Therapies for Children With Autism Spectrum Disorder: Behavioral Interventions Update
Weitlauf, A. S., McPheeters, M. L., et al. (2014).
Rockville (MD): Agency for Healthcare Research and Quality, (Comparative Effectiveness Review No. 137. (Prepared by the Vanderbilt Evidence-based Practice Center under Contract No. 290-2012-00009-I). AHRQ Publication No. 14-EHC036-EF).
This systematic review investigates the effect of behavioral interventions on children, birth to 12-years-old, on the autism spectrum or birth to 2-years-old who may be on the autism spectrum. This review is a partial update of a previous review by Warren, et al. (2011), and has itself been partially updated by Weitlauf et al. (2017); see the Notes on this Article section below for the full citations.
Agency for Healthcare Research and Quality (AHRQ)
Studies published since the development of the 2011 review to December 2013
Randomized controlled trials; prospective cohort studies; retrospective cohort studies; nonrandomized controlled trials
79 (65 unique studies)
Included studies examined at least one of the following early behavioral and developmental interventions:
<ul>
<li>UCLA/Lovaas; </li>
<li>Early Start Denver Model; </li>
<li>the Learning Experiences and Alternate Program for Preschoolers and their Parents (LEAP) program; and</li>
<li>other broadly defined and delivered approaches.</li>
</ul>
Results indicated early behavioral interventions based on principles of applied behavior analysis (ABA) with intensive (more than 15 hours per week) and comprehensive delivery can significantly affect the development of children on the autism spectrum. “Across approaches, children receiving early intensive behavioral and developmental interventions have demonstrated improvements in cognitive, language, adaptive, and ... impairments compared with children receiving low-intensity interventions and eclectic non-ABA based intervention approaches” (p. 103).
"There is also evidence across a variety of play-based interventions that young children may display short-term improvements in early play, imitation, joint attention, and interaction skills. However, evidence that these short-term improvements are linked to broader indexes of change over time is not substantial" (p. ES-11).
"A growing number of studies of improved quality demonstrated positive effects of social skills interventions on at least one outcome measure, but a lack of consistency in the interventions studied and outcome measures used makes it difficult to understand specific effects of different intervention modalities" (p. ES-11).
“A growing evidence base suggests that some children receiving early intensive behavioral and developmental interventions (e.g., many hours of intervention a week over the course of 1–2 years) show substantial improvements in cognitive and language skills over time compared with children receiving low-intensity interventions, community controls, and eclectic non-ABA based intervention approaches” (p. 80)
"Children receiving targeted joint attention packages in combination with other interventions show substantial improvements in joint attention and language skills over time" (p. ES-11).
"Although parent training programs modified parenting behaviors during interactions, data are more limited about their ability to improve broad developmental skills (such as cognition, adaptive behavior, and ASD symptom severity) beyond short-term language gains for some children" (p. ES-11).
