A study of approaches and methods in early intervention in autism and other developmental disorders.

The present project studies the approaches and methods of practice of early intervention for young children aged 3 to 6 years with autism and other developmental disorders in Victoria. The project consists of a survey of centre-based early intervention (EI) programs and home-based applied behaviour analysis (ABA) programs, a six-year follow-up survey and a 12-month longitudinal study of children with autism in EI programs. The combined results of the surveys showed that firstly, there were some major changes in the profile of centre-based EI programs over time - (1) there was an increase intake of children by EI centres, in particular, children with autism; (2) a drop of 48% in intensity of services in terms of hours per week provided to children with autism and other developmental needs; and (3) a greater emphasis on documenting individualised goals for the child in the program and a plan for family support. Secondly, there were differential developmental outcomes: (1) the centre-based EI programs demonstrated consistent positive outcomes in helping children with autism and other developmental disorders to achieve a higher level of social competence after a 24-month period; whereas (2) the home-based ABA programs demonstrated consistent positive outcomes in helping children with autism and other developmental disorders to achieve a higher level of self-help skills within the program. The longitudinal study revealed that overall, there were no significant differences between baseline and review assessment scores in nonverbal cognitive abilities, language, interpersonal relationships, play and leisure skills and autism severity as rated by parents. For parents, there were no significant differences in the pre- and post-intervention measures for parental coping strategies over the 8-12 months during which their children were in EI. However, there was a significant pre- and post- intervention difference in autism severity as rated by observation in real life settings. Moreover, age-of-start was differentially related to developmental gains. The combined results of the findings from the surveys and the longitudinal study revealed a differential rate of improvement in EI programs. For home-based ABA programs, there was no simple linear relationship between program hours per week and the length of time the program had been running that would indicate optimal child outcomes in the first survey. There was a general trend of more hours per week being associated with more effective developmental outcomes, however, there were critical time intervals (7 to 12 months and 19 to 24 months) in which more hours per week did not produce more effective developmental outcomes. A significant finding in the longitudinal study was that children after attending EI for six months demonstrated a larger reduction of autism related behaviours than the reduction of similar behaviours in the following six months and the effect appeared to be more prominent in an EI setting in the first six months than in the preschool setting. These findings add to our understanding of the impact of early intervention for autism.