New Directions in Behavioral Treatment of Autism Spectrum Disorders
Current Opinion in Neurology
Kasari, C., & Lawton, K. (2010).
Current Opinion in Neurology, 23(2), 137-143.
This review investigates the effects of behavioral interventions on social impairments, communication and language, and emotional regulation in children on the autism spectrum.
Autism Intervention Research Network; Maternal and Child Health Branch; Autism Speaks; National Institutes of Health
2008-2009
Peer-reviewed, English-language original studies
68
The following factors were indicated to possibly decrease the efficacy of a comprehensive treatment to improve cognition or adaptive performance:
<ul>
<li>treatments of shorter duration;</li>
<li>less-intensive treatments (e.g., focus on parent training); and </li>
<li>children with more impaired cognition and/or language skills.</li>
</ul>
Findings indicated communication and language interventions yielded gains in joint attention and play skills; however, children who received the applied behavior analysis (ABA) intervention did not make significant gains in language development and made minimal progress during the one-year, follow-up period. Findings reported that children with minimal verbal skills made the largest gains when they received joint attention intervention.
Almost all of the studies investigating augmentative and alternative communication in children on the autism spectrum reported improvements when using highly preferred items to target requesting; however, the ability to generalize skills to other environments and the impact on comprehension or spoken production remained unclear.
Results reported comprehensive interventions to make improvements in children on the autism spectrum. These interventions typically consisted of short play sessions, discrete trial training, and/or functional communication. “Nearly all comprehensive treatment studies reported a minimum dose of 20 h[ours] per week; however, it is not clear whether the 20 h were that similar in approach and content because only a few studies used a treatment manual” (p. 140).
Most of the included studies that investigated social impairment studies demonstrated improvements in almost all targeted social skills. The generalization of these skills was unknown. Studies that investigated interventions in elementary-age children or older were taught similar social skills:
<ul>
<li>emotion and affect recognition; </li>
<li>conversational skills; </li>
<li>theory of mind; and</li>
<li>bullying/teasing</li>
</ul>
Studies that investigated interventions in younger children were taught similar social skills:<br />
<ul>
<li>joint attention;</li>
<li>imitation;</li>
<li>scripted and unscripted social vocalizations;</li>
<li>eye contact;</li>
<li>peer relationships; and</li>
<li>emotional, motivational, and interpersonal responsiveness</li>
</ul>
