Intervention Effects of Intensity and Delivery Style for Toddlers With Autism
Condition: Autism Spectrum Disorder
MeSH terms: Autistic Disorder; Autism Spectrum Disorder
Study type: Interventional

Summary: 
      A multi-site randomized study of intensive treatment for toddlers with autism involving a
      three-site collaborative network plus a data coordinating center to evaluate the effects of
      intervention intensity and intervention style delivered for 12 months, on the progress of
      very young children with ASD ages 12-30 months old and their families, and the effect of
      children's developmental rates and autism severity on their response to intervention.
    

Detailed description: 
      High quality, intensive early intervention is a powerful treatment for ASD, improving IQ and
      language markedly in randomized controlled clinical trials (RCTs), though little long term
      follow-up data exists. Few core characteristics that affect child change have been tested.
      Two potential core characteristics that invoke considerable debate among parents,
      professionals, and administrators are the delivery style of intervention: play-based versus
      discrete trial teaching, and the intensity (dosage) of intervention. This ACE treatment
      network conducted an RCTs to answer the following question: what are the effects of intensity
      and delivery style on developmental progress of toddlers with ASD?

      87 young children with ASD, mean age 23.4 months who live within a specified radius near the
      university at each site were enrolled in one of three national sites and randomized into one
      of four cells varying on two dimensions: dosage - 15 or 25 hours per week of 1:1 treatment;
      and discrete trial teaching or naturalistic developmental-behavioral intervention. Other
      aspects of intervention held constant were: use of the principles of applied behavior
      analysis, 1:1 adult:child ratios, parent coaching in the assigned treatment, and treatment
      location. Developmental progress was measured frequently allowing for growth curve analysis
      to examine fine-grained differences in groups as well as interactions among major child and
      family initial variables and these two experimental variables.
    

Intervention name(s): Early Start Denver Model (ESDM); Early Intensive Behavioral Intervention (EIBI)
Intervention type(s): Behavioral; Behavioral
Intervention description(s): The Early Start Denver Model (ESDM) is a comprehensive developmental and behavioral early intervention approach for children with autism, ages 12 to 48 months. The program encompasses a developmental curriculum that defines the skills to be taught at any given time and a set of teaching procedures based in applied behavioral analysis to deliver this content. The teaching format focuses on trained therapists delivering the intervention 1:1 by engaging reciprocally with children in typical toddler activities involving play or daily routines, adding additional structure for children who need it to progress well. Progress data is collected throughout each session and used to make decisions about teaching approaches.; EIBI is a one-to-one instructional approach based in applied behavior analysis used to teach skills in a planned, controlled, and systematic manner. Each trial or teaching opportunity has a definite beginning and end, thus the descriptor discrete trial. Within DTT, the use of antecedents and consequences is carefully planned and implemented. Positive praise and/or tangible rewards are used to reinforce desired skills or behaviors. Trial by trial data collection is an important part of DTT and supports decision making by providing teachers/practitioners with information about beginning skill level, progress and challenges, skill acquisition and maintenance, and generalization of learned skills or behaviors.
Other intervention name(s): Naturalistic developmental-behavioral intervention (NDBI); ABA, DTT, Lovaas method
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: autism; autism spectrum disorder; intensive intervention; early intervention; Early Start Denver Model