Comparing Early Intervention Outcomes in ASD

[mrsbuttinski]

We know very little about which preschool intervention placements produce the best outcomes for which children with Autism Spectrum Disorder (ASD). A team from the University of Pennsylvania examined the effectiveness of three early intervention preschool placements: inclusive, mixed disability, and autism-only.



Children in this study had completed early intervention and were now enrolled in elementary school autism support classes. The researchers assessed each child’s current cognitive skills and reviewed their preschool early intervention educational records.



The three early intervention placements were categorized as follows:



Inclusive placements took place in a variety of settings, including center-based programs run by a special education teacher for typically developing children that included children with ASD, Head Start preschools, community-based typical preschools, and day-care settings.


Mixed disability placements included children with developmental or other disabilities as well as children with ASD.

Autism-only placements took place in center-based autism support preschool programs.



Children who attended inclusive early intervention placements scored higher on cognitive measures when they started elementary school than the children who were in mixed disability and autism-only placements. This was particularly true for children with at least minimal communication skills, lower adaptive behavior skills, and lower social skills.



These findings suggest that having more opportunities to interact with, and learn from, typically developing peers may be particularly important for the cognitive outcomes of some children with ASD. However children with ASD with other strengths and weaknesses may benefit from other types of intervention settings.



Based on the findings from this project, the University of Pennsylvania has begun a new study that is following children currently enrolled in the preschool early intervention system in Philadelphia. The researchers plan to follow the children over the course of nine months and observe whether children with different strengths and weaknesses benefit more or less in certain types of settings (inclusive, mixed-disability, or autism-only).





Source: Nahmias, A.S., Kase, C., Mandell, D.S. (2014). “Comparing cognitive outcomes among children with autism spectrum disorders receiving community-based early intervention in one of three placements.” Autism, 18(3), 311-320. PMID: 23188885

Posted by CenterForAutismResearch at 8:13 AM



centerforautismresearch.blogspot.com/2015/03/comparing-early-intervention-outcomes.html

[typeset]

Hm.

[anintrovert]

Interesting.

My DS was in an mainstream environment usually 12 typical/4 IEPs. We were there by default because I was clueless until he started preschool. He had an IEP by the end of November. He did and does learn from his typical peers. He also had an AMAZING team including a teacher who got it and took her lead from the SPEd teacher. The progress he made in that environment was amazing. The first year he was only communicating in echolalia and to label/ get needs met. He would even answer a yes or no question with echolalia. During the second year it was all spontaneous speech and they were working on pronouns. During the first year he couldn't attend to carpet time for 30 second. He could attend for the whole expected time the second year and would attend for 20+ if it was a preferred activity. There's so much more but I have no doubt that the reason he's currently in the mainstream environment (with about 3 hours of pull outs a week) is because of the support he got in preschool including the friendships and modeling that took place.

[bigpoppa22]

I definitely prefer inclusive/integrated approach, which unfortunately, is not offered by my city's EIP.

[mrsbuttinski]

It'll be interesting to see the follow up to this.

I wonder if there isn't some sort of filter bias in place- where kids whose parents have more resources/dual incomes are choosing traditional daycare centers instead of integrated or ASD-specific classrooms. Or if the kids are being placed based on degree of atypicality or impairment. Or if there's something different about the staffing levels of the different settings that might encourage/discourage adaptive, communication and cognitive skills.

In looking at the HFA/AS kids from DS's social skills groups and my friends' kids, it can be really hard to guess where each one started by the time they hit middle school. Some of the more capable kids started in ABA classes, some weren't identified until well into elementary.

bigpoppa22 In Philadelphia, from what I see, an integrated preschool class is one that serves students with a range of different disabilities- there might be kids on spectrum, with ID, with physical mobility issues, speech delays. One of my niece's friend's had a son (Asperger dx) in an integrated preschool there; his class did not have NT peers as models as some districts do. He's a triplet and mom hoped to send all three to the same place. My BFF's great-nephew, also in Philadelphia, (significant speech delay, challenging behaviors) is in an ASD only program.

[bigpoppa22]

We just started our ABA therapies - this is our 3rd week - and still do not have everything fully scheduled, yet, but we opted for home-based services, for now. I think in 3-4 months, however, we are going to do the 10 hours center-based in the morning and 10 hours home-based in the afternoon (plus ST and OT afternoons). This is all pretty new to us, we are pretty early in the whole process. DS was diagnosed in February. It looks like all of the center-based programs available to us here are ASD specific. Not that it matters, though, because we are only interested in the one center that we chose that also provides home-based services because they are the only one that does no DTT and is all naturalistic method ABA.

I know it is a bit naive, but we were initially reluctant to do the center-based because our DS is high functioning and we were worried that in an environment with many severely autistic children, he may not get much useful interaction. But the clinical director pointed out that high functioning children seek each other out for interaction, so we are on board and will visit the center sometime soon.

[mrsbuttinski]

ABA can be a great choice for higher functioning kids. This is a great book that talks about building skills using ABA-

www.pattyrbashe.com/_i_the_parents__guide_to_teaching_kids_with_asperger_syndrome_and_similar_asds_r_118151.htm

IME, when kids with differences are served in an inclusion style classroom with typical kids as peer models, the NT students tend to gravitate to one another except in situations where girls might "adopt" a girl with ASD and act as mother hens.

[anintrovert]

Mar 25, 2015 10:48:37 GMT -5 mrsbuttinski said:

ABA can be a great choice for higher functioning kids. This is a great book that talks about building skills using ABA-

www.pattyrbashe.com/_i_the_parents__guide_to_teaching_kids_with_asperger_syndrome_and_similar_asds_r_118151.htm

IME, when kids with differences are served in an inclusion style classroom with typical kids as peer models, the NT students tend to gravitate to one another except in situations where girls might "adopt" a girl with ASD and act as mother hens.

I also think my DS gravitates toward kids who are less typical.

[macchiatto]

Interesting!
For my DS, even though we were initially disappointed that he got all itinerant services on his IEP at 3 rather than a classroom placement, I think it was helpful that he did end up in private preschool instead, with typically developing peers. Granted, he hasn't had an ASD Dx but he's been so close at times and I do wonder what trajectory he would have followed with different/fewer interventions or perhaps even without a built-in typically developing peer model.

[bigpoppa22]

Mar 25, 2015 10:48:37 GMT -5 mrsbuttinski said:

ABA can be a great choice for higher functioning kids. This is a great book that talks about building skills using ABA-

www.pattyrbashe.com/_i_the_parents__guide_to_teaching_kids_with_asperger_syndrome_and_similar_asds_r_118151.htm

IME, when kids with differences are served in an inclusion style classroom with typical kids as peer models, the NT students tend to gravitate to one another except in situations where girls might "adopt" a girl with ASD and act as mother hens.

Very interesting.  And thanks for the link!

[hopecounts]

DD's ABA school is a reverse inclusion situation and it has been amazing for her, her speech and social skills have really blossomed.
they have roughly 50-50 NT/ASD in each class and 3 teachers (lead teacher must have their master's and the assistants their BS plus they receive ABA training from the BCBA) it's pretty awesome.
I think the difference here is the tiny classes (max of 15) with the high staffing and training.
Plus most of the NT kids start in the 2s room so are kind of used to the ASD kids and are more used to it I think.