Early Intervention

In class I note the landmark study by Lovaas (1987) (UCLA Young Autism Project Model) that studied the effects of using applied behavior analysis (ABA) with very young children with autism (younger than 3 1/2 years of age). [now referred to as Early and Intensive Behavioral Intervention - EIBI] In that study, Lovaas suggested that almost half of the children "recovered" from their autism - meaning that several years later teachers could not tell them apart from their students without autism. That study - now over 20 years old - generated a great deal of controversy. Over the years, over 20 studies have sought to replicate Lovaas' (1987) original study. Several new reviews look at progress to date (see references below).

First, the original study did not randomly assigned children to the treatment groups. This is a potential problem because we do not know if children who received the intensive intervention (40 hours per week for 2 years) were somehow different from those who did not - potentially affected the outcomes. Newer studies have attempted to remedy this problem.

Second, the study used educational placement as an outcome measure. This is a problem because where a child is placed (for example, in a regular class or a special education class) has more to do with the educational philosophy of the school than the abilities of the child. Other studies use IQ scores as well as adaptive and maladaptive behavior as outcomes.

Third, many people questioned whether or not 40 hours per week for 2 years (which is very expensive) was necessary. More recent work suggests that the range may be more like 30-40 hours per week to achieve optimal results.

To date, these newer studies generally support the effectiveness of EIBI for some children with autism. Researchers are now examining the characteristics of children that may predict the best outcomes (for example, language ability). Overall, the treatment progress seems to greatly improve for some children if early intensive behavioral intervention is implemented properly.

References
Eikeseth, S. (2009). Outcome of comprehensive psycho-educational interventions for young children with autism. Research in Developmental Disabilities, 30(1), 158-178.

Lovaas, O. I. (1987). Behavioral treatment and normal educational and intellectual functioning in young autistic children. Journal of Consulting and Clinical Psychology, 55, 3–9.

Reichow, B., & Wolery, M. (2009). Comprehensive synthesis of early intensive behavioral interventions for young children with autism based on the UCLA Young Autism Project Model. Journal of Autism and Developmental Disorders, 39(1), 23-41.