- by Dr Gowher Pebbles n Pearl Pediatrics and Child Care
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- Mar 31 2017
Early intensive behavioural intervention appears beneficial for young children with autism spectrum disorders
Question: Among children with autism spectrum disorder, what is the clinical efficacy of early intensive behavioural intervention (EIBI), compared with routine treatment, in lessening the impact of symptoms on children’s functioning?
Conclusions: There is some evidence that EIBI is an effective behavioural treatment for some children with autism spectrum disorder. However, the current state of the evidence is limited because of the reliance on data from non-randomized control trials due to the lack of RCTs. Additional studies using RCT research designs are needed to make stronger conclusions about the effects of EIBI for children with autism spectrum disorder.
Commentary: Conclusions reached by the authors of this review of the efficacy of EIBI are consistent with previous reviews. Positive effects on outcomes of children with autism are consistently found, including effects on adaptive behaviour, language, and IQ. These outcomes affect children’s everyday lives. Results of the present review showed that, on average, children receiving EIBI had IQs 11 points higher and exhibited 20 more daily living skills compared with children receiving “treatment as usual.” IQ and adaptive behaviour are predictors of long term functional outcome in individuals with autism. Looking ahead, future reviews would benefit from a broader definition of EIBI beyond those studies based on Lovaas’ applied behaviour analysis model (ie, discrete trial training).
Newer EIBI approaches have been developed based on naturalistic applied behaviour analysis methods. Results of studies evaluating their efficacy are promising. Multi-site randomized clinical trials of these approaches, as well as the Lovaas model, are being conducted. These studies are large enough to begin to address the next set of important questions, namely, what are the essential active ingredients of EIBI, who responds best to which approach, and what factors are associated with the most positive long-range outcomes?
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