TY - JOUR
T1 - A Multisite Randomized Controlled Trial Comparing the Effects of Intervention Intensity and Intervention Style on Outcomes for Young Children With Autism
AU - Rogers, Sally J.
AU - Yoder, Paul
AU - Estes, Annette
AU - Warren, Zachary
AU - McEachin, John
AU - Munson, Jeff
AU - Rocha, Marie
AU - Greenson, Jessica
AU - Wallace, Lisa
AU - Gardner, Elizabeth
AU - Dawson, Geraldine
AU - Sugar, Catherine A.
AU - Hellemann, Gerhard
AU - Whelan, Fiona
N1 - Funding Information:
This study was supported by the National Institute of Mental Health (NIMH)/the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) award number 1R01MH100030 (Sally J. Rogers, PI) as part of the Autism Centers of Excellence (ACE) Treatment Network and by the MIND Institute Intellectual and Developmental Disabilities Research Center U54HD079125 (Leonard Abbeduto, PI). The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agency.
Publisher Copyright:
© 2020 American Academy of Child and Adolescent Psychiatry
PY - 2021
Y1 - 2021
N2 - Objective: This randomized, multisite, intent-to-treat study tested the effects of 2 levels of treatment intensity (number of hours) and 2 treatment styles on the progress of young children with autism spectrum disorder (ASD). We predicted that initial severity of developmental delay or autism symptoms would moderate the effects of intensity and style on progress in 4 domains: autism symptom severity, expressive communication, receptive language, and nonverbal ability. Method: A total of 87 children with ASD, mean age 23.4 months, were assigned to 1 of 2 intervention styles (naturalistic developmental/behavioral or discrete trial teaching), each delivered for either 15 or 25 hours per week of 1:1 intervention for 12 months by trained research staff. All caregivers received coaching twice monthly. Children were assessed at 4 timepoints. Examiners and coders were naive to treatment assignment. Results: Neither style nor intensity had main effects on the 4 outcome variables. In terms of moderating the effects of initial severity of developmental delay and of autism symptom severity, neither moderated the effects of treatment style on progress in any of the 4 domains. In terms of treatment intensity, initial severity moderated effect of treatment intensity on only 1 domain, namely, change in autism symptom severity; in a secondary analysis, this effect was found in only 1 site. Conclusion: Neither treatment style nor intensity had overall effects on child outcomes in the 4 domains examined. Initial severity did not predict better response to 1 intervention style than to another. We found very limited evidence that initial severity predicted better response to 25 vs 15 hours per week of intervention in the domains studied. Clinical trial registration information: Intervention Effects of Intensity and Delivery Style for Toddlers With Autism: https://clinicaltrials.gov/; NCT02272192
AB - Objective: This randomized, multisite, intent-to-treat study tested the effects of 2 levels of treatment intensity (number of hours) and 2 treatment styles on the progress of young children with autism spectrum disorder (ASD). We predicted that initial severity of developmental delay or autism symptoms would moderate the effects of intensity and style on progress in 4 domains: autism symptom severity, expressive communication, receptive language, and nonverbal ability. Method: A total of 87 children with ASD, mean age 23.4 months, were assigned to 1 of 2 intervention styles (naturalistic developmental/behavioral or discrete trial teaching), each delivered for either 15 or 25 hours per week of 1:1 intervention for 12 months by trained research staff. All caregivers received coaching twice monthly. Children were assessed at 4 timepoints. Examiners and coders were naive to treatment assignment. Results: Neither style nor intensity had main effects on the 4 outcome variables. In terms of moderating the effects of initial severity of developmental delay and of autism symptom severity, neither moderated the effects of treatment style on progress in any of the 4 domains. In terms of treatment intensity, initial severity moderated effect of treatment intensity on only 1 domain, namely, change in autism symptom severity; in a secondary analysis, this effect was found in only 1 site. Conclusion: Neither treatment style nor intensity had overall effects on child outcomes in the 4 domains examined. Initial severity did not predict better response to 1 intervention style than to another. We found very limited evidence that initial severity predicted better response to 25 vs 15 hours per week of intervention in the domains studied. Clinical trial registration information: Intervention Effects of Intensity and Delivery Style for Toddlers With Autism: https://clinicaltrials.gov/; NCT02272192
KW - autism spectrum disorder
KW - early intensive behavioral intervention
KW - early intervention
KW - Early Start Denver Model
KW - treatment intensity
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U2 - 10.1016/j.jaac.2020.06.013
DO - 10.1016/j.jaac.2020.06.013
M3 - Article
C2 - 32853704
AN - SCOPUS:85090857340
JO - Journal of the American Academy of Child and Adolescent Psychiatry
JF - Journal of the American Academy of Child and Adolescent Psychiatry
SN - 0890-8567
ER -