Association for Behavior Analysis International

The evaluation of treatment outcomes is key to a wider adoption of behavioral treatments by key players in health and education including health insurance providers, advocacy groups, and government agencies. As part of this symposium we will present a series of pioneering studies in the area of treatment evaluation and outcome research in behavioral services for people with autism and fragile X syndrome. Study 1 from Scott Hall's group at Standford University presents a randomized controlled trial of function-driven interventions for problem behavior provided via telehealth. Study 2 from Svein Eldevik's group at Oslo Metropolitan University presents a 10-year follow up of treatment outcomes for adolescents and adults that have received early intensive behavioral intervention (EIBI) during childhood. Study 3 by Bill Ahearn's group at the New England Center for Children presents an evaluation of an early detection and treatment protocol. The study hopes to demonstrate that early detection followed by early treatment can result in optimal outcomes for young children with autism. Finally, Study 4 by Javier Virues-Ortega's group at The University of Auckland and Universidad Autónoma de Madrid presents the results of a case-control study aimed at identifying neural biomarkers of treatment outcomes. The study compared a range of neural pathways in two groups of children with autism who had or had not received parent-managed behavioral intervention. Together these studies feature a variety of emerging approaches to evaluate behavioral services. Dr. Brian Reichow author of several high-impact Cochrane reviews of EIBI will discuss the session.

Practitioners, researchers, advocates and policy decision-makers.

Introduction:Early Interventions for children with developmental disabilities are increasingly being delivered via telehealth to reduce health access disparities. In this paper, we describe the outcomes of a study designed to evaluate behavior analytic treatments for problem behaviors exhibited by young children with fragile X syndrome (FXS), the most common known inherited cause of Autism Spectrum Disorder. Methods:Participants were 61 boys with FXS, aged 3 to 10 years, who exhibited problem behavior on a daily basis. Following a functional analysis, participants were randomized to receive function-based behavioral treatment over 12 weeks (n=26) or treatment as usual (n= 25). The primary outcome measures were scores obtained on the Aberrant Behavior Checklist- Community (ABC-C) and the Treatment Acceptability Rating Form - Revised (TARF-R). Results:Children who received function-based behavioral treatment via telehealth evidenced significant decreases in problem behavior compared to those who received treatment as usual (Cohen’s d = 0.65, p<.001). Scores obtained on the TARF-R indicated that treatment acceptability remained high at 4-week follow-up. Discussion:These data provide initial evidence to support the efficacy of delivering function-based behavioral treatments via telehealth for this population. The advantages and disadvantages of using RCT designs to evaluate treatment effects will be discussed.

This presentation reports the current outcomes of adolescents and adults with autism who received Early Intensive Behavioral Intervention (EIBI) in their childhood. Nineteen children (16 boys and three girls) who had received two years of EIBI starting at a mean age of 2.9 years took part in an extended follow up 12 years later. Results showed that participants had significantly increased their cognitive and adaptive standardized scores during the two years of EIBI, and that these gains were maintained 10 years after EIBI had ended. Participants also showed a significant reduction in autism symptoms between intake and follow-up. Participants had not received any additional psychiatric diagnoses and were not taking psychotropic medication at the 10-year follow up. Results indicate that treatment gains achieved in EIBI are maintained into adolescence. Treatment outcomes during adulthood are reported for eight children from Eikeseth, Smith, Jahr and Eldevik (2002, 2007) who received either three years of EIBI (n = 4) or three years of eclectic special education (n = 4). Preliminary results suggest that children who had received EIBI made larger gains and maintained their progress to a greater extent than those who received eclectic treatment. Overall, our results indicate that gains made after EIBI may persist into adolescence and adulthood.