally appropriate behavioral techniques in a natural environment, have been at the forefront of research based on their positive outcomes (Dawson et al. 2010; Kasari et al. 2006; Koegel et al. 1999; Prizant et al. 2006; Schreibman et al. 2015). However, as the symptoms of ASD are heterogeneous, more research is needed to better understand the mechanisms of successful interventions and to identify which variables predict optimal outcomes. As emphasized by Vivanti et al. (2014), studying which variables predict what outcome is essential to being able to individualize early intervention programs based on a child’s clinical and developmental profile.
Age at Intervention Start Throughout the literature, there is a consensus that a child’s age at the start of intervention is one of the most decisive variables influencing outcome (Dawson 2008; Flanagan et al. 2012;
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